Custom Hand, Wrist & Finger Splinting in Sterling, Virginia
Individually fabricated hand and upper-extremity orthoses designed to protect healing tissues, support injured joints, improve positioning, and help restore function.
Custom Splinting at a Glance
Service: Individually fabricated hand, wrist, finger, and selected upper-extremity orthoses
Also Called: Custom splints, custom braces, or hand orthoses
Made By: Occupational hand therapists with specialized upper-extremity training
Common Uses: Protecting an injury or surgical repair, supporting painful joints, limiting unwanted movement, improving positioning, and helping restore motion
Common Areas: Fingers, thumb, hand, wrist, forearm, and selected elbow conditions
Location: Sterling Physical Therapy & Wellness, Suite 260
Fit: Custom-molded to your anatomy and adjusted as your condition changes
What Is a Custom Hand or Wrist Splint?
A custom splint, more formally called a custom-fabricated orthosis, is a supportive device made specifically for an individual patient's hand, wrist, finger, or other upper-extremity area.
Unlike an off-the-shelf brace that is manufactured in standard sizes, a custom orthosis is shaped around your anatomy and designed for the specific condition being treated.
Our occupational hand therapists commonly use lightweight thermoplastic materials that can be heated, shaped, trimmed, padded, and adjusted to achieve the desired fit and position.
Depending on the condition, an orthosis may be designed to protect healing tissue, restrict certain movements, support a painful joint, maintain alignment, improve function, or gradually increase motion.
Learn more about occupational hand therapy.
Who May Benefit from a Custom Splint?
Custom orthoses can be used for many different hand, wrist, and upper-extremity conditions.
The design depends on the diagnosis, stage of healing, tissues involved, functional needs, and treatment goals.
Fractures, Sprains & Injuries
A custom orthosis may be used to protect a healing fracture, sprain, ligament injury, or other traumatic condition.
The amount of movement permitted depends on the injury and the recommendations of your physician and therapist.
Custom fabrication can be particularly helpful when a standard brace does not provide the positioning or protection required for the injured area.
Tendon Injuries & Tendonitis
Tendons may need protection after an injury, surgical repair, or period of overuse.
An orthosis can limit movements that place stress on the affected tendon while allowing other safe movements when appropriate.
Custom splinting may be used as part of treatment for selected conditions such as trigger finger, De Quervain's tenosynovitis, and other tendon disorders.
Carpal Tunnel & Other Nerve Conditions
Orthoses are sometimes used to maintain the wrist or elbow in a position that reduces irritation of a compressed nerve.
For example, nighttime wrist positioning may be part of nonsurgical treatment for selected patients with carpal tunnel syndrome.
The correct device depends on which nerve is involved and where the compression is occurring.
Learn more about hand numbness, carpal tunnel, and other common nerve conditions.
Arthritis & Joint Pain
Arthritis can make gripping, pinching, writing, opening containers, and other everyday activities painful.
A custom orthosis may support an arthritic joint, limit painful motion, improve alignment, or make certain activities more comfortable.
The design depends on which joint is affected and which movements need support.
Learn more about arthritis treatment.
Joint Stiffness & Loss of Motion
Some orthoses are designed not simply to immobilize a joint but to gradually improve motion.
Static progressive or dynamic designs may apply a controlled stretch to a stiff joint as part of a broader hand-therapy program.
These devices are adjusted over time based on progress, comfort, and treatment goals.
After Hand, Wrist or Finger Surgery
Custom splinting is frequently used after hand and upper-extremity surgery.
Depending on the procedure, an orthosis may protect a repaired tendon, ligament, nerve, bone, or joint while healing occurs.
As recovery progresses, the orthosis may be modified or replaced to allow additional movement and support the next phase of rehabilitation.
Our hand therapists work closely with the orthopedic team to follow the appropriate postoperative protocol.
What Types of Custom Splints Are Available?
Custom orthoses can be designed in many different ways depending on the goal of treatment.
Three broad categories are commonly used in hand therapy.
Static Orthoses
A static orthosis has no moving components.
It is generally used to hold the hand, wrist, finger, or other body part in a specific position.
Static orthoses may be used to protect healing structures, limit motion, rest irritated tissues, support an arthritic joint, or maintain alignment.
Some static orthoses can be remolded over time as swelling decreases or positioning needs change.
Dynamic Orthoses
Dynamic orthoses contain components such as elastic bands or other mechanisms that permit controlled movement or apply a gentle force.
They may be used to assist movement that has been lost or provide a controlled stretch to stiff joints and soft tissues.
The amount and direction of force are determined by the therapist based on the condition and treatment goals.
Static Progressive Orthoses
Static progressive orthoses apply an adjustable, sustained stretch to a stiff joint.
As motion improves and the stretch becomes easier to tolerate, the position can be adjusted to continue progressing toward the desired range of motion.
These orthoses are often used as one component of treatment for significant joint stiffness.
Custom Splint vs. Over-the-Counter Brace: What's the Difference?
Both custom and prefabricated braces can be useful.
The best option depends on the condition being treated.
Over-the-Counter or Prefabricated Braces
Prefabricated braces are manufactured in standard shapes and sizes.
They can be appropriate when a condition only requires general support or when an available brace provides the necessary position and fit.
They are often convenient and may cost less than a custom-fabricated device.
Custom-Fabricated Orthoses
A custom orthosis is made specifically for one patient.
Your therapist can shape the device around your anatomy, accommodate swelling or sensitive areas, control which joints are included, and position the hand or wrist according to the goals of treatment.
Custom fabrication may be particularly useful after surgery, with complex injuries, when precise positioning is required, or when a standard brace cannot provide an appropriate fit.
Custom does not automatically mean better for every condition.
Your therapist can determine whether a prefabricated brace is adequate or whether a custom device provides an important clinical advantage.
What Happens During a Custom Splinting Appointment?
The process begins with understanding your diagnosis, symptoms, stage of healing, and treatment goals.
Evaluation
Your occupational hand therapist may evaluate areas of pain or swelling, joint motion, strength, skin condition, sensitivity, and the activities that are difficult because of your condition.
If you recently had surgery or are being treated by an orthopedic specialist, your therapist will also consider the postoperative or treatment protocol.
Fabrication
For many custom orthoses, a sheet of thermoplastic material is warmed until it becomes moldable.
The therapist shapes the material directly around the appropriate area of your hand, wrist, or finger and allows it to cool into the desired position.
Straps, padding, and other components may then be added.
Fitting & Education
Before you leave, your therapist will check the fit and make necessary adjustments.
You will receive instructions about:
when and how long to wear the orthosis;
how to put it on and remove it;
which activities are safe while wearing it;
skin and pressure-point monitoring;
cleaning and care;
when to contact your therapist for an adjustment.
Your orthosis should provide the intended support without creating excessive pressure, numbness, skin irritation, or other new symptoms.
How Long Will I Need to Wear My Splint?
There is no single wear schedule that applies to every custom orthosis.
A device may be worn only during certain activities, primarily at night, for several hours at a time, or more consistently during an early stage of healing.
The appropriate schedule depends on the tissue involved, severity of the injury, surgical procedure if applicable, and purpose of the orthosis.
A fracture, tendon repair, arthritic joint, nerve condition, and stiff finger all have different treatment needs.
Follow the wear schedule provided by your physician and therapist rather than stopping use simply because symptoms begin to feel better.
Can My Custom Splint Be Adjusted?
Yes.
One advantage of many thermoplastic custom orthoses is that they can often be reheated, reshaped, or otherwise modified as your condition changes.
Adjustments may be needed when:
swelling increases or decreases;
motion improves;
a pressure area develops;
your treatment goals change;
a surgical protocol advances to the next stage;
straps or other components wear out.
Do not attempt major modifications at home unless your therapist has specifically instructed you how to do so.
Contact the hand-therapy team if the device becomes uncomfortable, no longer fits correctly, or causes new numbness, tingling, pressure, or skin irritation.
Is Custom Splinting the Same as Hand Therapy?
Custom orthosis fabrication is one service that may be incorporated into occupational hand therapy.
Hand therapy can also include therapeutic exercise, joint and soft-tissue techniques, scar management, strengthening, range-of-motion exercises, education, and functional training.
Depending on your condition, the orthosis may protect the affected area between therapy sessions while your rehabilitation program works on restoring motion, strength, coordination, and normal use of the hand or arm.
Learn more about occupational hand therapy at Arthritis & Sports.
Coordinated Hand & Upper-Extremity Care
Arthritis & Sports offers orthopedic hand care and occupational hand therapy within the same Sterling practice.
Elaine J. Ahillen, MD, is a board-certified orthopaedic surgeon with fellowship training in hand surgery who treats conditions affecting the hand, wrist, elbow, and upper extremity.
When custom splinting is part of treatment for an orthopedic injury or postoperative condition, our hand-therapy and orthopedic teams can coordinate care throughout recovery.
Custom Hand & Wrist Splinting in Sterling, Virginia
Custom orthosis fabrication is available through our Occupational Hand Therapy program at the Arthritis & Sports Sterling Physical Therapy & Wellness clinic.
Arthritis & Sports Physical Therapy & Wellness
21475 Ridgetop Circle
Suite 260
Sterling, VA 20166
Our Sterling office serves patients throughout Loudoun County and Northern Virginia, including Sterling, Ashburn, Leesburg, Reston, Herndon, Chantilly, and surrounding communities.
Orthopaedic appointments are located in Suite 150 on the first floor, while occupational hand therapy and custom splinting are located in Suite 260 on the second floor.
Frequently Asked Questions About Custom Hand Splinting
Is a custom splint better than a store-bought brace?
Not always. Many conditions can be appropriately managed with a well-fitting prefabricated brace. A custom-fabricated orthosis may be more appropriate when precise positioning is needed, anatomy or swelling makes a standard brace difficult to fit, a surgical repair requires a specific design, or the therapist needs to control particular joints or movements. Your therapist can help determine which option is most appropriate.
Can a custom splint be made during my appointment?
Many thermoplastic hand and wrist orthoses can be fabricated and fitted during a therapy visit. The time required depends on the complexity of the design. More advanced dynamic or static progressive orthoses may require additional fabrication or adjustment time.
Will a custom splint be uncomfortable?
An orthosis may feel unfamiliar at first, but it should not cause excessive pressure, worsening pain, persistent numbness, skin breakdown, or significant discomfort. Your therapist will check the fit when the device is fabricated and can make adjustments when necessary.
Can I sleep in my custom splint?
Some orthoses are specifically prescribed for nighttime use, while others should not be worn while sleeping. Follow the wear schedule provided by your therapist rather than assuming that a splint should be worn overnight.
Can I exercise while wearing my splint?
That depends on the type of orthosis and the condition being treated. Some devices are designed to restrict movement and protect healing tissues, while others are designed to allow specific controlled movements. Your therapist will explain which activities and exercises are appropriate.
How do I clean my custom splint?
Cleaning instructions depend on the materials used. Your therapist will explain how to clean the orthosis and straps safely without damaging the material or altering the fit. Avoid exposing thermoplastic orthoses to excessive heat because the material can soften and change shape.
Schedule a Custom Splinting Appointment
If a hand, wrist, or finger condition requires additional protection, support, positioning, or controlled motion, a custom orthosis may be an appropriate part of your treatment plan.
Our occupational hand-therapy team can evaluate your needs, determine whether a custom or prefabricated device is appropriate, fabricate the orthosis when indicated, and adjust it as your recovery progresses.
