Certificate Program
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
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Apply manual therapy techniques to address joint stiffness, tendinopathy, and nerve compression issues in the upper extremity to optimize patient outcomes.
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Explain the importance of a capsular pattern when finding a passive limit and how this affects your treatment plan.
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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.
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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
Accredited Online Courses*
18 hours of online video lectures and patient demonstrations.
Case Study Interviews
Recorded Q&A sessions between instructors and practice managers.
Interactive Learning Assessments
Case-based quizzes to evaluate and improve clinical reasoning.
Certificate Program overview
Section 1
Manual Therapy for Joint Stiffness 4 ItemsManual Therapy Techniques to Address Stiffness at the Elbow Course
Chapter 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.
Chapter 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.
Chapter 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.
Chapter 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.
Forearm Rotation Limitations Post Trauma Course
Chapter 1: Understanding the Anatomy & Kinematics of Forearm Rotation
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.
Chapter 2: Distal Radioulnar Joint Assessment & Treatment
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.
Chapter 3: Proximal Radioulnar Joint Assessment
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.
Manual Therapy Techniques to Address Stiffness for the Wrist Course
Chapter 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.
Chapter 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.
Chapter 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.
Manual Therapy Techniques to Address Stiffness at the Thumb Course
Chapter 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.
Chapter 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.
Chapter 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.
Chapter 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.
Section 2
Manual Therapy for Soft Tissue Disorders 2 ItemsDifferential Diagnosis of Lateral Elbow Pain Course
Chapter 1: Anatomy of the Lateral Elbow
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.
Chapter 2: Pathomechanics of Lateral Elbow Pain
This chapter covers the pathomechanics of tendinopathy, articular, ligamentous, and neural issues at the lateral elbow.
Chapter 3: Clinical Examination
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.
Treatment of Lateral Elbow Pain Course
Chapter 1: Treatment of Musculotendinous Issues at the Lateral Elbow
This chapter covers treatment for a musculotendinous issue at the lateral elbow using transverse friction massage, and rhythmic stretching, in addition to providing an overview of the literature regarding strengthening.
Chapter 2: Treatment of Articular Issues at the Lateral Elbow
This chapter provides treatment methods to address issues at the humeroradial joint: manual techniques to address both hypomobility and hypermobility, which can contribute to lateral elbow pain.
Chapter 3: Treatment of Radial Nerve Issues at the Lateral Elbow
This chapter provides additional special tests to determine if a radial nerve irritation is present, followed by a treatment proposal consisting of neural flossing, addressing underlying mechanics at the HRJ, and a brief overview of ergonomic considerations.
Section 3
Manual Therapy for Nerve Compression Syndromes 6 ItemsIdentification and Evaluation of Thoracic Outlet Syndrome Course
Chapter 1: Types of Thoracic Outlet Syndrome
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.
Chapter 2: Clinical Testing for TOS
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.
Chapter 3: 1st & 2nd Rib Mobility Assessment
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.
Thoracic Outlet Syndrome: Assessing the Elevation Chain Course
Chapter 1: Scapular & Elevation Chain Assessment
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).
Chapter 2: Glenohumeral Joint Assessment
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.
Chapter 3: Cervicothoracic Assessment
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.
Treatment of Thoracic Outlet Syndrome: Where to Begin Course
Chapter 1: Joint-Specific Treatment to Address 1st & 2nd Rib Limitations
This chapter covers the manual therapy techniques to address limitations at the 1st and 2nd ribs. 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.
Chapter 2: Addressing Scapular Alignment & Dynamic Control
Poor scapular alignment and limited mobility in the upper extremity elevation chain can contribute to TOS, especially with compressors. This chapter covers how to address poor resting scapular position and dynamic control with scapular taping techniques and therapeutic exercise.
Chapter 3: Joint-Specific Treatment to Address Limitations at the Acromioclavicular and Sternoclavicular Joints
TOS patients who experience their symptoms with overhead motion can sometimes present with clavicular dysfunction. This chapter covers joint-specific techniques to address limitations at the sternoclavicular joint (SCJ) or acromioclavicular joint (ACJ).
Treatment of Thoracic Outlet Syndrome: Addressing Shoulder and Upper Thoracic Limitations Course
Chapter 1: Joint-Specific Treatment to Address Glenohumeral Joint Limitations
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 treat posterior GHJ tightness and limitations at end-range.
Chapter 2: Joint-Specific Treatment to Address Limitations at the Cervicothoracic Junction
Stiffness in the upper thoracic spine can be a culprit with poor scapular mechanics and brachial plexus issues. This chapter covers how to address upper thoracic extension and rotation limitations.
Chapter 3: Treatment Strategies for Addressing Adverse Neural Tension Issues and Chronic Pain
Patients with TOS often present with longstanding issues. Nerve gliding must be performed cautiously to avoid an exacerbation of the patient’s symptoms. This chapter covers neural flossing techniques and chronic pain considerations with TOS.
Nerve Compression Syndromes of the Elbow and Forearm Course
Chapter 1: Principles of Conservative and Post-Operative Management
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.
Chapter 2: Cubital Tunnel: Conservative & Post-Operative Management
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.
Chapter 3: Radial Tunnel and Wartenberg’s Syndrome: Conservative Management
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.
Chapter 4: Pronator Syndrome: Conservative and Post-Operative Management
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.
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.
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Browse PlansFrequently asked questions
Everything you need to know about Certificate Programs.
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.
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.
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.
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.
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