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Manual Therapy Techniques to Address Stiffness for the Wrist

presented by Ann Porretto-Loehrke

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Distal radius fractures are a common diagnosis that hand therapists treat. Often times, these patients end up with significant loss of motion. Sharpen your skills with joint specific techniques to address stiffness at the radiocarpal and midcarpal joints through reviewing the arthrokinematics of the wrist as well as surface anatomy to know exactly where to place your hands. Develop an understanding of how the trapezoid-on-scaphoid articulation guides motion of the midcarpal joint in the dart-throwers plane and learn joint-specific techniques to address limitations in this region. These manual therapy techniques will be covered in a step-by-step fashion for both the radiocarpal and midcarpal joints to use immediately in the clinic.

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

Download Learning Objectives
  1. Carpal Anatomy and Arthrokinematics of the Wrist

    1. Carpal Anatomy and Arthrokinematics of the Wrist

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

  2. Bony Surface Anatomy of the Wrist

    2. Bony Surface Anatomy of the Wrist

    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.

  3. Joint Mobilization Techniques for the Wrist

    3. Joint Mobilization Techniques for the Wrist

    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.