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Hand Therapy

Stanford Health Care - ValleyCare provides outpatient hand therapy services and rehabilitation, delivered by Certified Hand Therapists (CHT). Our CHTs have advanced training and experience in the assessment, treatment and care of conditions affecting the upper extremity.

Certified hand therapists, with advanced skills and experience, offer comprehensive care and provide accurate assessments, immediate care and effective treatment with conditions affecting the hands and upper extremity. They can effectively work with patients through post-operative rehabilitation, preventative, non-operative or conservative treatment or industry consultation.

Hand therapists address problems like pain, swelling, stiffness, numbness or sensory changes, weakness, limited range of motion and decreased dexterity. The following therapeutic interventions can be provided according to the needs of individual clients:

  • BTE computerized work simulation training
  • Customized static and dynamic splinting
  • Ergonomic evaluation and recommendation
  • Exercise and range of motion
  • Graded motor imagery & mirror box therapy
  • Home program instruction
  • Joint and soft-tissue mobilization
  • Kinesiology taping
  • Management of scar and edema
  • Modalities to manage pain and reduce inflammation
  • Myofascial decompression / cupping
  • Rehabilitation of upper extremity trauma and post-reconstructive surgeries
  • Strengthening
  • Sensory re-education and desensitization
  • Work simulation and functional training

Hand Therapy has been effective for a variety of conditions, including:

  • Arthritic conditions
  • Burns
  • Complex Regional Pain Syndrome
  • Entrapment syndromes
  • Fractures and dislocations
  • Hand diseases such as Dupuytren's disease
  • Inflammatory conditions such as Trigger finger, De Quervain's tenosynovitis
  • Myofascial pain
  • Reconstructive hand surgeries
  • Repetitive stress injuries
  • Soft tissue injuries
  • Sports injuries
  • Trauma to upper extremities
  • Tendon / Nerve injuries and repairs, such as carpal tunnel, brachial plexus injury

For more information about Certified Hand Therapists, please visit and

Your Care Team

Choosing a Certified Hand Therapist for yourself or a loved one is an important decision that impacts in recovery. We dedicate ourselves to providing you with compassion and empathy throughout your care. Select a Certified Hand Therapist from the list below to learn more about their experience and expertise:


Mei-Kuen Chung, OTR/L, CHT, CEAS


Mei graduated from the Occupational Therapy program in Hong Kong Polytechnic University and moved to California in the 1990’s. In 2014, she joined Valley Care and has worked in the outpatient, inpatient acute, and skilled nursing settings. With over 20 years of experience in multiple health settings including ICU, acute, rehab center, burns unit, home health and psychiatric inpatient, she is passionate about applying her wide range of clinical skills to direct patient care. She is a Certified Hand Therapist, Certified Ergonomic Assessment Specialist and is also certified in Saebo orthosis. She is also well versed in motor and sensory rehabilitation of stroke patients with various techniques including Mirror Therapy and Visual/Perceptual Training. She can speak Mandarin and Cantonese. Travelling and playing badminton are her favorite leisure activities.

Areas of Expertise
  • Hand Function training
  • Myofascial Decompression
  • Saebo orthosis
  • Stroke Rehab

Jenn DiGrazia MSOT/L, CHT


Jenn is an Occupational Therapist and Certified Hand Therapist, who graduated from Boston University. Jenn has been working in hand therapy since 2004. She has extensive orthotic fabrication skills and specializes in hand and elbow trauma including fractures, nerve and tendon reconstructions. She enjoys spending her free time with her family, fishing and travelling.

Areas of Expertise
  • Orthopedics
  • Stiff Hand
  • Repetitive Stress Injury
  • Hand and Elbow Trauma
  • Orthotic Fabrication
  • Post-Surgical Hand and Elbow Rehabilitation
  • Conservative Management of CMC Arthritis

Denice Nielson MOTR/L, CHT, CEAS


Denice studied Human Development and Music at U.C. Davis prior to discovering her passion for Occupational Therapy while working in a hand clinic as a therapy aide for four years. She returned to school and earned her Master's of Occupational Therapy degree from Samuel Merritt University in 1999. In 2000 she began working at ValleyCare, now Stanford Healthcare - ValleyCare. Outpatient hand therapy was so rewarding for Denice that she decided to pursue a specialty, and she became a Certified Hand Therapist in 2007. Denice is a Clinical Educator for Stanford-ValleyCare, running the Occupational Therapy student internship program and mentoring therapists interested in working toward advanced certifications. She is a Certified Ergonomics Assessment Specialist (CEAS) and a STAR Certified Oncology Rehabilitation Clinician. When Denice is not healing hands, she enjoys coffee, music, sewing/crafts, pets and movies. She also actively volunteers with community events, fostering animals, and her children's schools/sports.

Areas of Expertise
  • Hand therapy
  • Ergonomics
  • Certified Oncology Rehabilitation for hand and upper extremity
  • Student and New therapist mentoring.

Jerry Paulo, OTR/L, CHT, CEES


Jerry graduated from San Jose State University in 1995 with a Bachelor's degree in Occupational Therapy. He began his career working with inpatients and outpatients at the Eden Medical Center in Castro Valley. Jerry became a Certified Hand Therapist in 2001 and a Certified Ergonomic Evaluation Specialist in 2002. Jerry has been working at Stanford Health Care - ValleyCare since 2013. Jerry and his wife Lisa enjoy sharing backyard barbeques with friends and waterskiing, snowboarding and golfing with their two sons.

Areas of Expertise
  • Hand Therapy
  • Ergonomics

Sheetal Shah-Encarnacion, OTR/L


Sheetal received her degree in Occupational Therapy from San Jose State University and has advanced certifications in dysphagia and physical agent modalities. She is also certified in the use of neuromuscular electrical stimulation (VitalStim) for use in dysphagia therapy. Sheetal has worked as an Occupational Therapist for over 20 years in multiple settings at ValleyCare: outpatient, inpatient, and rehab units. She loves applying her range of clinical skills while treating patients with dysphagia and neurological diagnoses. She loves to travel, hike, coach her kids on the tennis courts and is a very enthusiastic amateur photographer.

Areas of Expertise
  • Dysphagia therapy
  • VitalStim treatment for dysphagia
  • Stroke / Neurological rehab