C.J. Allen Upper Extremity & Hand Therapy provides specialized, one-on-one hand therapy to patients throughout Commack. Whether you are recovering from surgery, managing arthritis, or dealing with an injury that has made ordinary tasks difficult, our care is evidence-based and tailored to what you actually need to get back to.
Why Specialization Matters
The hand contains 27 bones, more than 30 muscles and an intricate network of tendons and nerves working in a very small space. Treating it well requires pattern recognition built from seeing these injuries constantly. Our therapists work only on the upper extremity, so the case in front of them is rarely unfamiliar.
Conditions Commonly Treated
- Carpal tunnel syndrome — often manageable without surgery when addressed early.
- Trigger finger and trigger thumb — splinting and tendon gliding before more invasive options.
- De Quervain's tenosynovitis — common in new parents and repetitive-grip occupations.
- Fractures of the hand, wrist and forearm — restoring motion safely once healing allows.
- Tendon and ligament injuries — including post-repair protocols.
- Thumb and hand arthritis — joint protection and custom orthoses.
- Work-related and repetitive strain injuries.
Carpal Tunnel Syndrome
Carpal tunnel syndrome develops when the median nerve is compressed as it passes through a narrow channel at the wrist. The usual complaint is numbness or tingling in the thumb, index and middle fingers — often worst at night, and often bad enough to wake people. Grip weakness follows, and patients start dropping things or struggling with buttons and jar lids.
Repetitive hand use contributes, but so do wrist anatomy, pregnancy, thyroid disease and diabetes. Caught early, it frequently responds without surgery. We fit a night splint that holds the wrist in neutral, work through nerve and tendon gliding exercises, and look hard at what your hands do all day — because the activity that provoked it will usually undo the progress if nothing changes. Where symptoms are long-standing or the nerve testing shows real compromise, surgery may be the right answer, and we will say so.
Trigger Finger and Trigger Thumb
Trigger finger — stenosing tenosynovitis — happens when a flexor tendon thickens or its sheath narrows, so the tendon no longer glides smoothly. The finger catches, then releases with a snap. Some people wake with a digit locked into the palm and have to straighten it with the other hand.
Early cases often settle with a splint that blocks the joint from flexing, combined with tendon gliding work to restore smooth excursion. Cortisone injection is a reasonable next step and frequently effective. Surgical release is straightforward when it is needed, and recovery from it is quick. The mistake we see most often is waiting: a finger that has been locked for months stiffens at the joint itself, and that stiffness outlasts the trigger.
De Quervain's Tenosynovitis
This affects the two tendons on the thumb side of the wrist. Lifting anything with the thumb out to the side hurts — which is precisely how you lift a baby, so we see it constantly in new parents. It is equally common in trades and hobbies requiring repetitive pinch and wrist deviation.
Treatment starts with a thumb spica orthosis that rests the tendons without immobilising the whole hand, then a graded return to load once the pain settles. We spend real time on technique — how you pick up your child, how you hold your tools — because the mechanics are usually the cause.
Fractures and Dislocations
Hand and wrist fractures come from falls, sport and direct trauma. Distal radius fractures at the wrist and metacarpal fractures in the hand are the two we see most. Whether the bone was pinned, plated or simply cast, the therapy question is the same: how much motion can we safely restore, and when.
Move too early and you jeopardise the fixation. Wait too long and the joints and soft tissue stiffen — and in the hand, stiffness is often harder to reverse than the original fracture was to fix. We work from the surgeon's protocol, progressing range of motion, then strength, then the specific tasks you need back.
Tendon and Ligament Injuries
Repaired flexor and extensor tendons are among the most protocol-driven work we do, and among the least forgiving. A flexor tendon repair sits under real tension; too much load too soon and it ruptures, requiring another operation. Too little movement and it scars down to the surrounding sheath and never glides again.
The therapy is a controlled path between those two failures, staged over weeks, adjusted to how your tissue is actually responding rather than to a calendar. Ligament injuries — thumb UCL tears, scapholunate injuries — follow the same logic: protect what is healing while preserving everything that does not need protecting.
Arthritis of the Hand and Thumb
Osteoarthritis at the base of the thumb is the most common arthritic complaint we treat, and one of the most disabling — that joint is involved in nearly every grip and pinch. Rheumatoid arthritis presents differently, affecting joints symmetrically and driven by an autoimmune process rather than wear.
Arthritis is not curable, but hand function is very often improvable. A well-made thumb orthosis can transform daily activity by unloading the joint during the tasks that hurt most. Beyond that: joint protection strategy, adaptive technique, exercise that maintains motion without aggravating the joint, and honest conversation about when a surgical consult is worth having.
Custom Orthoses Made for Your Hand
We fabricate custom splints on site. A well-fitted orthosis protects healing tissue while still permitting the motion that prevents stiffness — a balance an off-the-shelf brace rarely strikes. If something rubs or does not feel right, we remold it during your visit.
Hand Therapy After Surgery
Post-surgical rehabilitation is timing-sensitive. Move too early and you risk the repair; wait too long and stiffness sets in and becomes its own problem. We work from your surgeon's protocol and adjust within it as your tissue responds, which is why so much of our referral base comes from hand surgeons directly.
Rehabilitation generally moves through three phases, though they overlap and the timing depends entirely on what was repaired. In the protective phase, the priority is safeguarding the repair while preventing the adhesions that form fastest in the first weeks — usually controlled, limited motion inside a protective orthosis. The mobilisation phase progressively restores active range as healing allows, and is where most of the ground is won or lost. The strengthening phase rebuilds grip, pinch and endurance, and targets the specific demands you are returning to.
We fabricate any post-operative orthosis on site, which matters more than it sounds: when swelling changes the fit, we adjust it that day rather than sending you away in a splint that no longer does its job. We also communicate directly with your surgeon's office when something is not progressing as expected, rather than waiting for your next post-op visit to raise it.
Treatment Is One-on-One
You work with a therapist for your full session — not handed off to an aide while the therapist manages three other patients. For hand therapy, where progress often depends on very precise technique, that time matters more than it might in a larger-joint setting.
Returning to Work
Many Commack patients need to get back to physically demanding jobs. We build treatment around the specific demands of your work — grip strength, sustained pinch, overhead reach, tool use — and communicate clearly with employers and case managers when documentation is required.
How Long Does Hand Therapy Take?
It depends entirely on what is being treated. A straightforward case of trigger finger or mild tendonitis may resolve in four to six weeks. A tendon repair or complex fracture can require three to four months of structured rehabilitation. At your evaluation we will give you a realistic range rather than an optimistic one, and we will revise it openly if your recovery is moving faster or slower than expected.
Do I Need a Referral?
Bring your prescription, surgeon’s protocol, or referral to your first visit and we’ll build your treatment plan from there. If you’re not sure whether you need a referral, give us a call and we’ll sort it out with you.
Hand Therapy Is Not General Physical Therapy
The two are often confused. General physical therapy addresses the whole body, most commonly larger joints and the spine. Hand therapy is a post-professional specialization focused entirely on the hand, wrist, elbow and shoulder, and it includes skills a general clinic typically does not offer — most notably custom orthotic fabrication and the surgical protocols that govern what a healing tendon can safely do in a given week.
Getting Here From Commack
From Commack, our Smithtown office is a straight run east on Jericho Turnpike (Route 25), typically ten to fifteen minutes. Our Hauppauge office is a similar distance south via Commack Road and Veterans Memorial Highway (Route 454). Both locations have parking directly at the building.
Scheduling an Appointment
Call (631) 761-6996 or request an appointment online. Most insurance accepted — our team will assist with insurance verification and help coordinate your care. Many conditions are best addressed early — if something has been bothering you for weeks, it is worth having it looked at.
Common Questions
What should I bring to my first appointment?
Your prescription or referral if you have one, your insurance card, any imaging reports or operative notes, and any splint or brace you have been given — even if it does not fit well. If you have had surgery, the surgeon's post-operative protocol is the single most useful document you can bring.
Will therapy hurt?
Some discomfort is normal, particularly when restoring motion to a stiff joint. Sharp pain is not, and it is a signal to change what we are doing rather than to push through. We would rather you tell us early than tolerate something quietly for three sessions.
How often will I need to come in?
Typically two to three times a week initially, tapering as you progress. Post-surgical cases often start more frequently. Much of the work happens between visits, so the home programme matters as much as the sessions do — we would rather give you three exercises you will actually do than twelve you will not.
Do you treat work-related injuries?
Yes. We build treatment around the physical demands of your specific job rather than a generic return-to-work timeline. If your role requires sustained grip, vibration tolerance or overhead work, that is what we train for before discharge.
What if I had surgery somewhere else?
That is common and not a problem. We work from whatever protocol your surgeon provides and coordinate directly with their office. Many Commack patients have surgery in Manhattan and prefer to do the rehabilitation closer to home rather than making the trip each week.
Do you treat sports injuries?
Regularly. Hand and wrist injuries are common in contact sports, racquet sports, climbing and weight training — jammed and dislocated fingers, thumb ligament tears from a fall onto an outstretched hand, wrist pain from repetitive loading. The rehabilitation goal is different from a general return to daily activity: an athlete needs the joint to tolerate impact and end-range load, not just to move comfortably. We build toward the specific demands of the sport, including protective taping or a custom orthosis that allows play while healing continues where the rules permit it.
How does this help with everyday activities?
That is really the point of occupational therapy, and it is what distinguishes it from treating a joint in isolation. Restoring twenty degrees of wrist motion matters because it is the difference between managing a steering wheel, a kettle or a shirt button and not managing them. We ask early what you are struggling with specifically — and it is usually something concrete, like fastening a bra, opening the car door or holding a fork — then treat toward that, and adapt technique or tools where the underlying limitation will not fully resolve.
How long before I see progress?
Most people notice something within the first two or three weeks — often less pain or better sleep before measurable motion changes. Full recovery ranges from a few weeks for straightforward tendonitis to several months after a tendon repair or complex fracture. We measure grip, pinch and range at intervals so progress is a number you can see rather than an impression.