Occupational therapy helps restore movement to injured hand

Fate played a nasty trick on Andrew Costello the day before Halloween 2021.

“We were just finishing up harvest on our family farm, and I pretty much just got my hand put in the wrong place at the wrong time,” he said. “It severed a whole bunch of nerves and tendons in the center of my forearm.”

After multiple surgeries, the St. Paul resident lost movement in his wrist and hand.

“I couldn't even move my hand for about a month and a half,” Andrew said. “Having mobility in both my hands, it’s one of those things that you don’t know that you have it until you lose it.”

Then he began working with Shelby O’Connor, occupational therapist at Howard County Medical Center.

“After this injury, I definitely realized how complex the hand is,” Andrew said. “It takes a special person to be able to work with a hand to where it can become functional again.”

“As an occupational therapist, we see patients across the lifespan, anywhere from young babies to children, adults, elderly,” Shelby said. “We focus on the skills, the modifications, the things the patient needs to complete whatever they want to fill their daily lives with.”

Andrew’s recovery included months in a splint, a lot of manual techniques and edema massage.

“That’s where he has extra swelling in that hand,” Shelby said. “There’s a technique that we use to help push that fluid back into circulation, back into his body and out of his hand.”

She also described the passive and active range of motion therapy Andrew needed.

“I’m stretching and moving those fingers and wrists through the movements that they used to go through, and then we do some active range of motion where he’s eliciting those movements,” Shelby said. “We meet the patient where they are. We adjust things as we need to and come up with the plan of care.”

If a patient has difficulty with work-related tasks, for instance, the occupational therapist will break down the steps needed to complete the task, identify the problem areas and work to improve them.

“I’m involved here in the community to where I play sports throughout the wintertime,” Andrew said. So recovery meant not only being able to do his job at Archer Credit Union and help on the farm but also picking up and squeezing a ball.

“It’s definitely been a learning experience,” he said.

“All of our treatment sessions look different depending on the patient’s priorities,” Shelby said. “We can work on things from vision to cognition to strength, activity tolerance and sensory processing.”

“I have full confidence in them,” Andrew said. “Any question that I ask, even though it may not pertain to my injury, Shelby will either find the answer or already actually know the answer.”

He was also glad to have the occupational therapy services he needed available in his own hometown.

“When I was first going through therapy, I was not able to drive. I mean, I could barely walk. They pulled the nerve out of my ankle,” Andrew said. “Having this service right here in St. Paul definitely is a convenience for me.”

“I work with some amazing co-workers,” Shelby said. “Most of us grew up around here. We have decided to settle with our families in this rural Nebraska town or towns close, and we take great pride in being able to provide these services to families closer to home.”

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