Distal Upper Extremity Online Bundle

You will receive access to five online courses, equalling 12.6 Contact Hours.

Diagnosis and Management of the Distal Upper Extremity – 8 Contact Hours – The lecture provides the critical fundamentals of pathoanatomy of the elbow, forearm, wrist, and thumb. Short but precise clinical assessments are demonstrated for differential diagnosis of elbow and wrist/thumb problems. Special topics include Complications and Considerations of Lateral Epicondylitis, Updates on Connective Tissue Research, Posterolateral Instability of the Elbow, Clinical Diagnosis and Suggested Treatment of Various Pain Locations: Medial, Lateral, Anterior and Posterior, and Neuropathies at the Elbow, Forearm, and Wrist/Hand.

Clinical Testing for Stability of the Wrist – 1 Contact Hour – A golden opportunity to brush up on stability testing of the wrist! This webinar provides participants with the tools for evaluating the stability of the scapholunate (SL) and lunatotriquetral (LT) intervals, midcarpal joint (MCJ), and distal radioulnar joint (DRUJ) to gain confidence in performing these tests in the clinic.

Rapid Identification of Lateral Elbow Pain Generators – 0.8 Contact Hour – Learn the most efficient tests and quickly identify the most common pain generators of the lateral elbow region.

Upper Quadrant Neural Testing and Management – 1.3 Contact Hours – Dr. Brismee discusses the neural testing and management for the upper quadrant using research-based guidelines for neural tensioning and sliding techniques. He also shares his expertise on how to apply the evidence into the clinical practice to treat patients with spinal potential discogenic, dural, or nerve root-related conditions, patients with suspected peripheral neural compression/tension conditions, and patients with suspected sensitization in chronic stages.

Proximal Screening of the Upper Extremity – 1.5 Contact Hours – Gain an appreciation of the relationship between the cervical spine and thoracic outlet region and sharpen your evaluation skills to optimize treatment outcomes! This course will review the anatomy of the cervical spine to develop an understanding of the potential pain generators in this region that can refer symptoms to the distal upper extremity. Testing of the cervical spine to differentiate between a cervical radiculopathy from a disc issue will be covered. An overview of thoracic outlet syndrome and techniques for screening this region will also be provided.

Diagnosis and Management of the Distal Upper Extremity

• Be able to integrate the pathoanatomy, physiology, and biomechanics of Elbow Complex and Wrist/Thumb Joint pathologies into one or more of the following and consequent, common clinical dysfunctions: Medial/Lateral/Anterior Elbow joint dysfunction, tennis elbow, humeroradial/humeroulnar internal joint pathologies, wrist functional instability, thumb osteoarthritis or more severe conditions such as fracture, tumor or systemic-inflammatory diseases.
• Be able to interpret, through a systematic process, the key findings from the proposed basic clinical examination of patients with Elbow Complex and Wrist/Thumb-related conditions.
• Decide which specific clinical tests are the most informative for diagnosis from the general clinical examination of the Elbow Complex and Wrist/thumb for a patient with acute, recurrent, or chronic distal upper extremity pain.
• Design 3 effective treatment interventions for acute elbow pain such as elbow and wrist/thumb joint active arthritis.
• Design 3 effective treatment interventions for muscle-tendinous and capsular disorders such as tennis elbow dysfunction and functional instability.
• Design 3 effective treatment interventions for recurrent wrist instability, such as secondary triangular fibrocartilage pathology.
• Design 3 effective treatment interventions for carpal bone/joint pathologies.

Clinical Testing for Stability of the Wrist

• SL interval: Scaphoid Shift/Watson’s test and SL Ballottement test
• LT interval: Derby Test and LT Ballottement test
• MCJ: Midcarpal Shift Test
• DRUJ: DRUJ Ballottement & Shift Tests

Rapid Identification of Lateral Elbow Pain Generators

• Identify pain patterns specific to the three most common musculoskeletal problems in the lateral elbow region.
• Clinically differentiate the most common musculoskeletal pain generator in the lateral elbow region.
• Confidently recommend management strategies for these musculoskeletal conditions.

Upper Quadrant Neural Testing and Management

• Identify three upper quadrant neural testing techniques to improve the diagnostic process.
• Design three treatment approaches based on neural mobilization principles for peripheral nerve entrapment dysfunctions.

Proximal Screening of the Upper Extremity

• Describe the research supporting the existence of double crush
• Explain the difference in clinical presentation between cervical radiculopathy versus a cervical disc.
• Perform a cervical spine screen with evaluation of sensation, strength, and reflexes to determine potential dermatomal and myotomal involvement.
• Verbalize the anatomy of the thoracic outlet region and be able to describe the three main areas of brachial plexus involvement.
• Identify the two types of thoracic outlet syndrome(TOS) clinical presentations: compressors and releasers.
• Perform a proximal screening to rule out disputed neurogenic TOS.

• Financial: The instructor(s) receive an honorarium for presenting this course.
• Non-financial: The instructor(s) have no relevant non-financial relationships to disclose.
• Partial credit is not available. For online courses, passing module assessments and completing the course evaluation is required to earn continuing education credit. For live courses, attendance is confirmed by signing the attendance sheet at the course; ensure name and professional license number are accurate, and initial both morning and afternoon attendance.