Hand Therapy Spotlight: Julie and Caitlyn

Patient Spotlight at Axes Physical Therapy, Caitlyn gets her hand rehabilitated by Julie Freiner, OTR/L, CHT

Caitlyn’s journey began when she was 16 years old when she woke up one morning with a paralyzed wrist and hand. After making a concerned visit to her primary care doctor, she learned that she suffered from a nerve injury. The cause was a complete mystery to her and her physician. For treatment, she was given a splint to help support her hand and was told that it should get better with time, although she would later find the cause and successful treatment through hand therapy.

Fast forward 16 more years – Caitlyn is now 32. Still suffering from the nerve injury, Caitlyn sought informal help. It was actually a medical rep that advised Caitlyn’s mother that she may benefit from electrical stimulation. Electrical stimulation or E-stim is a type of physical therapy modality used to accomplish various tasks in physical therapy or hand therapy. Caitlyn was then referred to me for a free injury screening to see if we agreed that E-stim would be helpful. Within minutes, we established that E-stim wouldn’t help and referred Caitlyn to a St. Louis based hand surgeon, Dr. Richard Howard at Orthopedic Specialists.

6 months before Caitlyn came in to see me, I had been on a medical hand mission trip in Honduras alongside Dr. Howard (learn more about my mission here.) The surgeons on our team did probably a dozen tendon transfers with conditions similar to Caitlyn’s. Many of the individuals in Honduras who sustained injuries to the radial nerve require tendon transfers because of the lack of medical resources to repair the injured nerves at the time of injury.  When too much time has passed, the options to improve function typically result for the need of a tendon transfer – much like that of Caitlyn’s.

A tendon transfer involves a surgery to use a tendon that works for one motion and transferring it to the muscle to do a new job. Tendon transfers are used to restore balance and function to a paralyzed, injured, or absent tendon or muscle. A hand therapist then helps the patient learn how to use the muscle to perform the desired motion in a new way.

In Caitlyn’s case, she sustained a radial nerve injury which resulted in the inability to extend her wrist, fingers, or thumb (so imagine holding your wrist, fingers, and thumb down and not being able to lift them up.) Typically, a nerve palsy (paralyzed nerve) will improve within 3-6 months, but Caitlyn’s nerves did not.  Caitlyn followed up with Dr. Howard and underwent tendon transfer surgery (initially scheduled for March, it was cancelled due to Covid-19) and performed in late May.

Caitlyn’s hand therapy and rehab journey began in June where she learned how to use her left wrist, thumb, and fingers in a new way. The little things, that we often take for granted, Caitlyn was thrilled to be able to do again! She is now able to type, hold a water bottle, and use her fingers to use her phone with her left hand, and so much more.

“I can use both of my hands now instead of just my right to hold things so much easier.” -Caitlyn

We are THRILLED for Caitlyn and are honored to have been an integral part of her healthcare team.

Axes Physical Therapy in St. Louis is proud to offer this specialized and elite service to our customers. Whether you’ve suffered trauma, had surgery due to a chronic injury or are managing the daily struggles of an arthritic condition, our team of experienced hand therapists in St. Louis are here to guide you along the road to recovery. We understand the physical and emotional toll that accompanies these injuries.


Julie Freiner is a certified hand therapist at axes physical therapy in o'fallon, mo.

To schedule an appointment with  Julie or any of our expert physical therapists, request an appointment online today.