Hand, Wrist & Upper Extremity

Specialized hand therapy.

Approximately 4 million people visit their healthcare provider each year for hand and finger injuries. The hand has 27 bones, dozens of small muscles and tendons, and nerves that control fine motor work you do every day. When something goes wrong, it deserves a specialist. Our certified hand therapists treat patients in Franklin and Spring Hill, TN.

Request an appointment See what we treat
A patient receiving clinical therapy for elbow pain.

A specialized program

A discipline within PT, built around the hand.

Hand therapy at Beyond Physical Therapy is a specialized program for the hand, wrist, elbow, and forearm. Our therapists treat traumatic and non-traumatic upper-extremity injuries including fractures, tendon repairs, nerve repairs, sprains, repetitive stress, wound care needs, and joint replacements, with custom orthosis fabrication available in the clinic.

We coordinate with your surgeon when post-operative protocols matter, focus on pain reduction and edema control before progressing to strength and dexterity work, and build a home exercise program designed to fit your life.

A specialist in hand therapy

A Certified Hand Therapist on staff.

Portrait of Dr. Javier Pere

Javier Pere.

Owner · Doctor of PT

Dr. Javier Pere holds the Certified Hand Therapist (CHT) credential, the recognized advanced certification in hand and upper extremity care in the United States. He's also an Occupational Therapist by background, which means he understands not just how the hand works, but how to get you back to typing, gripping, and using your hands for what matters.

Hand & wrist Post-surgical Manual therapy Dry needling

Other Doctors of Physical Therapy at Beyond also treat elbow conditions including tennis elbow, golfer's elbow, and little leaguer's elbow.

What we treat

Conditions we treat.

Find your condition below to see how we approach it, from the source of pain to the plan that gets you moving again.

  1. Fractures

    Distal radius (broken wrist), scaphoid, finger fractures, mallet finger. Post-cast rehab to restore range of motion and strength.

  2. Tendon repairs

    Flexor and extensor tendon repair rehab in coordination with your surgeon's protocol, including dorsal blocking orthoses to protect the repair.

  3. Nerve injuries

    Carpal tunnel syndrome (pre and post-surgery), cubital tunnel, and peripheral nerve repair. Sensory re-education and graded motor recovery.

  4. Tennis & golfer's elbow

    Lateral and medial epicondylitis. Manual therapy, dry needling, and progressive loading.

  5. Trigger finger

    Stenosing tenosynovitis. Soft tissue work, splinting, and gentle tendon glides to restore smooth tendon movement.

  6. Hand & thumb arthritis

    Basal joint (CMC) arthritis, finger arthritis, and rheumatoid hand changes. Custom thumb spica orthoses, joint protection education, and strengthening that doesn't aggravate.

  7. Little Leaguer's elbow

    Medial apophysitis (inflammation of the inner elbow growth plate), most common in young pitchers ages 9 to 14. Throwing mechanics evaluation, progressive supervised throwing program, and pitch count education.

  8. Repetitive stress injuries

    De Quervain's tenosynovitis, work-related strain, gaming and typing injuries. Ergonomics training, manual therapy, and graded reintroduction of activity.

  9. Post-surgical rehab

    Tendon repair, joint replacement, fracture ORIF, carpal tunnel release. We coordinate with your surgeon's protocol throughout recovery.

A unique service we offer

Custom orthoses, fabricated in-house.

Sometimes a well-known orthosis isn't the answer because there are several factors to consider. Your healing stage, your activity, your specific anatomy. We fabricate custom orthoses on-site when prefabricated options aren't suitable, molded specifically to your hand.

  • Gutter splints
  • Mallet protectors
  • C-splints
  • Hand-based MP extension orthoses
  • Forearm-based MP extension orthoses
  • Wrist supports
  • Thumb spica orthoses
  • Resting hand orthoses
  • Dorsal blocking orthoses
  • Long arm orthoses
  • Biceps-style long arm orthoses
  • Dynamic orthoses
A therapist working with a patient on hand and shoulder mobility.

How it works

What treatment looks like.

The path from your first visit to discharge. We measure progress at every step and tell you straight what's working.

  1. Step 1: Hand therapy evaluation

    Your therapist measures range of motion, strength, sensation, and functional capacity, and reviews any imaging or surgeon notes you bring.

  2. Step 2: Manual therapy and therapeutic exercise

    Hands-on work to mobilize joints and tissue, paired with targeted exercises for range of motion, strength, coordination, and dexterity.

  3. Step 3: Custom orthosis (when needed)

    If a splint is part of the plan, we fabricate it in the clinic the same day. We also handle wound care, edema control, and scar management.

  4. Step 4: Scar, edema, and sensory work

    Wound care, edema control, scar management, sensory re-education, and modalities are added when your condition needs them.

  5. Step 5: Discharge to function

    We progress your plan based on what's healing and what's still limited, working toward full return to your activity.

Common questions.

If we missed yours, call us. We'll talk it through over the phone before you book.

Related services

More of what we do.

Our doctors handle a full range of conditions and rehab paths. Pick what's relevant to you.

01

Sports Rehab

Get back to lifting, running, training

02

Post-Surgical

Structured recovery after surgery

03

Dry Needling

Targeted relief for stubborn pain

04

Functional Recovery

Root-cause support for recovery plateaus

Ready when you are

Book a free 15-minute consult.

Talk to a Doctor of Physical Therapy. We'll tell you whether we can help — and if we can't, we'll tell you who can. No referral needed.

Request an appointment