Effie Sibson on Hand Therapy, Recovery, and Hope After Stroke

Hand Therapy After Stroke: How Small Steps Lead to Big Wins

Introduction

When a stroke changes the way your hand works, it’s not just about movement — it’s about your independence. Hand therapy after stroke isn’t a quick fix. It’s a journey of patience, persistence, and celebrating the little wins that add up to life-changing progress.

In this episode of the Recovery After Stroke podcast, I sat down with occupational therapist Effie Sibson, co-founder of Banksia Tech, to explore what hand therapy really looks like, why the word “plateau” doesn’t belong in recovery, and how survivors can keep making progress even years down the track.

What Is Hand Therapy After Stroke?

Hand therapy is more than just exercises for your fingers and wrist. Effie explains that occupational therapy looks at how the hand fits into everyday life:

• Can you dress yourself again?

• Can you cook a meal?

• Can you hold your baby or grandchild?

• Can you return to work or hobbies?

While physiotherapy often focuses on muscles, balance, and walking, occupational therapy connects those improvements to real-world tasks. Hand therapy after stroke bridges the gap between physical recovery and meaningful independence.

The Science: Neuroplasticity and “Learned Non-Use”

Effie reminds us that recovery isn’t only about regaining what was lost — sometimes it’s about learning new ways to do things. That’s where neuroplasticity comes in.

Neuroplasticity is the brain’s ability to rewire itself. The more you use your affected hand, the stronger those pathways become. But the opposite is also true. If you avoid using your weaker hand and rely only on your stronger one, your brain actually shrinks its “map” for that affected hand. This is called learned non-use or maladaptive plasticity.

That’s why even tiny, daily attempts with your weaker hand are so important. As Effie puts it: “Recovery is not something that happens to you. Recovery is something you do for yourself.”

“Every little attempt you make with your affected hand keeps that part of your brain alive and engaged.” – Effie Sibson

Busting the Plateau Myth

Many survivors hear the word “plateau” — often from an insurance company or during discharge from hospital. It’s a word that can steal hope. Effie doesn’t use it at all in her clinic.

The truth? Recovery never stops. Progress may slow, but it doesn’t disappear. If things feel flat, it’s often a sign to change the approach, not give up. As one of Effie’s clients wisely said: “Don’t change the goal — change the plan.”

Celebrating Small Wins

Hand therapy is a long road, and it always feels hard. That’s by design — challenge drives neuroplasticity. But that doesn’t mean progress isn’t happening.

Effie encourages survivors to celebrate small wins:

• Holding a cup without spilling

• Buttoning one shirt sleeve

• Picking up a coin

• Cooking a simple meal

These milestones matter bec