




Dr. Matthew Hwu
PT, DPT, OCS, CSCS

Dr. Elliot Smithson
PT, DPT, MS, ATC
About Us
Elliot and Matt saw a huge gap in the healthcare system of people suffering from wrist, hand & forearm pain.
People weren't getting the care they needed. And many times they were invalidated (gaming, music, programming, etc.)
So we spent the past decade specializing in treating wrist & hand injuries. We've read 1000s of research studies, published a few of our own (see below), spoken at national Physical Therapy Conferences (APTA CSM)…
…and have focused all of our efforts on helping you realize you have MORE CONTROL in managing your wrist pain than you realize.




Carpal tunnel accounts for less than 1% of the wrist pain cases we see. Learn how to tell the difference and why the misdiagnosis happens so often.
The "too much, too quick, too soon" principle explained. Why small repetitive movements cause big problems over time, and why rest alone doesn’t reverse it.
Think of your tendons like a video game healthbar. Every click depletes it. Only endurance training builds it back. A simple model for understanding your capacity.
The fear of making it permanently worse keeps many people from recovering. Here’s what a decade of treating 3,000+ cases actually shows.
If you’ve been dealing with this for over a year, the problem changes. Here’s how RSI becomes chronic and what a more complete treatment approach looks like.
All pain is processed in the brain — but that doesn’t mean it isn’t real. The structural and neuroplastic models of pain, and why you need both to fully recover.
About 8% of arm and hand pain cases are actually TOS. Includes self-assessment tests, the three compression sites, and how to tell it apart from carpal tunnel and cubital tunnel.
Pinky and ring finger tingling that worsens when your elbow is bent? This explains how forearm endurance deficits compress the ulnar nerve and what to do about it.
Pain at the base of the thumb when gripping or scrolling. Why surgery is rarely necessary and how to fix the underlying tendon endurance deficit instead.
A full breakdown of what tennis elbow actually is, why cortisone shots make it worse long-term, and a progressive loading protocol to fix it for good.
If your symptoms don’t include numbness in your thumb, index, and middle fingers, it may not be CTS at all. What to try before an irreversible decision.
The most common RSI diagnosis, explained from first principles. Covers the tendinopathy spectrum, why it’s not the same as tendonitis, and how to treat it at each stage.
They treat the source of the pain, not the cause. Here’s the difference, and why cortisone injections in particular are now considered harmful for tendon problems.
Less than 2% of medical school curriculum covers musculoskeletal conditions. Here’s why your doctor gave you outdated advice, and what to do instead.
Abnormal imaging is found in 59% of people with zero pain. Why imaging alone is a poor diagnostic tool for RSI, and what a proper evaluation should look like.
Fear-avoidance, catastrophizing, and misinformation echo chambers can actively slow your recovery. How to filter what you read and protect your mindset.
Everything in one place. A five-part structured guide covering the healthcare system, the physiology, treatment, what doesn’t work, and complex nerve cases.
A detailed look at how we helped a programmer go from instant pain with typing to a full pain-free workday, including the full exercise program and pain science approach used.
Work sprints, hackathons, and long coding sessions are the most common trigger. How load management and endurance training apply specifically to a desk-work lifestyle.
14,400 wrist movements per hour of drumming. The specific muscle groups involved, why stretching alone won’t save you, and the prevention protocol that actually works.
Find your pain pattern, get the right exercises. Built by a DPT who works with professional esports teams, adapted for every gamer from casual to competitive.
Sytho went from 40 minutes of play to 7 hours daily in 4 weeks. His endurance was fine. The real issue was fear-avoidance. A detailed breakdown of how we got him back.
It depends on where your pain is. A scenario-by-scenario guide based on your specific pain pattern, with the biomechanics of why the same mouse helps some people and hurts others.
A lot of CS professors teach this. It’s wrong. Here’s the biomechanical reason floating your forearms increases strain, and what to do instead.
Ergonomics accounts for about 10 to 20% of most RSI cases. The rest is tissue capacity and lifestyle. Why changing your peripherals without exercising is like buying better shoes for a marathon you never trained for.
Why death gripping happens, how the stress response drives it, and how to retrain your grip using cardio, biofeedback, and specific aim training protocols.
We surveyed 334 players. Zeri, Evelynn, Cassiopeia, and Kalista top the list. A breakdown of which mechanics cause the most strain and why.
High-stress boss fights and sustained grip tension are a specific pattern. Why intense platformers put unusual strain on your hands and how to stay ahead of it.
High actions-per-minute games create a specific injury profile. Why the standard doctor advice fails this population and what a proper recovery approach looks like.
A full Q&A covering wrist pain, posture, sleep, nutrition, mental performance, and injury prevention for competitive players at every level.
Fear-avoidance beliefs predict disability more strongly than actual tissue damage. How chronic pain rewires your brain, and why addressing the psychological side is not optional.
What to look out for in online communities, how to identify fear-amplifying content, and a checklist for telling the difference between evidence-based advice and misinformation.
The single most common belief that slows recovery. The physiology of why peripheral nerves regenerate, why degenerative tendons are still mostly healthy, and what the research actually shows.
The 1HP Team
Repetitive Strain Injury Specialists