Professional Documents
Culture Documents
Wrist Elbow Shoulder Adjustments
Wrist Elbow Shoulder Adjustments
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
lockout
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
tubercle
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