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Hand and Upper Extremity Manual Therapy

Distinguish yourself as an expert with a high level of practice, skill, and knowledge using manual therapy techniques for treatment of the hand and upper extremity!

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About this Certificate Program

The Hand and Upper Extremity Manual Therapy Certificate distinguishes you for achieving a higher level of knowledge and skills for your practice. Using an evidence-based approach, this certificate utilizes a manual therapy philosophy combined with current research to prepare therapists to evaluate and treat joint stiffness, soft tissue disorders, and nerve compression syndromes in a systematic fashion. Therapists who successfully complete this 11-course program have distinguished themselves among their colleagues as highly-motivated healthcare providers.

Target Audience

Certified Hand Therapists (CHTs) and therapists (OTs, COTAs, PTs, PTAs) who want to be recognized as experts in their field.

Goals & Objectives

  • Apply manual therapy techniques to address joint stiffness, tendinopathy, and nerve compression issues in the upper extremity to optimize patient outcomes.
  • Explain the importance of a capsular pattern when finding a passive limit and how this affects your treatment plan.
  • Define the arthrokinematic rules with convex and concave relationships to determine the appropriate traction and glide directions for improving motion at the thumb, wrist, elbow, and shoulder.
  • Describe the clinical presentation of a patient with disputed neurogenic thoracic outlet and apply treatment techniques to address this condition.

What's Included in the Certificate Program

Courses
Accredited Online Courses*

18 hours of online video lectures and patient demonstrations.

Courses
Case Study Interviews

Recorded Q&A sessions between instructors and practice managers.

Courses
Interactive Learning Assessments

Case-based quizzes to evaluate and improve clinical reasoning.

Section 1: Manual Therapy for Joint Stiffness

4 Chapters

Manual Therapy Techniques to Address Stiffness at the Elbowkeyboard_arrow_down

Course
  • Bony Anatomy of the ElbowChapter 1

    This chapter covers the specific bony and ligamentous anatomy of the elbow to provide a foundation for understanding the arthrokinematics of the HUJ and PRUJ. This is critically important to understand when initiating joint-specific treatment for the elbow complex.

  • Bony Surface Anatomy of the ElbowChapter 2

    Knowing exactly where to place your hands when performing manual therapy techniques for the elbow is critical. This chapter covers the bony surface anatomy of the elbow to gain an appreciation of where these structures lie below the skin.

  • Manual Therapy Techniques for the Humeroulnar JointChapter 3

    Through lecture and demonstration, this chapter covers specific joint mobilization techniques in a step-by-step fashion to address limitations with elbow flexion and extension. This information is critical to know when faced with a patient with a significant limitation at the HUJ.

  • Manual Therapy Techniques for the Proximal Radioulnar JointChapter 4

    Through lecture and demonstration, this chapter covers specific joint mobilization techniques to address limitations with forearm pronation and supination. These techniques are so valuable when addressing a patient with limitations at the PRUJ.

  • View full course details »

Forearm Rotation Limitations Post Traumakeyboard_arrow_down

Course
  • Understanding the Anatomy & Kinematics of Forearm RotationChapter 1

    Having an appreciation for the interosseous membrane and the interplay between the proximal and distal radioulnar joints is imperative when determining what structure is limiting forearm rotation. This chapter covers the anatomy of the forearm, including the interosseous membrane and key structures about the distal radioulnar joint, as well as the kinematics with forearm pronation and supination.

  • Distal Radioulnar Joint Assessment & TreatmentChapter 2

    How do I know if my patient’s DRUJ is stable and in good alignment? This chapter reviews the testing of key ligamentous structures at the triangulofibrocartilage complex (TFCC) and provides guidance with appropriate treatment intervention.

  • Proximal Radioulnar Joint AssessmentChapter 3

    Most distal radius fractures occur as a result of a fall on an outstretched hand. Increased loading of the radial head can sometimes result in stiffness at the PRUJ. This chapter covers how to manually assess the PRUJ, which can contribute to stiffness with forearm rotation.

  • View full course details »

Manual Therapy Techniques to Address Stiffness for the Wristkeyboard_arrow_down

Course
  • Carpal Anatomy and Arthrokinematics of the WristChapter 1

    This chapter covers the specific bony anatomy of the wrist to provide a foundation for understanding the arthrokinematics of radiocarpal and midcarpal joint motion.

  • Bony Surface Anatomy of the WristChapter 2

    Knowing exactly where to place your hands when performing manual therapy techniques for the wrist is critical. This chapter covers the bony surface anatomy of the dorsal and volar aspect of the wrist to gain an appreciation of where these structures lie below the skin.

  • Joint Mobilization Techniques for the WristChapter 3

    Through lecture and demonstration, this chapter covers testing for a capsular pattern of the wrist as well as joint-specific testing of the radiocarpal and midcarpal joints. Joint-specific mobilization techniques will be presented to address a capsular pattern at the wrist. Manual therapy techniques will be covered in a step-by-step fashion to improve mobility at both the radiocarpal and midcarpal joints.

  • View full course details »

Manual Therapy Techniques to Address Stiffness at the Thumbkeyboard_arrow_down

Course
  • Anatomy and Kinesiology of the Thumb and Radial ColumnChapter 1

    Through lecture and demonstration, this chapter covers the intricate anatomy of the thumb CMC joint, including the arthrokinematics of the saddle joint which provides a foundation for performing joint mobilization to this region. This chapter also covers the clinical reasoning of why the radial column is important to address in patients with limitations at the thumb CMC joint.

  • Surface Anatomy of theThumb and Radial ColumnChapter 2

    Knowing exactly where to place your hands when performing manual therapy techniques for the thumb and radial column is critical. This chapter covers the bony surface anatomy of the radial side of the wrist and thumb to gain an appreciation of where these structures lie below the skin.

  • Joint Mobilization of theThumb Carpometacarpal (CMC) JointChapter 3

    Through lecture and demonstration, this chapter covers specific joint mobilization techniques for the thumb CMC in a step-by-step fashion to readily apply in the clinic! Techniques to address limitations with both radial and volar glide at the CMC will be covered.

  • Radial Column TechniquesChapter 4

    Through lecture and demonstration, this chapter covers specific joint mobilization techniques to address limitations of the scaphoid-on-radius and trapezoid-on-scaphoid. This is critical to restore full thumb retroposition, as well as maximize motion at the midcarpal joint.

  • View full course details »

Section 2: Manual Therapy for Soft Tissue Disorders

2 Chapters

Differential Diagnosis of Lateral Elbow Painkeyboard_arrow_down

Course
  • Anatomy of the Lateral ElbowChapter 1

    This chapter provides an overview of the anatomy in the lateral elbow including the humeroradial joint, lateral ligamentous support, musculotendinous structures, and radial nerve. Having a solid understanding of these structures and their location will give better insight of the involved structure when performing the clinical examination.

  • Pathomechanics of Lateral Elbow PainChapter 2

    This chapter covers the pathomechanics of tendinopathy, articular, ligamentous, and neural issues at the lateral elbow.

  • Clinical ExaminationChapter 3

    This chapter provides a systematic approach to differentiating between musculotendinous, articular, ligamentous, and neural issues at the lateral elbow. An analysis of recognizing special tests needed and performing these will be showcased.

  • View full course details »

Treatment of Lateral Elbow Painkeyboard_arrow_down

Course

Section 3: Manual Therapy for Nerve Compression Syndromes

6 Chapters

Identification and Evaluation of Thoracic Outlet Syndromekeyboard_arrow_down

Course
  • Types of Thoracic Outlet SyndromeChapter 1

    This chapter covers the anatomy of the thoracic outlet and the types of thoracic outlet syndrome (TOS). It is important to differentiate vascular versus neurogenic TOS to identify the most appropriate therapy intervention.

  • Clinical Testing for TOSChapter 2

    This chapter identifies key information to glean from the patient history, as well as instruction on how to perform a cervical screen and clinical testing for disputed neurogenic TOS. Therapists will develop an understanding of a cluster of tests needed to confirm the diagnosis of TOS.

  • 1st & 2nd Rib Mobility AssessmentChapter 3

    This chapter covers the mechanics of the 1st and 2nd ribs, reviews how motion occurs at both the costovertebral and costotransverse joints, followed by instruction in how to assess 1st and 2nd ribs mobility. This is critical for TOS patients, as an elevated 1st rib can contribute to brachial plexus irritation at both the scalene triangle and costoclavicular space.

  • View full course details »

Thoracic Outlet Syndrome: Assessing the Elevation Chainkeyboard_arrow_down

Course
  • Scapular & Elevation Chain AssessmentChapter 1

    Poor scapular alignment and limited mobility in the upper extremity elevation chain can contribute to TOS, especially with compressors. This chapter covers how to assess resting scapular position and dynamic control as well as performing the Passive Elevation Test to determine if further joint-specific testing is indicated at the acromioclavicular joint (ACJ) or sternoclavicular joint (SCJ).

  • Glenohumeral Joint AssessmentChapter 2

    Posterior glenohumeral joint (GHJ) tightness can contribute to poor scapular mechanics. In addition, end-range GHJ limitations can contribute to TOS “compressor” symptoms. This chapter covers how to assess posterosuperior and posteroinferior GHJ with the arm at the side as well as how the Passive Elevation Test can determine if further joint-specific testing is indicated at the GHJ at end-range.

  • Cervicothoracic AssessmentChapter 3

    Stiffness in the upper thoracic spine can be a culprit with poor scapular mechanics and brachial plexus issues. This chapter covers how to assess upper thoracic extension and rotation mobility.

  • View full course details »

Treatment of Thoracic Outlet Syndrome: Where to Beginkeyboard_arrow_down

Course

Treatment of Thoracic Outlet Syndrome: Addressing Shoulder and Upper Thoracic Limitationskeyboard_arrow_down

Course

Nerve Compression Syndromes of the Elbow and Forearmkeyboard_arrow_down

Course
  • Principles of Conservative and Post-Operative ManagementChapter 1

    This chapter provides an overview of the principles of conservative and post-operative management of neural compression syndromes as well as instruction in how to perform a proximal screen. This is important to rule out other pathologies prior to evaluating the localized symptoms.

  • Cubital Tunnel: Conservative & Post-Operative ManagementChapter 2

    Cubital tunnel is the second most common nerve compression syndrome in the upper extremity. Understanding the anatomy of the cubital tunnel and principles of conservative and post-operative management can greatly benefit your patients! This chapter covers the sites of potential ulnar nerve compression at the medial elbow, provocative tests, and guidance with both conservative and post-operative management.

  • Radial Tunnel and Wartenberg’s Syndrome: Conservative ManagementChapter 3

    How do you differentiate between radial tunnel and Wartenberg’s syndrome? This chapter covers the sites of potential nerve compression at the elbow and forearm, provocative tests, and guidance with both conservative and post-operative management for radial tunnel and conservative management for Wartenberg’s syndrome.

  • Pronator Syndrome: Conservative and Post-Operative ManagementChapter 4

    How can I discern median nerve symptoms coming from the carpal tunnel versus more proximally in the forearm? This chapter covers the sites of potential median nerve compression at the elbow and forearm, provocative tests, and guidance with both conservative and post-operative management for pronator syndrome.

  • View full course details »

Final Quiz

Quiz
Instructors
Ann Porretto-Loehrke

PT, DPT, CHT, COMT, CMTPT

CEU Approved

18 total hours* of accredited coursework.
MedBridge accredits each course individually so you can earn CEUs as you progress.

      Our clinic could not be happier with MedBridge.

Amy Lee, MPT, OCS
Physical Therapy Central

       MedBridge has allowed us to create a culture of learning that we were previously unable to attain with traditional coursework.

Zach Steele, PT, DPT, OCS
Outpatient Physical Therapy & Rehabilitation Services

    MedBridge has created a cost-effective and quality platform that is the future of online education.

Grant R. Koster, PT, ATC, FACHE
Vice President of Clinical Operations, Athletico Physical Therapy

Frequently Asked Questions

Do I get CEU credit?
Each course is individually accredited. Please check each course for your state and discipline. You can receive CEU credit after each course is completed.

When do I get my certificate?
You will receive accredited certificates of completion for each course as you complete them. Once you have completed the entire Certificate Program you will receive your certificate for the program.

*Accreditation Hours
Each course is individually accredited and exact hours will vary by state and discipline. Check each course for specific accreditation for your license.

Do I have to complete the courses in order?
It is not required that you complete the courses in order. Each Certificate Program's content is built to be completed sequentially but it is not forced to be completed this way.

How long do I have access to the Certificate Program?
You will have access to this Certificate Program for as long as you are a subscriber. Your initial subscription will last for one year from the date you purchase.

Sample Certificate

Sample Certificate

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