Wrist & Hand Mobilization Techniques
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| Radiocarpal/Ulnocarpal Joint OPP | Neutral with slight ulnar deviation
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| Radiocarpal/Ulnocarpal Joint CPP | Full extension
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| Radio/Ulnocarpal Joint Orientation | Radius & Ulna- caudal, ventral, ulnar
Carpals- cranial, dorsal, radial
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| Radio/Ulnocarpal Joint Articular Surfaces | Radius/ulna: concave
Carpals: convex
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| Radio/Ulnocarpal Joint Capsular Pattern | Limitation = in all directions
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| What motion is radio/ulnocarpal joint distraction good for gaining? | Non-specific overall hand ROM, articular nourishment
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| What motion is radio/ulnocarpal joint dorsal glide good for gaining? | Non-specific overall ROM, slight emphasis on flexion, good for articular nourishment
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| What motion is radio/ulnocarpal joint ventral/palmar glide good for gaining? | Good for non-specific overall ROM with slight emphasis on extension, good for articular nourishment
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| What motion is radio/ulnocarpal joint radial glide good for gaining? | Ulnar Deviation, articular nourishment
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| What motion is radio/ulnocarpal joint ulnar glide good for gaining? | Radial Deviation, articular nourishment
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| Specific Manipulations for Scaphoid, Lunate, & Triquetrium for Restricted Extension | Manipulating hand grips proximal carpal with thumb on dorsal suface, index finger on volar surface & manipulate volarly.
-Scaphoid on radius
-Lunate on radius
-Triquetrium on disc
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| Specific Manipulations for Scaphoid, Lunate, & Triquetrium for Restricted Flexion | Manipulate given carpal dorsally
-Scaphoid on radius
-Lunate on radius
-Triquetrium on disc
*Could reduce volar positional fault of lunate, when lunate manipulated dorsally on ulna
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| Proximal Row Intercarpal Manipulations | -Scaphoid on dorsal/volar lunate
-Triquetrium on dorsal/ventral lunate
-Pisiform medial/lateral on triquetrium
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| Mid-Carpal Joint OPP | Neutral or slight flexion with slight ulnar deviation
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| Mid-Carpal Joint CPP | Full extension
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| Mid-Carpal Joint Orientation | Proximal row: Caudal
Distal row: Cranial
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| Mid-Carpal Joint Articular Surfaces | Scaphoid/trapezium & trapezoid: Sellar
Scaphoid: Convex ventral to dorsal (flex/ext); Concave radial to ulnar (rad/uln dev)
Trapezium & Trapezoid: concave ventral to dorsal; convex radial to ulnar
Scaphoid, lunate, triquetrium/capitate, hamate: Ovoid
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| Mid-Carpal Joint Articular Surfaces | Scaphoid, Lunate, Triquetrium: Concave
Capitate, Hamate: Convex
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| Mid-Carpal Joint Capsular Pattern of Restriction | Limitation = in all directions
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| What motion is mid-carpal distraction good for gaining? | Non-specific overall ROM, articular nourishment
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| What motion is mid-carpal dorsal glide good for gaining? | Wrist flexion, articular nourishment
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| What motion is mid-carpal ventral glide good for gaining? | Wrist extension, articular nourishment
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| What motion is mid-carpal radial glide good for gaining? Ulnar glide? | Ulnar deviation
Radial deviation
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| Specific Manipulation for Restricted Extension | Stabilizing hand holds prox carpal while manipulating hand glides trapezium/trapezoid dorsally on scaphoid, capitate volarly on scaphoid, capitate volarly on lunate, hamate volarly on triquetrium
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| Specific Manipulation for Restricted Flexion | Stabilizing hand holds prox carpal in place, manipulating hand glides trapezium & trapezoid volarly on scaphoid, capitate dorsally on scaphoid, capitate dorsally on lunate, hamate dorsally on triquetrium
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| Distal Row Intercarpal Manipulations | Trapezoid dorsally & volarly on capitate; Hamate dorsally & volarly on capitate;
Used to increase joint play b/t distal carpal row & increase articular cartilage nutrition
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| Distal Radioulnar Joint OPP | 10 deg supination
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| Distal Radioulnar Joint CPP | 5 deg supination
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| Distal Radioulnar Joint Orientation | Radius- Medial
Ulna- Lateral
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| Distal Radioulnar Joint Articular Surface | Radius- Concave
Ulna- Convex
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| Distal Radioulnar Joint Capsular Pattern of Restriction | Pronation = Supination
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| Distal Radioulnar Joint- Dorsal Glide of Radius good for gaining what? | Supination
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| Distal Radioulnar Joint- Ventral Glide of Radius good for gaining what? | Pronation
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| Trapeziometacarpal (CMC) Joint OPP | Midway b/t flexion & extension, & b/t abduction & adduction
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| CMC Joint CPP | Full opposition
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| CMC Joint Orientation | Trapezium: caudal, ventral, lateral
1st MC: cranial, dorsal, medial
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| CMC Joint Articular Surface | Trapezium: convex radial to ulnar (flex/ext); concave dorsal to ventral (abd/add, dev)
1st MC: concave radial to ulnar (flex/ext); convex dorsal to ventral (abd/add, dev)
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| CMC Joint Capsular Pattern of Restriction | Abduction > Extension
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| CMC Joint Distraction good for what? | Gaining joint play in CMC joint & increasing overall ROM; articular nourishment
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| CMC Joint Dorsal Glide good for what? | Gaining abduction
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| CMC Joint Volar/Palmar Glide good for what? | Gaining adduction
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| CMC Joint Radial Glide good for what? | Gaining extension
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| CMC Joint Ulnar Glide good for what? | Gaining flexion
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| CMC Joints 2-5 OPP | Midway b/t flexion & extension, slight ulnar deviation
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| CMC Joints 2-5 CPP | Not described
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| CMC Joints 2-5 Joint Orientation | Carpals: Caudal
MC's: Cranial
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| CMC Joints 2-5 Type of Joint? | Synovial
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| CMC Joints 2-5 articular surface | Carpals: Convex
MC's: Concave
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| CMC Joints 2-5 capsular pattern of restriction | = in all directions
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| CMC Joints 2-5 distraction good for what? | Gaining joint play in digits 2-5; movements in these joints are minimal, esp, in stable column of rays 2 & 3
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| CMC Joints 2-5 dorsal glide good for what? | Gaining joint play; gaining wrist/finger extension
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| CMC Joints 2-5 volar glide good for what? | Gaining joint play; gaining wrist/finger flexion
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| InterMC Joints 2-5 OPP | Not described
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| InterMC Joints 2-5 CPP | None; not synovial joint
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| InterMC Joints 2-5 Joint Orientation | Medial MC's: Lateral;
Lateral MC's: Medial
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| InterMC Joints 2-5 type of joint | Synarthrosis
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| InterMC Joints 2-5 Articular Surface | MC's III, MC IV ulnar border: Convex;
MC II ulnar border, MC IV & V radial border: Concave
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| InterMC Joints 2-5 Capsular pattern of restriction | None; not synovial joint
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| InterMC Joints 2-5 Dorsal glide good for what? | gaining joint play in MC articulations; increase ROM for arch of hand
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| InterMC joints 2-5 ventral glide good for what? | gaining joint play in MC articulations; increase ROM for arch of hand
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| MCP 1-5 OPP | 1st MCP: slight flexion
MCP's 2-5: slight flexion with slight ulnar deviation
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| MCP 1-5 CPP | 1st MCP: full extension
MCP's 2-5: full flexion
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| MCP 1-5 joint orientation | Medial MC's: Lateral
Lateral MC's: Medial
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| MCP 1-5 type of joint | Synovial
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| MCP 1-5 articular surface | MCPs: Convex
Phalanges: Concave
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| MCP 1-5 capsular pattern of restriction | Flexion > Extension
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| MCP 1-5 distraction | Good for gaining joint play in MC articulations; Increase ROM for arch of hand
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| MCP 1-5 dorsal glide good for what? | gaining joint play; Increase ROM into MCP extension
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| MCP 1-5 ventral glide good for what? | gaining joint play; Increase ROM for MCC flexion
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| MCP 1-5 radial glide good for what? | gaining joint play; increase ROM for MCP abduction of digits 1 & 2, radial and of digit 3, and adduction of digits 4-5
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| MCP 1-5 ulnar glide good for what? | gaining joint play; increase ROM for MCP adduction of digits 1 & 2, ulnar abduction of digit 3, & abduction of digits 4 & 5
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| IP Joints 1-5 OPP | PIP: 10 deg flexion
DIP: 30 deg flexion
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| IP Joints 1-5 CPP | Full extension
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| IP Joints 1-5 joint orientation | Proximal phalanx: caudal
Distal phalanx: cranial
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| IP Joints 1-5 type of joint | Synovial
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| IP Joints 1-5 articular surface | Proximal phalanx: Convex
Distal phalanx: Concave
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| IP Joints 1-5 Capsular Pattern of Restriction | Flexion > Extension
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| IP Joints 1-5 Distraction | Good for gaining joint play in IP joints
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| IP Joints 1-5 Dorsal glide good for what? | gaining joint play; IP joint extension
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| IP Joints 1-5 Ventral glide good for what? | gaining joint play; IP joint flexion
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