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Manual Therapy Techniques to Address Stiffness at the Elbow

presented by Ann Porretto-Loehrke

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Have you ever been frustrated with a stiff elbow that doesn’t seem to move no matter how much you try? Because of the close articular congruency of the elbow, loss of motion can sometimes occur even with a small trauma. This course covers the anatomy and arthrokinematics of the elbow, including the humeroulnar joint (HUJ), humeroradial joint (HRJ), and proximal radioulnar joint (PRUJ), which provides a foundation for joint mobilization. The manual therapy techniques presented in this course address limitations for elbow flexion and extension as well as forearm rotation. These techniques can be invaluable for a patient with either large and small limitations of motion, as implementation can lead to immediate improvements.

Meet Your Instructor

  • Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

    Ann Porretto-Loehrke is a skilled clinician and dynamic instructor. She is the therapy manager of a large department at the Hand to Shoulder Center. Ann is a Certified Hand Therapist (CHT) and a Certified Orthopedic Manual Therapist (COMT) for treatment of the upper quadrant through the International Academy of Orthopedic Medicine (IAOM). She has extensive training in the evaluation and treatment of the upper quadrant. Ann completed a post-professional Doctorate in Physical Therapy (DPT) degree from Drexel University with a specialty in hand and upper quarter rehabilitation. Most recently, Ann has become certified in dry needling through Myopain Seminars, as a Certified Myofascial Trigger Point Therapist (CMTPT). She previously served as the Vice-Chair of the Examination committee for the Hand Therapy Certification Commission (HTCC). Ann also previously served as the Northeast District chair for the Wisconsin Physical Therapy Association from 2004 to 2008. She is a lead instructor who developed the Hand & Upper Extremity Track through IAOM, a set of six manual therapy courses designed specifically for hand and upper extremity specialists. Ann has presented at American Society of Hand Therapists (ASHT) annual conferences, Canadian Hand Conferences, Philadelphia meeting, and Teton Hand Conference.

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Chapters & Learning Objectives

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  1. Bony Anatomy of the Elbow

    1. Bony Anatomy of the Elbow

    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.

  2. Bony Surface Anatomy of the Elbow

    2. Bony Surface Anatomy of the Elbow

    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.

  3. Manual Therapy Techniques for the Humeroulnar Joint

    3. Manual Therapy Techniques for the Humeroulnar Joint

    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.

  4. Manual Therapy Techniques for the Proximal Radioulnar Joint

    4. Manual Therapy Techniques for the Proximal Radioulnar Joint

    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.