Hand therapy

The hand therapy service at the Royal Free Hospital provides specialist care to both adults and children with acute injuries or chronic conditions affecting their hand or forearm. 

The team includes physiotherapists, occupational therapists and therapy assistants.

They work closely with plastic, orthopaedic and rheumatology consultants to rehabilitate patients after hand surgery and hand trauma, offering both inpatient and outpatient hand therapy services.

Hand injuries can be very debilitating because we rely on our hands for everyday tasks, so our hand therapists combine knowledge of both hand physiotherapy and occupational therapy to restore the hand function of our patients.

Our specialist services include:

  • advanced practitioner trauma clinic
  • consultant therapist clinic
  • a therapy clinic in the plastics dressings service
  • a rehab group
  • steroid injection service

Hand therapy consists of:

  • education of injury, surgery or acquired condition
  • tailored assessment
  • custom made splinting of the affected hand
  • wound and scar management
  • individualised exercises to preserve and regain function, to enable returning to work and hobbies
  • manual therapy, including joint mobilisations and soft tissue release
  • adjuncts to treatment: ultrasound, tools for scar management, computer-based rehabilitation programmes, assessment of appropriate aids to daily living

Some of the common conditions we treat include:

  • hand fractures
  • tendon and muscle injuries and repairs
  • tendon transfers
  • nerve injuries and repairs
  • ligament and other soft tissue injuries
  • nailbed and fingertip injuries
  • replants and revascularisations
  • osteoarthritis
  • rheumatoid arthritis
  • joint replacements
  • Dupuytren’s disease
  • hand and wrist tendinopathies, including DeQuervain's
  • trigger fingers
  • congenital abnormalities
  • carpal tunnel syndrome and cubital tunnel syndrome
  • work-related upper limb disorders
  • complex regional pain syndrome
  • scar management
  • burns

Plastic surgery physiotherapy

The team also works closely with the plastic surgery service, providing both an inpatient and outpatient service to those who have undergone reconstructive plastic surgery.

Some of the common conditions we treat include:

  • flaps and graft surgery

  • facial reanimation

  • ear reconstruction

  • breast reconstruction surgery

Internal referrals

The hand therapy department accepts internal referrals from consultants within our trust.

External referrals

The hand therapy department accepts external referrals from GPs. 

GPs can write a referral letter to the hand therapy unit at either the Royal Free Hospital or Mount Vernon Hospital for patients with hand injuries or conditions.

We are also able to accept referrals from patients from healthcare professionals from other hospitals, provided the patient is registered with a GP. 

Please provide a summary of treatment including operations notes if appropriate, clinical history, and any hand therapy treatment provided to date.

Please note we do not accept self-referrals.

Opening hours

Our opening hours are Monday to Friday, 8am to 4pm.

Late or unable to attend?

If you are unable to attend your appointment, please give at least 24 hours’ notice. This will enable us to offer your appointment to another patient. 

Please be aware that if you are late, we may not be able to see you on the day and you may have to arrange a new appointment.

If you do not attend your appointment and do not contact us, you may be discharged from the hand therapy department. If you are discharged, you will need a new referral from your GP for further treatment.

Research and clinical trials

You may have the opportunity to help improve healthcare by taking part in research studies. 

During your appointment, if eligible, you may be offered the opportunity to join in research studies. 


As the Royal Free Hospital is a teaching hospital, students may be involved in your care. Please speak to a member of staff if you have any concerns. 

Arthritis Action

UK charity giving hands-on, practical help to improve the quality of life of people affected by arthritis.

Changing Faces

UK charity providing support and promoting respect for everyone with scars, marks or conditions on their face or body.