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Occupational therapist Sue Winters and physical therapist Dean Hanlon like to work with others' hands.

They are part of a growing specialty at Yampa Valley Medical Center -- hand therapy. It's the kind of specialty where patient and therapist get to know each other well, through treatments such as hand massages.

"You have to be within two feet (of the patient)," Winters said.

Hanlon said that after a few minutes of hand massaging many of his patients are willing to tell him their life stories.

Hand therapy has evolved into a specialized service over the last few decades and is slowly being seen in clinics throughout the country.

"It's a real specialty," Hanlon said. "Most clinics don't offer it."

Hanlon and Winters treat patients with injuries caused by repetitive use or trauma and people recovering from hand operations.

Hanlon said their main focuses are minimizing pain, establishing range of motion in the injured hands and assisting in good healing. Winters said patients are often eager to rehabilitate injured hands.

"There's such a psychological component to it. People need their hands," she said.

Hand therapy involving movement of the hand often comes soon after a surgery. When the tendons in the hand adhere to its tissue, the hand could have a major loss in functionality, he said.

"Scarring is just a nightmare," Hanlon said. "Early mobilization creates less adhesion."

The delicate pattern of muscles and tendons in the hand requires special treatment and rehabilitation. "There are just too many muscles to list," Hanlon said. "It's a ton. It just goes on and on."

Hand therapy, which is given in the sports medicine area of the hospital, offers personalized splints made out of thermal plastic. The hot malleable plastic is molded to the hand and then allowed to cool.

"We use a lot of splinting to support injuries or mobilize fractures," Winters said.

She and Hanlon agreed that many people often misuse their hands, and actually contribute to problems that could lead to things such as carpal tunnel syndrome.

"Repetitive motion does not cause injury," Hanlon said. "Repetitive motion in a bad position does. There's a ton of education that goes with the hand."

Hanlon and Winters said that holding the hands in one position for a long time is not good. Also, allowing the wrist to flop, or resting the head on the hands can be damaging to the muscles and tendons. Prolonged pinching or gripping is also discouraged. "Never use your hand as a tool," Winters said, referring to patients who have been injured trying to hammer things with their hands.

The need for hand therapy is prevalent in Steamboat Springs, Hanlon said. He and Winters see about 40 patients a week.

"It's gotten bigger. A lot less are going down to Denver," he said. "Our numbers doubled from the first year. There's definitely a demographic for it."

The therapy was first offered by an occupational therapist at YVMC in 1988. Winters said $10 evaluations of bothersome or injured hands are available in the sports medicine department of YVMC.