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Stephen Raine, a 33-year-old piano teacher and concert performer, was rushed to Wexham Park Hospital after he sustained a life changing injury to his hand from a circular saw at his home in Iver, Bucks, in January 2023 that amputated his little finger and left his other three hanging by their skin.
The injury was especially horrific for Stephen because playing piano had been his passion since he was six. But eight hours of surgery, followed by months of hand therapy treatment, including a pioneering new casting technique sourced by occupational therapist Gaby Willis, means that after many months of hard work Stephen can play recitals again to a professional standard.
For Gaby, helping Stephen in his recovery was a labour of love. Her mother Sheila Ackerman had also been a brilliant pianist, winning a scholarship to the Royal Academy of Music at 16 and going on to play a piano concerto at the Wigmore Hall, conducted by Sir Malcolm Sargent. Gaby was just six years old when she lost her mother to cancer, but she still remembers early piano lessons with her and how she continued to play until just a few days before she died.
So when Gaby found out about Stephen’s talent and realised that he needed a different treatment if he was to recover his abilities, she recalled a new casting technique she had heard about that was developed in America and called CMMS or ‘casting motion to mobilise stiff joints’.
Wexham surgeons have been astounded at the results which saw Stephen recover so well that he was able to play a full concert repertoire in front of an audience at Chelmsford Cathedral just 18 months after his injury.
Stephen kept the fixture in his calendar to give himself the incentive and focus he needed for several hours of therapy each day.
He said: “As I’d lost my little finger, I had to learn new finger patterns for the pieces I’d chosen, but I never thought I’d be able to play so freely and as well again and certainly not such an ambitious repertoire.”
Gaby said: “I found it so incredibly moving to hear Stephen play, not just because he’s a great pianist but also knowing the emotional journey he had been on and how hard he had worked on his recovery.”
Stephen had regained some function in his hand within a few months of the accident. He could just about press piano keys, but his fingers were fibrosed, weak and completely stiff. Not being satisfied with the results Gaby decided to investigate the new CMMS technique developed by US occupational therapist Judy Colditz, and took a course in her own time from South African hand therapy specialist Robyn Midgely.
CMMS involves several weeks of casting and recasting with plaster of Paris to immobilise the mobile joints and redirect movement forces to the stiffer ones. The conformity and warmth provided by the plaster of Paris helps to shift swelling and remodels the collagen and scar tissue as the patient exercises within the cast. These exercises gradually re-establish normal movement which are re-learnt in the brain, and they help to stretch the muscles and tendons in the hand which have become tight.
Gaby was also able to support Stephen through his recovery while he showed determination and perseverance to put in the hard work needed to improve his movement. Last October, when he was finally ready for his recital, he chose to play Handel’s Chaconne in G Major. Its 21 variations move through different moods and themes before a joyous ending, reflecting Stephen’s own triumph over adversity.
As well as getting back to teaching and playing piano Stephen, who grew up in Durham and was admitted to the London College of Music, also now draws on his own experiences to work as a motivational speaker.
Gaby, who admits that she was extremely nervous when first attempting to cast Stephen’s hand, has since used the CMMS technique to successfully treat at least four further patients and she is now teaching it to colleagues at Wexham Park.
Stephen added: “The accident was traumatic at the time, but I feel very lucky since then.
“From my neighbour’s back door being open on the day it happened so I could call for help, doctors saving my index finger when it looked like I might lose that as well, then becoming one of Gaby’s patients just as she’d heard about this amazing technique to help me. My recovery has been better than I could ever have hoped for.”
Wexham Park Hospital is a specialist centre for reconstructive plastic surgery and has several specialist hand surgeons.
