Date of Award


Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)


Occupational Therapy

First Advisor

Anne M. Haskins


Cumulative Trauma Disorders -- therapy; Occupational Therapy -- methods


According to Kasch, Greenberg, and Muenzen (2003), occupational therapists (OTs) who are initiating entry into upper extremity orthopaedic therapy specialization do not have the knowledge and skills of experienced therapists; a concerning viewpoint considering the fairly high rate of cumulative trauma injuries each year in the United States. Carpal metacarpal osteoarthritis occurs in “approximately 8% of all adults” (Hunter, Schneider, Mackin & Callahan, 1990, p. 886), whereas ulnar neuropathy at the elbow occurs in “10 to 15 percent of adults” (Trumble, 2000, p. 327). “Tennis elbow occurs in approximately one third of the tennis population because of the requirements of sustained power gripping and repetitive use of the wrist extensors” (Hunter, Mackin, Callahan, 1995 p. 1816) and there is an overall reporting by the World Health Organization (2008) that one in seven Americans will sustain a musculoskeletal injury. While many occupational therapists subscribe to specialize in this area of patient treatment, there are multitudes of OTs who are required to treat patients with upper extremity orthopaedic injuries in non-specialized clinics. This poses a problem as many entry-level therapists or practicing OTs have limited experience in the areas of upper extremity orthopaedic dysfunction. While entry-level occupational therapy programs often provide overviews of specialty areas, which include upper extremity orthopaedics, an already crowded curriculum provides restrictive time limits and prevents in-depth coverage of these areas. In addition to the limitations of entry-level occupational therapy orthopaedic exposure, there is a dearth of occupational therapy literature for the entry-level occupational therapist audience. Additionally, literature that does exist is often costly and unaffordable for small clinics in which therapists treat a small number of patients with upper extremity orthopaedic dysfunction. The intention of this product is to provide a cost-effective, comprehensive overview of three common cumulative trauma injuries for the entry-level occupational therapist who is not specializing in the care of patients with upper extremity orthopaedic dysfunction.

To write this entry-level protocol for therapists not specializing in the treatment of upper extremity dysfunction, a search for references was conducted. References that were utilized were derived from a variety of literary sources which included the Journal of Hand Therapy and The American Journal of Occupational Therapy. Pre-existing hand therapy protocols were also used.

This product includes definitions, prevalence, evaluation, and treatment methods of the three most common cumulative hand injuries: lateral epicondylitis, CMC osteoarthritis and ulnar neuropathy. The information provided within the product may be beneficial for use by entry-level occupational therapists who are not experienced with treating patients with upper extremity dysfunction. The handbook will provide entry-level occupational therapists with ideas on which evaluations are commonly used on certain diagnosis. The handbook will also cover the types of treatment interventions used with specific diagnosis along with corresponding timelines when these treatment methods are the most effective.