New clinic lends helping hand

For small business owner and certified hand therapist Midge Horwood, experience is everything.

Horwood brings 20 years’ worth to her new Lihu‘e clinic, Kauai Hand Therapy, and along with it a lot of specialized skills.

As the only certified hand therapist on-island — she is one of 12 in the state — Horwood said the experience she offers can go a long way for patients with limited resources or insurance companies that allow a finite number of visits to rehabilitate an in jury.

Hand therapy is used to treat a range of conditions, from tendonitis to carpal tunnel, broken bones, amputations and burns.

On Kaua‘i, she sees many cumulative-trauma injuries, or those caused by repetitive motions such as typing.

“It’s kind of amazing how automated our lives have become,” she said, noting that daily activities were more varied 20 years ago.

Horwood said all occupational therapists, including those on-island, are trained in hand therapy, as they work with fine motor skills.

But it’s her focus on hands throughout her career that sets Horwood apart.

She began as an occupational therapist at Rancho Los Amigos National Rehabilitation Center in Los Angles County, which specializes in burns, rheumatoid arthritis and problem fractures and joints. She focused on severe hand injuries and gained extensive experience working closely with respected hand surgeons, both orthopedic and plastic.

Horwood spent four years in Kona before moving to Kaua‘i in 1995.

For 11 years, she worked at Wilcox Memorial Hospital, where she said she helped build its hand therapy program from the ground up. It was during that period that she became certified in hand therapy.

The thought of opening her own clinic came years before Kauai Hand Therapy debuted on Jan. 2.

She had kept her eye on the corner office in the shopping center across from Big Save, watching as its tenants changed from travel agents to dance students to campaigners for Sen. Daniel Akaka.

When it finally became available last November, Horwood knew it was time to make a move.

“It took 20 years for me to figure it out, but I felt like I needed to change professions or do something a little different,” she said.

The burden of the “managed care” approach to medicine had become stifling.

While being her own boss has allowed increased freedom to direct her practice, Horwood said insurance companies are still the biggest challenge she faces.

More now than ever, she said, it’s important that consumers take a proactive approach to health care and educate themselves about choices.

Horwood takes all insurance — with the exception of Kaiser Permanente — to be accessible to all patients and referrals. She said Kaiser declined to add her to their provider list because they said the area of care was sufficiently covered with its staff of hand therapists on O‘ahu.

“My vision wasn’t so much about the money as much as it was (that) I wanted to be available to anyone on the island,” she said. “I wanted all the doctors to know that I was available for referrals.”

Now, Horwood said, her patient list is already full.

Multiple tables allow her and a part-time occupational therapist to stagger care for as many as four patients at once.

Her work is equal parts immobilizing an injury and encouraging movement.

She creates splints for patients, uses ultrasound to decrease swelling and scarring, and treats injuries with massage, acupressure and electric stimulation.

Horwood said icing an injury is a timeless method of controlling pain, and she promotes healthy living with balanced nutrition and exercise.

For the office worker at a desk all day, Horwood said microbreaks and stretching are key.

With five months under her belt as a business owner, Horwood is looking to expand her staff in the future. But for now, she’s enjoying the new path her career has taken.

• Blake Jones, business writer, can be reached at 245-3681 (ext. 251) or


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