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The pair of certified hand therapists help people of all ages overcome a variety of maladies, from seasonal ailments to more Lowcountry-specific injuries such as wounds caused by the improper use of oyster knives or deer-cleaning knives.
But their work is serious business. They've treated a gunshot victim and occasionally help injured U.S. Marine Corps recruits stationed on Parris Island. One of their patients had all of his fingers cut off in a work accident. Another patient was a baby born without skin on a portion of her forearm. The therapists say treating patients such as these make their work rewarding and satisfying.
"I love it because it is challenging," said Garbade, who has worked as a hand therapist for the past five years.
Problems with the hands often extend to the entire body. The baby born with skin missing on her forearm was unable to open her fist and avoided the use of the hand. This has caused her not to use that arm nor that whole side of her body. With therapy, the use of the hand and arm are improving and she should gain more normal development of the entire body as more surgeries are planned.
In cases such as the man who had lost all his fingers, Garbade and Hetherington help patients overcome phantom pain -- a condition where someone still feels pain in a body part they've lost.
"We work on desensitizing," Hetherington said. "We also provide wound care as well as helping them get fit for prosthesis."
While other physical therapists work with hands, Garbade and Hetherington are among the 5,200 hand therapists certified by the Hand Therapy Certification Commission. They specialize in the rehabilitation of the upper extremities -- including the hand, wrist, elbow and shoulder -- after an injury, trauma or degenerative changes. They treat many types of hand trauma including tendon injuries, fractures, carpal tunnel syndrome, tendonitis, tennis and golfer's elbow and arthritis. They also see a lot of injuries from table saws.
Patients with severe injuries such as double wrist fractures also find help learning to be independent again, performing simple daily tasks such as dressing, bathing, grooming and feeding themselves. They can learn to use tools and adaptive equipment such as reachers, shower benches, dressing sticks -- even aids to help when putting on socks. A special program they offer teaches patients how to write with their non-dominant hand.
Hetherington, a therapist since 1982, loves the aspect of her job that let's her help people get part of their lives back.
"It is so fulfilling when you improve somebody's life," she said.
