Hand and upper-extremity occupational therapy in La Mesa's Grossmont area operates through Wendy McNamara, OTL, a licensed occupational therapist specializing in hand rehabilitation from Suite 110 at 5360 Jackson Drive near Sharp Grossmont Hospital. Geriatric hand-function restoration for residents of assisted-living communities like Grossmont Gardens Senior Living addresses post-stroke fine-motor deficits, arthritic joint contractures, and grip-strength loss that compromise feeding, dressing, and medication-management independence. The practice co-locates with Inline Orthotic & Prosthetic at the same Jackson Drive suite, creating a single-visit pathway where custom orthotic fabrication and therapeutic hand exercise happen in the same appointment block. Soft-tissue mobilization for post-surgical tendon repairs coordinates with myofascial providers like San Diego Myofascial Release, where targeted fascial work on the forearm flexor and extensor compartments complements the controlled active-motion protocols McNamara prescribes. Treatment utilizes Jamar hydraulic dynamometry and pinch-gauge testing at standardized grip positions to quantify palmar, lateral, and tip-pinch strength against normative values stratified by age, sex, and hand dominance before establishing return-to-work clearance thresholds.