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 pronation can be the direction a wrist joint derangement needs for treatment, but it could also be extension, flexion, radial or ulnar deviation, supination, or a combo movement. 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.

This was the repeated movement I needed 2 years ago for a few days to fix my wrist pain! The pain was there when doing several exercises in the gym, especially those with weight/load through the wrist.

Dr. Laura Mannering DPT, OCS, Dip MDT
Doctor of Physical Therapy
Board-certified in Orthopedic Physical Therapy
Diploma in MDT (Mechanical Diagnosis and Therapy)

My website: www.drlauramannering.com/
My Instagram: www.instagram.com/drlauramannering/

Clinic located in Dupont Circle in downtown Washington, DC.

#orthopedics #wristpain #carpaltunnel #handpain #physicaltherapy