BEYOND THE STRETCH
THERAPY PARTNERS GROUP NEWSLETTER
April is Occupational Therapy Month, and here at TPG, we’re taking a moment to say a heartfelt thank you to the 47 amazing OTs and OTAs on our team. Your work is nothing short of life-changing. Every day, you help patients regain their independence, adapt to challenges, and find confidence in doing the things they love whether it’s getting dressed, returning to work, or simply enjoying the little moments that make life meaningful. Your expertise, creativity, and deep compassion make a lasting impact not just on your patients but on your teammates and the entire TPG community. From pediatrics to post-op recovery, you meet every challenge with skill and heart, and we are so proud to have you as part of the TPG family.
This month and every month we celebrate YOU and the vital role you play in helping others live life to the fullest. Thank you for all that you do!
GET KNOW TO OUR SUPERSTAR OTS
Meet Shelby Townsend
Which OT activity brings you the most joy?
My favorite thing about my job is watching patients see their progress over time. I love hearing about the new activities they can do as they go through therapy from simple daily tasks like brushing their teeth, to bigger goals like going on international trips, or playing golf. I love when we re-evaluate and compare their initial performance to their current performance. Seeing my patient's joy with their activity performance brings me joy!
Frank Arena
What’s your hidden talent that comes in handy during therapy?
Having a background in game production and design has afforded me the unique opportunity to understand what keeps people engaged. Similarly, in therapy, I utilize this skill to "gamify" my patient interventions to help increase engagement. I've found that through basic tenets like "competition" or "keeping score", interventions used in outpatient hand therapy settings require only a tweak to turn them into fully fleshed out games. Patients seem to enjoy the change, and it also helps build rapport, taking the role of a "competitor", opposed to just an OT.
Meet SueWilliamson
What’s the one myth about OT that you’d love to bust?
I would love to eliminate the myth that Occupational Therapy helps people find jobs! After many years of practicing as an OT and various explanations about what the discipline of OT involves, I still get asked about how I will help patients find work!
Meet Ariel Alexander
Squigz, they're great for pinch and grasp training and patients have a lot of fun with them! Which OT activity brings you the most joy?
Meet
Allyson Basch
What’s one skill you’ve learned from your patients?
To be more patient. These individuals are coming to me for help and trusting and relying on me to get better from symptoms they are experiencing.
Career Growth
Your Way | Choose Your Path
Formal Residency Program
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12-month structured program
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15-month ABPTRFE-accredited
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Available in Arizona & California
Qualify to sit for APTA's Specialization
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Advanced Clinical Programs
Sports, Pelvic Health, Geriatrics, Orthopedics, Hand Therapy, Neurology, & Pediatrics
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EMERGING LEADERS & CLINICAL LEADERSHIP PROGRAM
The Emerging Leaders Program is designed for clinicians beginning their leadership journey. It focuses on developing foundational leadership skills, communication, and effective team management.
The Clinical Leadership Program is specifically tailored for clinic directors within TPG. This program enhances leadership abilities, clinical expertise, and operational management skills.
75% pass rate of all courses & completion of program requirements
Case study write-up & presentation
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Specialty outpatient rotations available including outpatient neurology, pelvic health, pediatrics, sports rehabilitation, orthopedic specialists. All rotations from early ICE to terminal clinical experiences with hiring opportunities are welcome. Local brand partners accepting students in 7 states.
Northern & Central California | Southern California
Physical Therapist: Golden Bear PT: Modesto, CA
Physical Therapist: Golden Bear PT: Ripon, CA
Physical Therapist: Golden Bear PT: Salinas, CA
Physical Therapist: Golden Bear PT: Turlock, CA
Physical Therapist: Silver Creek PT: Sunnyvale, CA
Physical Therapist: Napa Valley PT: Napa, CA
Clinical Director: Sport & Spine PT: Novato, CA
Physical Therapist: Body in Balance: Fairfield, CA
Clinical Director: Body in Balance: Fairfield, CA
Physical Therapist: Two Trees PT: Ventura, CA
Physical Therapist: Two Trees PT: Simi Valley, CA
Physical Therapist: Two Trees PT: Santa Paula, CA
Physical Therapist: Two Trees PT: Camarillo, CA
Physical Therapist: Two Trees PT: Oxnard, CA
Physical Therapist: Pair & Marotta: Bakersfield, CA
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Written by Michael Browne, Occupational Therapist
TRIGGER FINGER
Trigger finger can be a challenging condition to treat. It involves a nodule that forms on the flexor tendon, typically at the level between the A1 and A2 pulleys. Conservative management often yields mixed results, primarily due to compliance issues—especially when patients are asked to wear an orthosis full-time for 6 to 12 weeks.
The most used orthosis is the MCP blocking orthosis, which holds the metacarpophalangeal (MCP) joint in extension. This positioning encourages differential tendon glide between the flexor digitorum profundus (FDP) and the flexor digitorum superficialis (FDS), which can help relieve symptoms.
As research continues to seek orthotic options that promote function and increase compliance, movement-friendly designs are gaining attention particularly because inflammation plays such a central role in exacerbating symptoms. Reducing inflammation through controlled movement may shorten the required duration of orthosis use.
That was the focus of the 2024 study by Leong et al., which compared a relative motion extension orthosis to the traditional MCP blocking orthosis. While the relative motion extension orthosis also holds the MCP in extension, the increased mobility it permits may not be sufficient to prevent the nodule from slipping under the A1 pulley (CONT. on the next page)
The conclusion of this study was to continue the MCP blocking orthosis , but I’ve found two alternative approaches that offer both improved mobility and effective symptom relief:
Relative Motion Flexion Orthosis
Blocking MCP extension instead of MCP flexion seems counterintuitive but keeping the nodule proximal to the A1 pulley will reduce inflammation while allowing more mobility to the fingers.
Volar PIP Bandage Technique
For acute cases, I’ve had great success with a simple adhesive bandage (like a Band-Aid) placed over the volar PIP joint. The padding limits end-range flexion, which can significantly reduce triggering and subsequent inflammation. I typically transition patients to nighttime use only as soon as possible, and within a couple of weeks, many no longer report symptoms and can discontinue use altogether.
These small adjustments to orthotic intervention can make a big difference in comfort, compliance, and outcomes—especially when initiated early.
Citations:
Lunsford, Dianna et al. Conservative management of trigger finger: A systematic review Journal of Hand Therapy, Volume 32, Issue 2, 212 – 221
Leong LX, Chai SC, Howell JW, Mohd Rasdi HF, Abdul Rahman NR. Relative motion splints versus metacarpophalangeal joint blocking splints in the management of trigger finger: Study protocol for a randomized comparative trial. PLoS One. 2024 Aug 13;19(8):e0307033. doi: 10.1371/journal.pone.0307033. PMID: 39137205; PMCID: PMC11321552.
COO, Kim Kollwelter
GOLDEN MOMENTS
We know great patient care starts with strong leadership. That’s why we invest in our Directors equipping them with the tools, support, and strategic vision they need to lead their teams, elevate the patient experience, and continue growing our best-in-class environments across the country.
Directors and Managers from our teams in SoCal came together to connect, collaborate, and grow at our third Clinical Director Summit of the year! These in-person meetings are so much more than just training—they’re about building relationships, reinforcing our culture, and sharpening leadership skills that directly impact the success of our clinics.
C D S U M M I T
CLINICALPEARL
AboutPDandPT:
Parkinson’sDisease(PD)isaneurodegenerativeconditioncharacterizedbytremor, posturalrigidity,andbradykinesia,butcanalsocauseseveralnon-motorsymptomssuch asneuropsychiatriceffects,sensoryandsleepdisorders,andautonomicdysfunction.As theconditionprogresses,theindividualoftenstruggleswithmovement,balance,andan overalldecreasedqualityoflife.WhilethereisnocureforPD,exercisehasbeenshownto bethemosteffectivetreatmentmethodtoslowthediseaseprogression,improving qualityoflifeTheroleofthePTistoevaluatethepatient,determinetheirrehabilitation potentialandPOC,helpmanagethediseaseprogression,aidinthetransitiontoa community-basedprogramifappropriate,andbeinformedaboutmedication,DBS,and nutrition.ThePTalsoplaysaroleinidentifyingearlysignspre-diagnosisandbeinga strongadvocatefortheirpatients.
CaseStudy:AnExamplePOCforLife-LongManagementofDiseaseProgression
A72-year-oldfemalewasdiagnosedwithPDin2015.Hersymptomsincludebradykinesia, truncalrigidity,restingright-handtremor,impairedsensoryintegration,incoordination, andposturalinstability.Shedeniesfreezingofgait.
ShehasbeeninPTformanyyearswithvaryingPTsandPOCs;however,lastyearshe transitionedtoquarterlyassessmentswithanHEPtohelpmanagediseaseprogression. OnhermostrecentassessmentinDecember2024,shedemonstratedadeclinein dynamicandstaticbalanceandgaitspeed,withcontinueddeficitsinreactivebalance. Duetothedecline,weinitiatedPTfor1xaweekfor8weeks.Duringthistime,wealso introducedPWR!concepts.BytheendofherPOC,shehadreturnedtobaseline,as determinedbyherpreviousquarterlyevaluations,andimprovedherQOLperPDQ-9 score.RatherthananHEP,wetransitionedhertoacommunity-basedprogramto improvediseasemanagementathome.ShechosetoparticipateinvirtualPWR!exercise classes.In3months,shewillreturnforanevaluationwherewewilldeterminewhetherPT isneededagain,orifwecancontinuequarterlyassessments.
EverypatientdiagnosedwithPDisdifferentanditisuptothePTtodeterminethemost appropriatePOCtobestmanagetheirdiseaseprogression.Ifyouarenotworkingwitha neurologicalpopulation,beonthelookout!Youmaybethefirsttoidentifysymptomsand leadtoanearlydiagnosis!
RESOURCES:
SacheliMA,MurrayDK,VafaiN,etal.Habitualexercisersversussedentarysubjectswith Parkinson’sDisease:MultimodalPETandfMRIstudy.MovDisord.2018;33(12):1945-1950. doi:10.1002/mds.27498
VanderKolkNM,KingLA.EffectsofexerciseonmobilityinpeoplewithParkinson’s disease. MovDisord2013;23(11):1587-1596
SchootemeijerS,vanderKolkNM,EllisT,etal.BarriersandMotivatorstoEngagein ExerciseforPersonswithParkinson’sDisease.JParkinsonsDis.2020;10(4):1293-1299. doi:10.3233/JPD-202247
Written by Harli Nagel, PT, DPT, ATC, CEEAA & Zeb Kiggins PT, DPT
