I may use this particular repeated movement test as part of my orthopedic evaluation for wrist and hand complaints. If this specific movement positively impacts symptoms & signs, this will then become the treatment (making the diagnosis wrist joint derangement).

There are many different movements a wrist joint derangement could need. The key is to use repeated movement testing to isolate the specific one that resolves a patient’s symptoms & restores normal, pain-free motion, strength, sensation, etc. This is called the joint’s directional preference.

Clinicians often pin wrist & hand symptoms on tendons, the TFCC, ligament sprains, different nerves, arthritis, and the structure of the carpal tunnel.

I find many complaints in fact come from a mechanical joint derangement in the wrist joint itself or in a relevant joint in the spine. To figure out the root cause diagnosis, in addition to any orthopedic special tests (OSTs), I use McKenzie’s repeated movement testing. By using repeated movement testing (in the wrist and/or spine), I very often find that moving the affected joint in the right direction restores the wrist/hand to normal.

Wrist flexion with or without traction can be the direction a wrist joint derangement needs for treatment, but it could also be extension, radial or ulnar deviation, pronation, supination, or combo movements. Movements are further specified based on how much body weight goes through the limb & if traction is applied or not. There are thus many movements of the wrist one could test … and thus many that could be the beneficial treatment. The specific verbal history & the patient’s physical exam inform which test to apply later in the testing portion of my orthopedic evaluation.

#orthopedics #wristpain #carpaltunnel #handpain #physicaltherapy