For professionals
Hand therapy tools clients actually use between sessions
The short answer
Hand tools for therapy are usually chosen on movement and resistance, but the thing that decides whether they work is whether the client uses them at home. Therapy putty and resistance bands are the low-cost standards and are graded by resistance. Spring grippers and extension trainers cover specific movements precisely. Boulder Block™ ($69.99) is a wooden block with twelve resin climbing holds and 32 graded routes that therapists buy as an engaging hands-on activity rather than a prescribed exercise. Match the tool to the client's motivation as well as the movement.
What professionals reach for
Therapy putty The standard
The default for a reason: graded by resistance, cheap enough to send home with everyone, and it fits almost any hand movement you want to load. Its weakness is the one every therapist already knows — it is dull, so it stops being used the moment nobody is watching.
Resistance bars and bands
Good for graded loading through a controlled range, and easy to progress. Best where the movement matters more than the motivation, because there is nothing in the object itself that makes anyone reach for it.
Spring grippers and finger-extension trainers
Precise and measurable for a specific movement — crush grip on one, finger extension on the other. Narrow by design, which makes them a good addition to a program and a poor centrepiece for one.
Boulder Block™Ours
A wooden block with twelve resin climbing holds and a deck of 32 routes across four levels. It is a game rather than an exercise, which is the whole point of it in this context: therapists buy it because clients pick it up on their own between sessions. It does not replace graded resistance work and we would not claim it does.
Side by side
| Therapy putty | Bars and bands | Spring grippers | Boulder Block™ | |
|---|---|---|---|---|
| What it is | Graded compound | Elastic bar or band | Sprung mechanism | Wooden block, 12 resin holds, 32 routes |
| Graded resistance | Yes, by colour | Yes, by colour | Yes, by spring | No — graded by route difficulty instead |
| Movements covered | Broad | Narrow to moderate | Narrow | Pinch, crimp, open hand, individual fingers |
| Measurable progression | Resistance grade | Resistance grade | Spring load | Route completed, level reached |
| Typical cost | Low | Low | Low to moderate | $69.99 |
| Picked up unprompted | Rarely | Rarely | Sometimes | The reason therapists report buying it |
| Works across a caseload | Yes | Yes | Limited by hand size | Yes — same object from child to older adult |
| Cleaning | Replaceable, absorbs debris | Wipeable | Wipeable | Wipeable wood and resin |
Costs are indicative and vary by supplier and pack size. The Boulder Block figure is its US list price in September 2026.
How to choose
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Decide whether your problem is the movement or the adherence
If you need a specific load through a specific range, the graded tools do that better and cost less. If the program is sound and the client simply is not doing it at home, no amount of extra resistance grading fixes that, and the choice becomes a question about motivation rather than mechanics.
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Check it works for the whole caseload, not one client
Tools that are sized or sprung for an adult hand quietly exclude the children and the smallest hands on your list. Anything you buy repeatedly is worth checking against the widest span of ages you actually see.
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Think about what happens in the client's house
Almost everything in this category performs well in a session, because you are there. The difference between tools shows up on the kitchen table on a Wednesday, and that is the only place worth optimising for once the program itself is right.
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Budget for a caseload, not a unit
Putty and bands are consumable and cheap per client. A block is durable and reused, so the comparison is not sticker price against sticker price — it is cost per client over a year against how many of them actually use the thing.
Questions professionals ask
What do occupational therapists use for hand strengthening?
Most commonly graded therapy putty, resistance bars and bands, and spring grippers, chosen by the movement and resistance the program calls for. The recurring complaint about all of them is not that they do not work, but that clients stop using them at home.
What are the alternatives to therapy putty?
Resistance bars and bands for graded loading, spring grippers and extension trainers for specific movements, and activity-based options — construction toys, climbing blocks, craft tasks — where the aim is to get the hands working without it feeling like a prescribed exercise. Most therapists end up using a combination rather than replacing one with another.
Do therapists actually use the Boulder Block with clients?
Yes, and they told us so unprompted. In our post-purchase survey, buyers identifying themselves as physical therapists, occupational therapists, educational assistants and special-education teachers described using it with clients and students. Those are their words about their own practice; we are not making a clinical claim on their behalf.
Is the Boulder Block a therapy device or a medical device?
No. It is a game — a wooden block with climbing holds and a deck of routes. It is not a medical device, it is not a treatment for any condition, and it does not diagnose, treat, cure or prevent anything. It is an engaging hands-on activity, and any clinical decision about whether it suits a particular client belongs to the clinician.
Can it be used with arthritic hands?
That is a judgement for the treating clinician, not for us. What we can tell you factually is that the holds unscrew, so the block can be rebuilt with fewer or larger holds, and that the easiest routes are designed to be completable on the first attempt. Several buyers have told us they intended to use it with clients who have arthritic hands.
Is there a multi-pack for a caseload or a classroom?
Yes — two and three-block packs, which is how most of the professional and classroom orders come through.
Sources
- 1. What is Occupational Therapy? — American Occupational Therapy Association
- 2. American Society of Hand Therapists — ASHT
- 3. Hand therapy exercises — Flint Rehab
- 4. Fine motor skills — activities and background — The OT Toolbox
- 5. Boulder Block Honest Review — an orthopedic occupational therapist's independent assessment — ChadGOrthoOT (YouTube)
- 6. Boulder Block™ — full specification — Climber's Gift
Written from our own post-purchase survey, including every response from a buyer who identified themselves as a therapist, educational assistant or teacher, and checked against the professional bodies and reference sources listed above. We describe our own product as an activity, never as a treatment — clinical judgement about any individual client belongs to the clinician.
Two and three-block packs are available for a caseload or a classroom.
See the Boulder Block