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 Phalanxes
 Distal intercarpals
LAE, AP/PA, Int/Ext rotation, med/lat glide
 Metacarpals- elbow flexed, back of hand work the metacarpals with the thumbs
 Carpal/Metacarpal
o Trapezium, first metacarpal, basilar joint
 Thumb squeeze at proximal carpal/metacarpal joint
 Double pinky adjustment or thumb into joint space
o Rotation of carpal/metacarpal
 Figure 8 motion while holding in joint space
o LAE of Carpals
 Hold forearm and other hand over back of wrist tractioning looking for joint
motion of carpals
o Flexion- Proximal row of carpals on the radius/ulna
 Supinated hand, elbow flexed, bring hand in flexion with thumbs on dorsum of
wrist LOD is anterior
o Extension- Distal row of carpals on the proximal row
 Thumbs on palm extending the pronated hand of pt. LOD anterior impulse
o AP/PA glide of Carpals
 3 rows: Metacarpal/Distal Row, Distal/Proximal Row, and Proximal/Radial Ulan
row. Hands together on the dorsum of patient to check each row
o Medial/ Lateral tils of the wrist
 Lateral index in joint space/ Impulse into restriction/ UMT adjustment
o UlnoMenisco Triquetral Joint (Modified handshake)
 Handshake and stabilize forearm with other arm, traction hands and laterally
deviate handshake
o AP/PA Triquetral
 Pt elbow flexed hand supinated. Slide off the ulnar styloid onto pisiform then
triquetral. Block with the other hand.
o Distal Radial/Ulnar Joint
 AP/PA Glide: Spock position on hand. Check AP/PA
 Supination:
 Pronation:
 Elbow
o LAE Ulnar Humeral Joint:
 Traction one hand on distal radius other on elbow
o Lateral/Medial Tilt of Elbow:
 Elbow flexed pinned at doctor’s side 5 to 10 flexion
o Extension of elbow:
 Squeeze olecranon between fingers move into extension thrust slightly before
o Radial head adjustment
 Palpate radial head, flex elbow and flex wrist. Extend elbow and internally
rotate arm. LOD anterior from test
o Superior Glide of Radial Humeral Joint
 Supine elbow at 90 degrees apply pressure to the floor
 Shoulder
o Anterior Glide
 Supine arm at side. One hand in axilla and other on clavicle.
o Lateral Glide
 Supine arm at side. One hand in axilla and other proximal to elbow
o Lateral Posterior Glide
 Arm at 90, elbow bent. Use Superior shoulder with hands encircling humorous.
o Lateral Inferior Glide
 Arm at 90, elbow bent. Use Inferior shoulder bring it lateral and inferior
o Superior Glide 10 degrees
 Elbow flexed and on stomach, shear thru elbow, palpate acromion and greater
o Posterior Glide 90 degrees
 Same as above with elbow at 90 degrees
o External Rotation
 Arm in 90/90 rotate with superior arm
o Internal Rotation
 Same as above but with inferior arm
 Block shoulder
o Circumduction
 Traction and take thru joint plane