Joint Manipulation: Elbow (Radial Head) and Wrist

Introduction

This course describes joint manipulation techniques for the elbow (radial head) and wrist. Various synonyms and definitions have been used to describe the term "manipulation". The Brookbush Institute uses one conventional definition of the term "manipulations;" implying low-amplitude (relatively small motions), high-velocity (quick) techniques, intended to target and reduce the stiffness of specific joints or segments, that exhibit a decrease in passive accessory range of motion (a.k.a. stiffness during arthrokinematic motion; specifically glide ). Research does imply that manipulations affect multiple joints simultaneously; however, the Brookbush Institute asserts that efforts to target the stiffest joints or segments will increase the likelihood that the stiffest segments are included in the "multiple joints" affected.

The Brookbush Institute has carefully selected manipulation techniques with the intent to increase the probability of practitioner success. That is, techniques have been chosen that are relatively easy to teach, reliably improve outcomes, and are the most commonly used. The Brookbush Institute does not wish to assert that these manipulation techniques are the only techniques that are effective, and/or that these are the best techniques for every outcome measure. It is possible that a highly complex, and/or advanced technique, may result in better outcomes, or that a particular pathology is better addressed with a rarely used technique.

Note, the term "mobilization" is reserved for low-velocity techniques that are taught in a separate set of courses.

This course includes manipulation techniques that intend to reduce excessive stiffness of the radiohumeral and radioulnar joints of the elbow, and the carpal joints of the wrist, with the intent of addressing upper extremity dysfunction. For example, elbow pain has been correlated with altered scapular motion and a reduction in grip strength, both of which can have a significant effect on the strength and power of the upper extremity during sports and functional activity. These techniques may also be used in an integrated approach for cervicothoracic dysfunction and upper body dysfunction (UBD) including lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), carpal tunnel syndrome, double-crush syndrome, shoulder impingement syndrome (SIS), chronic thoracic pain, chronic neck pain, and acromioclavicular dysfunction.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) to develop an evidence-based, systematic, integrated, patient-centered, patient-centered, and outcome-driven approach.

Techniques Covered in this Course:

• Elbow (Radial Head) Manipulation
• Wrist Manipulation

Sample Intervention (Lateral Epicondylitis)

• Manual Release
  • Vibration Release
• Mobilization or Manipulation
  • Elbow (Radial Head) Manipulation
  • Wrist Manipulation
• Instrument Assisted Soft Tissue Mobilization (IASTM)
  • Brachial and Forearm Fascia IASTM
• Activation
  • Flexor Carpi Radialis Activation
  • Flexor Activation
  • Supinator Activation
• Integration
  • Wrist and Elbow Integration
• Support
  • Wrist Extensor Inhibition Taping

Related Courses

Additional Joint Mobilization Courses

• Joint Manipulation: Cervical Spine
• Joint Manipulation: Thoracic Spine
• Joint Manipulation: Lumbar Spine, Sacroiliac Joint, and Pubic Symphysis
• Joint Manipulation: Elbow (Radial Head) and Wrist
• Joint Manipulation: Ankle, Midfoot, and Tibiofibular Joint

For an introduction to joint mobilizations and manipulations:

• Joint Mobilization and Manipulation: Introduction
• Joint Mobilization and Manipulation: Reliability
• Joint Mobilizations and Manipulations: Effects
• Joint Mobilization and Manipulation: Risk of Adverse Effects
• Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning