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Manual Therapy Techniques to Address Stiffness at the Thumb

presented by Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

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Disclosure Statement:

Financial— Ann Porretto-Loehrke receives compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Nonfinancial— No relevant nonfinancial relationship exists.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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This course is part of our CHT Prep Program. Learn more about the full prep program here: MedBridge CHT Prep Program.

Stiffness at the thumb carpometacarpal (CMC) joint can occur as a result of trauma, as seen with fractures at the base of the first metacarpal, and can also be present in the early stages of osteoarthritis (OA). Get reacquainted with the intricate anatomy of the thumb CMC joint and develop an understanding of how motion of the trapezoid and scaphoid play a role in thumb mobility. Gain knowledge in joint-specific techniques to address stiffness at the thumb CMC as well as the radial column of the wrist. This knowledge can be beneficial in restoring mobility for post-traumatic stiffness as well as for conservative management of mild CMC OA.

Meet Your Instructor

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

Ann Porretto-Loehrke is a skilled clinician with a passion for teaching and clinical treatment of upper extremity disorders. She serves as the clinical development coordinator at the Hand to Shoulder Center in Appleton, Wisconsin. Ann is a Certified Hand Therapist (CHT) and a Certified Orthopedic Manual Therapist (COMT) for treatment of the upper quadrant through…

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Chapters & Learning Objectives

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1. Anatomy and Kinesiology of the Thumb and Radial Column

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.

2. Surface Anatomy of theThumb and Radial Column

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.

3. Joint Mobilization of theThumb Carpometacarpal (CMC) Joint

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.

4. Radial Column Techniques

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.

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