Ellenville Regional Hospital has declared April Occupational Therapy Month, so the Shawangunk Journal called up to learn more about practice and those who perform it.

Occupational therapy (OT) is often defined – medical language alert! – as dealing with “upper extremity issues.” That phrase covers a veritable continent of different things: lower back pain, trauma from accidents, “cumulative stress disorders” like the dreaded carpal tunnel syndrome, various kinds of tendinitis, and a host of chronic conditions – arthritis at the front of the pack but paralysis from stroke or accident not far behind.

The Journal checked in with Emily Barsky, a Doctor of Occupational Therapy at ERH with a flotilla of qualifiers behind her name, OTD (Doctor of Occupational Therapy), OTR/L(Occupational Therapist, Registered, Licensed), and CHT (Certified Hand Therapist). A Certified Hand Therapist certification, just to select one off the menu, means three years of clinical experience and 4,000 hours of hand therapy plus acing an exam.

“We have five people in the unit,” she explains. “Two doctors and three COTAs – Certified Occupational Therapy Assistants.”

The OT section at the hospital is a happy group with good morale. Barsky describes a thriving department at the hospital with a constant supply of good results.

“When someone completes therapy and we can say goodbye,” she says, “everyone comes out and we applaud them.”

That happens just about every day, she adds.

“We work on the skills needed for living and working,” she says. “They are different for every patient, and they also differ depending on the daily environment. Like, say, teaching in the schools. What does a teacher need to be able to do her job?”

Barsky explains that the physical therapy world divides between outpatient services and the somewhat more difficult inpatient issues where “the goal is to get them home.”

What can lead to inpatient physical therapy?

“Could be they’re recovering from a surgery like a knee or hip replacement or they’re just deconditioned. Maybe they’ve been in the hospital for a long time and have to build back the strength and endurance in order to get home. And in those situations, they will rehab here in order to make sure they’re safe to go home.”

Turning back to the outpatient issues, Barsky says the most common ailments are carpal tunnel, cubital tunnel, and trigger finger, also known as stenosing tenosynovitis, “where a finger gets stuck in a bent position and can straighten with a snap, like a trigger being pulled. This is caused by inflammation that thickens the tendon sheath.”

For that condition the CHTs will use splints to reduce movement along with anti-inflammatory drugs and physical therapy. Sometimes there can be injections of steroids to reduce inflammation.

There is a long list of things that are treated by the ERH OT unit, going across the spectrum from arthritis to multiple sclerosis to tendonitis – certainly enough to keep them busy.

And of course there is also “golfer’s elbow” to worry about. “It’s the opposite of tennis elbow. It’s just the muscle group that involves the flexor muscles, and the pain is on the inside of the elbow. It’s caused by overuse of the tendons there, leading to inflammation and pain.”

The ERH OT group treat golfer’s elbow with prescribed rest and sometimes a brace on the arm. Sometimes it’s about being proactive. “A lot of what we do here is about education,” Barsky says, “whether about the condition that brings someone in, or things that might be harmful to them in their home… Removing some of the clutter, maybe some rugs which could be a hazard in terms of tripping. Maybe adding some grab bars in their bathroom to reduce risk of falling, all kinds of things like that.”

So, what would the ERH OT team say to those contemplating a career in the medical world?  “I would tell them to do some observation hours in different areas to see what would suit them best. This is especially true for OT, because what you do can be very different depending on what environment you’re working in. Like, you never know what the next diagnosis would reveal and what we would do to treat a condition.”

So, whether it’s trigger finger or getting back on your feet after a fall, Ellenville’s occupational therapy team stands ready to help.