Hand complex

Question 1

Palmar Glide of the 2nd on the 3rd Metacarpal

Answer 1

Purpose: to increase grasp of the hand; to increase the arch of the hand
Precautions: do not squeeze the metacarpals too aggressively
Stabilize: the base of the 3rd metacarpal with your thumb on the dorsal surface and your index finger on the palmar surface
Mobilize: gently grasp the base of the 2nd metacarpal in the same manner at the 3rd metacarpal; gently apply the mobilization with your thumb in the palmar direction

Question 2

: Dorsal Glide of the 5th on the 4th metacarpal

Answer 2

Purpose: to increase the opening of the hand; to decrease the arch of the hand
Precautions: do not squeeze the metacarpals too aggressively
Stabilize: the base of the 4th MC with your thumb on the dorsal surface and your index finger on the palmar surface
Mobilize: gently grasp the base of the 5th metacarpal in the same manner as the 4th metacarpal; Gently apply the mobilization with your index finger in the dorsal direction

Question 3

Distraction of the MCP joint

Answer 3

Purpose: to increase flexion, extension & overall AROM.
Precautions: do not squeeze the phalanges to aggressively
NOTE: this technique can be used with all the MCP, PIP & DIP joints
Stabilize: the proximal hand stabilizes by using your index finger & thumb at the distal end of the metacarpal on the palmar & dorsal surfaces; for IP applications, grasp the distal end of the more proximal phalanx
Mobilize: place your index finger on the palmar surface & thumb on the dorsal surface of the proximal phalanx. Gently pull on the phalanx to distract the joint; for IP applications, grasp the proximal portion of the more distal phalanx

Question 4

Dorsal Glide of the MCP joints

Answer 4

Purpose: to increase finger extension, to decrease pain
Precautions: do not squeeze the phalanges too aggressively
NOTE: this technique can be used with all the MCP joints
Stabilize: the proximal hand stabilizes by using your index finger and thumb on the distal end of the metacarpal on the palmar and dorsal surfaces
Mobilize: place your index finger on the palmar surface and thumb on the dorsal surface of the proximal phalanx. Use your index finger to apply the mobilization in the dorsal direction

Question 5

Palmar Glide of the MCP joints

Answer 5

Purpose: to increase finger flexion & grasp of the hand
Precautions: do not squeeze the phalanges too aggressively
NOTE: this technique can be used with all the MCP joints
Stabilize: the proximal hand stabilizes by using your index finger and thumb on the distal end of the metacarpal on the palmar and dorsal surfaces
Mobilize: place your index finger on the palmar surface and thumb on the dorsal surface of the proximal phalanx; use your index finger & thumb to apply the mobilization in the palmar direction

Question 6

Radial Glide of the MCP joint

Answer 6

Purpose: to increase abduction of the 2nd digit (adduction of the 4th & 5th)
Precautions: use this technique conservatively (especially in RA)
Stabilize: the thumb and index finger stabilize the distal end of the metacarpal
Mobilize: the index finger is placed on the lateral surface of the proximal end of the phalanx and the thumb is placed on the medial surface; gently squeeze your thumb and index fingers together & mobilize the phalanx in the radial direction

Question 7

Ulnar Glide of the MCP joint

Answer 7

Purpose: to increase adduction of the 2nd digit; abduction of the 4th & 5th digits
Precautions: use this technique conservatively; not recommended for patients with RA
Stabilize: the thumb & index finger stabilize the distal end of the metacarpal as shown
Mobilize: the index finger is placed on the lateral surface of the proximal end of the phalanx and the thumb is placed on the medial surface; gently squeeze your thumb and index fingers together & mobilize the phalanx in the ulnar direction

Question 8

Radial or Ulnar Spin of the MCP joints

Answer 8

Purpose: to increase mobility of the MCP joints
Precautions: use this technique conservatively
Stabilize: the proximal hand stabilizes by using your index finger & thumb on the distal end of the metacarpal on the palmar and dorsal surfaces; For IP applications, stabilize the distal end of the more proximal phalanx
Mobilize: place your index finger on the palmar surface and thumb on the dorsal surface of the proximal phalanx; Gently mobilize the proximal phalanx by providing a spin mobilization in the radial/ulnar direction; for IP applications mobilize the more distal phalanx

Question 9

: Distraction of the PIP joint

Answer 9

Purpose: to increase flexion & extension
Precautions: do not squeeze the phalanges too aggressively
Stabilize: the thumb and index finger are used to stabilize the dorsal and palmar surfaces of the distal end of the more proximal phalanx
Mobilize: the thumb and index finger are used to gently grasp the dorsal and palmar surfaces of the more distal phalanx; provide an axial distraction by gently pulling on the more distal phalanx

Question 10

Palmar Glide of the PIP joints

Answer 10

Purpose: to increase flexion
Precautions: do not squeeze the phalanges too aggressively
Stabilize: the thumb & index finger are used to stabilize the dorsal & palmar surfaces of the distal end of the more proximal phalange
Mobilize: the thumb & index fingers are used to gently grasp the dorsal and palmar surfaces of the more distal phalanx; provide a palmar glide by gently pushing on the more distal phalanx