What Are You Communicating with Your Hands?

Posted on October 19th, 2012 by Denise | No Comments

What Are You Communicating with Your Hands?


Denise Koonce OTR

Have you ever stopped and thought about what your hands are communicating to your patients?  I began thinking about this because of the recent graduation of several individuals who completed the NDT/Bobath Eight-Week Course in the Treatment of Children with Cerebral Palsy course at our Kirby clinic.  They have spent hundreds of hours over the last few months focusing on what their hands communicate to a patient and why.  Facilitation through the use of your hands is an integral part of NDT treatment but it is only one aspect which makes up Neuro-Developmental Treatment.  As I was contemplating this I began to think of other ways we as therapists communicate to our patients through the use of our hands.

For those who know me, know that when I have a choice, I love to work with babies.  My “itty bittys” as I call them.  Despite the fact that they do not speak, they do communicate!  In turn we communicate with them but not necessarily or solely with our voice.  One of the most powerful ways we communicate to them is through our hands and bodies.  For example, time and time again I would enter a treatment session with an infant where they were not in a good place.  They would be unhappy, crying, uncomfortable and/or inconsolable, even by their mother.  I would ask to take the child and we would begin together a journey of communication to determine what worked for them.  While holding the child my hands immediately began listening or assessing what the child’s body was communicating to me.   In addition to what my hands felt, I would look, listen and constantly adapt my actions based on the child’s reactions.  While holding them I could assess their breathing pattern and determine if it was swallow or belly breathing, slow or rapid, and if their ribs expanded with a breath.  I could feel their heart beat and determine whether it was fast or slow.  I could determine if their body temperature was cold or hot and know if they began to sweat.  I would feel their abdomen and assess if there was movement within their intestines or if they were distended and tight.  These events all happen simultaneously but as a therapist you assess the information that is being sent to you from your hands and body and then respond quickly and appropriately to induce a change.  At some point that journey of communication, between patient and therapist, becomes like a dance and we began to work in sync to accomplish a common goal.   For my “itty bittys”, many times that goal ended up with them calming and falling asleep in my arms.

What we communicate with our hands will vary based on the child’s needs, age, diagnosis, and goals. We can communicate movement preference or direction.  We can help change muscle tightness and break up inflammation with massage.  We can provide range of motion to joints and encourage particular muscle activation. We communicate emotions such as tenderness, encouragement, and love.  Your touch can help produce calm or excitement within their body or provide support.   Our touch is very powerful and a wonderful human treatment tool.

Over the next week pause and think about what you are communicating to your patient with your hands.   Regardless if you are an OT, PT, or ST, remember what lies within the power of your touch.  Is the message you are hoping to send your patient the same message your patient is receiving?  Or do you need to tweak what you are communicating with your hands?  Please share with us an experience you have had while communicating with your hands!

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