Treating the Wrist by Way of the Shoulder: The Interrelationship of Both Joints

• • Distinguish and accurately locate wrist and shoulder anatomy
• • Explain the interrelationship between the wrist and the shoulder and how this affects evaluation and treatment
• • Identify three biomechanical principles of the wrist and shoulder used during manual treatment
• • Articulate the role of fascia in the upper extremity and its impact on connective tissue
• • Evaluate the postural implications of wrist injuries and determine the role they play in the rehabilitation process
• • Demonstrate myofascial mobilization techniques to improve wrist motion in all planes, including pronation and supination
• • Recommend appropriate functional outcome tools used for the patient with a complex wrist injury

What Role Does the Shoulder Play in Rehabilitation After a Wrist Injury?
The wrist links the hand to the upper extremity, while the shoulder links the upper extremity to the trunk. The interdependence of these two joints has received little consideration in literature, and subsequently in treatment protocols. Identifying how the body moves through space and learning to notice changes in movement pattern, while relating them to function and loss of function, is imperative to addressing the proper sequence of tissue manipulation. After an injury, fascia gets stuck in predictable areas, thickens tissues, and no longer glides throughout each layer of the upper extremity.

This course offers attendees a deeper understanding of the wrist and the role the shoulder plays in rehabilitation after injury. Ms. Lucas Dellinger has developed an evaluation and treatment approach for the patient with a complex wrist injury, the Postural Analysis and Alignment Treatment (PAAT) method, which incorporates observation and manual work. This treatment approach offers an increase in motion, strength, and functional outcome for patients while reducing treatment time. Participants will learn how to free up the fascial bindings that wrap around the body after a wrist injury, and practice these techniques in a hands-on lab.