Elbow, Wrist, Hand Test Flashcards
Valgus Stress Test
indicates:
(+) test:
Sprained medial (ulnar) collateral ligament Pain/tenderness with palpation and valgus stress; increased laxity
Varus Stress Test
indicates:
(+) test:
Sprained lateral (radial) collateral ligament Pain/tenderness with palpation; increased laxity in LCL
Tinel Test
indicates:
(+) test:
Ulnar nerve entrapment/cubital tunnel syndrome
Elicits tingling sensation down forearm within ulnar nerve distribution
Golfer’s Elbow (Medial Epicondylitis) Test
indicates:
(+) test:
Medial epicondylitis
Pain/tenderness
Tennis Elbow (Lateral Epicondylitis)Test
indicates:
(+) test:
Lateral Epicondylitis
Pain/tenderness
Tinel’s sign
indicates:
(+) test:
Carpal tunnel syndrome
Parasthesia/numbness/tingling/pain radiating to the thumb, index, middle finger
Phalen’s sign
indicates:
(+) test:
Carpal Tunnel syndrome
Any reproduction of symptoms parasthesia in the distribution of the median nerve
Finkelstein Test
indicates:
(+) test:
DeQuervain’s tenosynovitis
Increased pain in lateral wrist
Elbow Extension SD MET
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.
Elbow Flexion SD MET
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.
Elbow Adduction SD MET
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.
Elbow Abduction SD MET
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.
Anterior Radial Head SD MET
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.
Posterior Radial Head SD MET
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.
coupled motion with wrist flexion
dorsal carpal glide
coupled motion with wrist extension
ventral carpal glide
Radiocarpal Flexion SD MET
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.
Radiocarpal Extension SD MET
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
Radiocarpal Adduction SD MET
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.
Radiocarpal Abduction SD MET
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
Flexor Retinacula MFR
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.
Wrist Isotonic MET
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.
Figure 8 Wrist Articulation
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.
Metacarpophalangeal Joint SD ART
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
