Elbow, Wrist, Hand Test

Question 1

Valgus Stress Test
indicates:
(+) test:

Answer 1

Sprained medial (ulnar) collateral ligament 
Pain/tenderness with palpation and valgus stress; increased laxity

Question 2

Varus Stress Test
indicates:
(+) test:

Answer 2

Sprained lateral (radial) collateral ligament 
Pain/tenderness with palpation; increased laxity in LCL

Question 3

Tinel Test
indicates:
(+) test:

Answer 3

Ulnar nerve entrapment/cubital tunnel syndrome

Elicits tingling sensation down forearm within ulnar nerve distribution

Question 4

Golfer’s Elbow (Medial Epicondylitis) Test
indicates:
(+) test:

Answer 4

Medial epicondylitis

Pain/tenderness

Question 5

Tennis Elbow (Lateral Epicondylitis)Test
indicates:
(+) test:

Answer 5

Lateral Epicondylitis

Pain/tenderness

Question 6

Tinel’s sign
indicates:
(+) test:

Answer 6

Carpal tunnel syndrome

Parasthesia/numbness/tingling/pain radiating to the thumb, index, middle finger

Question 7

Phalen’s sign
indicates:
(+) test:

Answer 7

Carpal Tunnel syndrome

Any reproduction of symptoms parasthesia in the distribution of the median nerve

Question 8

Finkelstein Test
indicates:
(+) test:

Answer 8

DeQuervain’s tenosynovitis

Increased pain in lateral wrist

Question 9

Elbow Extension SD MET

Answer 9

Physician places the elbow into flexion barrier
Patient gently attempts to extend elbow for 3-5
seconds while the physician applies an isometric
counterforce.
Patient is instructed to completely relax.
Repeat 3-5 times or until somatic
dysfunction is alleviated.

Question 10

Elbow Flexion SD MET

Answer 10

Physician places the elbow into extension barrier
Patient gently attempts to extend elbow for 3-5
seconds while the physician applies an isometric
counterforce.
Patient is instructed to completely relax.
Repeat 3-5 times or until somatic
dysfunction is alleviated.

Question 11

Elbow Adduction SD MET

Answer 11

Physician places the elbow into abduction barrier.
Patient gently attempts to adduct the elbow for 3-
5 seconds while the physician applies an
unyielding counterforce.
Patient is instructed to completely relax.
Repeat 3-5 times or until somatic
dysfunction is alleviated.

Question 12

Elbow Abduction SD MET

Answer 12

Physician places the elbow into adduction barrier.
Patient gently attempts to abduct the elbow for 3-
5 seconds while the physician applies an
unyielding counterforce.
Patient is instructed to completely relax.
Repeat 3-5 times or until somatic
dysfunction is alleviated.

Question 13

Anterior Radial Head SD MET

Answer 13

Patient is seated, and the physician stands
facing the patient.
he physician grasps the patient’s hand on the side
of dysfunction, contacting the dorsal aspect of the distal
radius with the thumb.
The physician’s other hand is palm up with the
thumb resting against the anterior and medial aspect of
the radial head.
The physician pronates the patient’s forearm to the
edge of the restrictive barrier.
The physician instructs
the patient to attempt supination while the physician
applies an unyielding counterforce.
This isometric contraction is held for 3 to 5
seconds, and then the patient is instructed to stop and
relax.
Once the patient has completely relaxed, the
physician pronates the patient’s forearm to the edge of
the new restrictive barrier while exaggerating the
posterior rotation of the radial head with the left hand.
Steps 5 to 7 are repeated 3 to 5 times or
until there is no further improvement in the restrictive
barrier.

Question 14

Posterior Radial Head SD MET

Answer 14

Patient is seated, and the physician stands
facing the patient.
he physician grasps the patient’s hand on the side
of dysfunction, (handshake position) contacting the palmar aspect of the distal
radius with the thumb.
The physician’s other hand is palm up with the
thumb resting against the posterolateral aspect of
the radial head.
The physician supinates the patient’s forearm to the
edge of the restrictive barrier.
The physician instructs
the patient to attempt pronation while the physician
applies an unyielding counterforce.
This isometric contraction is held for 3 to 5
seconds, and then the patient is instructed to stop and
relax.
Once the patient has completely relaxed, the
physician pronates the patient’s forearm to the edge of
the new restrictive barrier while exaggerating the
anterior rotation of the radial head with the left hand.
Steps 5 to 7 are repeated 3 to 5 times or
until there is no further improvement in the restrictive
barrier.

Question 15

coupled motion with wrist flexion

Answer 15

dorsal carpal glide

Question 16

coupled motion with wrist extension

Answer 16

ventral carpal glide

Question 17

Radiocarpal Flexion SD MET

Answer 17

The patient is seated with the physician standing facing
the patient.
The physician extends the patient’s wrist to the edge of
the restrictive barrier.
physician instructs the patient to flex the wrist
while the physician applies an unyielding counterforce.
This isometric contraction is maintained for 3 to 5
seconds, and then the patient is instructed to stop and
relax.
Once the patient has completely relaxed, the physician
extends the patient’s wrist to the edge of the new
restrictive barrier.
Repeat three to five times or until
motion is maximally improved at the dysfunctional
wrist.

Question 18

Radiocarpal Extension SD MET

Answer 18

The patient is seated with the physician standing facing
the patient.
The physician flexes the patient’s wrist to the edge of
the restrictive barrier.
The physician instructs the patient to extend the wrist
while the physician applies an unyielding
counterforce.
This isometric contraction is maintained for 3 to 5
seconds, and then the patient is instructed to stop and
relax.
Once the patient has completely relaxed, the physician
flexes the patient’s wrist to the edge of the new restrictive
barrier.
Repeat 3-5 times

Question 19

Radiocarpal Adduction SD MET

Answer 19

The patient is seated with the physician standing facing
the patient.
The physician abducts the patient’s wrist (radial
deviation) to the edge of the restrictive barrier.
The physician instructs the patient to adduct the wrist
while the physician applies an unyielding counterforce.
This isometric contraction is maintained for 3 to 5
seconds, and then the patient is instructed to stop and
relax.
Once the patient has completely relaxed, the physician
abducts (radially deviates) the patient’s wrist to the edge of
the new restrictive barrier.
Repeat three to five times or until
motion is maximally improved at the dysfunctional wrist.

Question 20

Radiocarpal Abduction SD MET

Answer 20

The patient is seated with the physician standing facing
the patient
The physician adducts the patient’s wrist (ulnar
deviation) to the edge of the restrictive.
The physician instructs the patient to abduct the wrist
while the physician applies an unyielding counterforce.
This isometric contraction is maintained for 3 to 5
seconds, and then the patient is instructed to stop and
relax.
Once the patient has completely relaxed, the physician
adducts (ulnar deviation) the patient’s wrist to the edge of
the new restrictive barrier.
Repeat 3-5 times

Question 21

Flexor Retinacula MFR

Answer 21

The patient sits on the table with the physician standing
facing the patient.
The operator interlaces the fingers of both hands
applying a thenar eminence contact across the distal radius
and ulnar on the dorsal side and the wrist retinaculum on
the volar side.
The operator maintains anteroposterior compression
over the wrist while the patient actively flexes and extends
fingers.
The patient repeats flexion and extension efforts several
times, mobilizing flexor tendons under the flexor
retinaculum while the operator’s hands maintain
compression resulting in distraction.

Question 22

Wrist Isotonic MET

Answer 22

Physician crosses thumbs and contacts the tissue over
the patient’s pisiform and trapezium
While the patient tries to flex the wrist, the doctor
applies pressure with both thumbs in a lateral direction.
Physician lightens force slowly to allow patient to
overcome the physician’s force.
Repeat steps 2-3 until somatic dysfunction is alleviated.

Question 23

Figure 8 Wrist Articulation

Answer 23

Place the patient’s wrist between the wrists of the
operator (perpendicularly)
Move the wrist in a figure 8 motion repetitively until
somatic dysfunction is alleviated.

Question 24

Metacarpophalangeal Joint SD ART

Answer 24

Physician evaluates the motion at the
metacarpophalangeal joint in flexion, extension,
abduction, adduction, clockwise and counterclockwise
circumduction.
When a restriction is felt, gentle repetitive motion is
made through the restrictive barrier toward the
anatomic barrier.
Continue articulation until somatic dysfunction is
alleviated

Question 25

Proximal & Distal Interphalangeal Joint SD ART

Answer 25

Physician evaluates the motion at the proximal and
distal interphalangeal joints in flexion, extension,
abduction, adduction, clockwise and counterclockwise
circumduction.
When a restriction is felt, gentle repetitive motion is
made through the restrictive barrier toward the
anatomic barrier.
Continue articulation until somatic dysfunction is
alleviated.