Mastering Wrist Treatment_ Unlock Immediate Results with Manual Techniques
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[00:00:00] When I teach, um, Wrists, you can do it next to someone. You could do it in front of someone, right? But you can also have them lay down and then you could do it here, too. So when I have them in supine and they're real tight here, I will stretch the metacarpal at the metacarpal head and then I might do some wrist extension here.
I might do some radial deviation. on their deviation here, right? So my hands are either here or they might be,
so I'm going to stretch more radial deviation. My hand might be a little bit more here. If I'm stretching more ulnar, then my hand might be a little bit more here. The reason why you have to learn multiple things for the same movement is to give your hands a break. You want to learn about body mechanics, you need to learn how to [00:01:00] do things where you're, you give your hands a break.
Because when I'm working, You know, my hands aren't hurting. I, you don't want your hands to be working either. Like you don't want to have hand pain. And I don't know if you've noticed, but when I work, my arms are as much as I can next to my body. Right, my elbows. Now, every once in a while, I might be like this, and I might do a distraction this way because the weight of the arm pulls, you feel, you see that?
See that indentation? Right, see that? The weight of the arm does it for me, right? So, but I don't want to be here, so staying for long periods of time. I might do it for a little bit. But I don't want to be there all day, every day. Does that make sense? So you can work here, and you can work here, and here, [00:02:00] right?
So you see? Now, if I'm working with a scar, right, on the wrist, um, again, I might put that scar on slack, and I will work the scar. in this direction, or this direction, or this direction, right? Versus normally, we're like, let's stretch that scar, let's move it, right? There's nothing wrong with that, sometimes I do it, but how does it get better movement?
How does it feel easier? I will do the same here. So if the wrist, if you have a distal radius scar right here, usually where does it get stuck? Right near the thumb, not in the forearm, right? So I'll put the wrist into a slight flexion, And I'll move the scar, but if you look at my hand, I'm trying to use my hand as much as possible.
If I can use my palm even better, right, why not bigger, wider surface is more comfortable instead of like, [00:03:00] right, it's just too much, y'all, y'all working too hard, right? Does that make sense? All right. So if I'm working supination and pronation now. I know that my biceps is my strongest supinator. And I know that my, my pronators here, here, and here.
Right? And then, of course, all my wrist muscles. The thing with this, um, supination and pronation, is you see the muscles? They have to roll. over the forearm, right? So if we're sitting here and we're just working where we're turning, it's not as helpful, right? Think about all of the tissues that affect your forearm, right?
So your triceps It comes and it ends in your, like, in that lower olecranon area. Feel that? Little tight, isn't it? You feel it? [00:04:00] Yeah. I should be able to lift this up, right? Relax your arm. She's trying to look at the same time I'm doing the work. You see here? Relax.
I should be able to lift this up. Look how tight this is right here. You see it?
So it's, it's stuck here. So, you could work that tissue, right? How's that feel? Does that feel good? Yeah. Or does this feel better? No, it feels good. It feels better this way? Yeah. Yeah. Alright. So, all I'm doing is I'm running my fingers across. It's a tricep fascia, right? It's a skin. But guess what's under here as well?
Her wrist extensors. So her wrist extensors are, right there, [00:05:00] right there, right, right there. Yeah, so her wrist extensors are shortest in supination, wrist extension, right, with the elbow extended. So all you have to do is you have to find, you could find that, um, find the olecranon. And you go just two to three fingers below that.
And if you take your finger and you roll it laterally, And you see how I'm taking the wrist, it's elbow is in a little bit of flexion. And then what I'm doing is when I move her arm, I am moving her arm into my finger instead of my finger into her arm. Feel that? You feel it? You guys see it? I'm taking her hand, so this is my movable hand, this is my stationary hand.[00:06:00]
And I'm pushing her into my finger. It's just easier. Now I could keep her here and then use my fingers to move, but sometimes that's more work for me. I don't like to work that hard. Right. I could do it. So it gives a break, right? The other way to shorten your extensors. is to put them into pronation, wrist extension, and elbow flexion.
And I could put that in a shortened position too. All I'm doing is I'm rolling my fingers. I grab it and I roll it. You feel it? Yeah. Right here, right? Relax. This is a manual stretch, right? So I can shorten it. I'm going to pull it short and then I can lengthen it. [00:07:00] Now
the funny thing with the wrist extensors is that in order to extend to really stretch it, you need to stabilize the humerus, pronate, extend, and stretch like this. And it's got to go into a stretch, into wrist flexion, it's also got to roll and deviate a little bit. And then you'll feel that. Or that stretch here.
You feel that? Yeah, I know, you're like, but wait. It feels tired. It feels tired, right? So guess what's there, right? Not only do you have your, your, um, wrist extensors, but you also have your radial nerve. So it is normal if you are tight when you stretch to feel a little fatigued. But what you don't want is the whole arm to feel really heavy.
If the arm is really heavy afterwards, you could be, um, The, the radial nerve runs [00:08:00] here and it just might be a little, can be a little irritated or a little stuck, right? Let me take a look. Um, you're, sorry, don't let me mess up your shoulder. No, it's fine. It's okay. So relax. Usually I have a towel right here.
Um, it's alright. No, it's okay, it's okay. So she's tight in external rotation and internal rotation, right? Yeah, remember I had this surgery I know, you shouldn't be tight. I know, I work hard. You're, you're, uh, So, yeah, so, a lot of times if someone cannot get end range motion, you're going to start to see it down their arm.
Relax for a second. She's lacking, um, forward flexion. So, I can stabilize her and see that she's lacking it, yeah? Now, if I let her go it looks like she's getting more, but look at what's happening here. Which is compensating, [00:09:00] right? So, um, in terms of the forearm, right? One of the things that I do to get better supination, let's say someone doesn't have supination, I will, um, wrap my hand all around, and I will roll out, right?
And that is a manual technique. You can roll this. You feel that? Does it feel good? So I can work in this direction, or I can work in this direction. Which direction feels better? This one feels better? Okay, so, yeah. So you see? So, I'm just gonna, so a lot of times I might use a little bit of cream, right? I'm just gonna roll.
The skin, the fascia. I'm affecting the muscles. My thumb is down here. So I'm, I'm hitting the wrist flexors, my fingers up here, and I am [00:10:00] affecting the wrist extensors. All right. Does that hurt? The stretching, feel the stretching. No, but does it hurt? No, just feel it. Is that too much? It's a little bit chocky.
Yeah, so maybe that's better. The other one is easier. Yeah, right. So, you gotta pay attention to your patient, because they sometimes think pain is better, but it's not. Alright? So then I'm gonna go back to doing this. And it's like a, you know, remember the Indian rug burn when you were little? That's exactly what this is.
So you're giving a certain amount of pressure and then you're sort of slowly letting go. So your pressure is gradual, right? Your pressure is gradual. Now this is a fully, completely passive, right? Now, you can do [00:11:00] manual with movement. So I'm going to twist her arm this way and you're going to turn your arm this way.
This way, right? Turn and turn palm down. How's that feel? How does that feel? Okay, now we're going to go in the opposite direction. Um, I'm going to twist you this way. I'm going to twist you this way. And nope. And then you're going to turn like this. And then you're going to turn your palm down. Turn your palm down.
Turn your palm down. Which direction feels better? This one. This one? Okay. So turn your palm up. So she's going to start in supination. And then I'm going to turn her like this. Now turn your palm down. That one feels better. Or, palms down. I'm going to roll her the other way. And she's going to turn her palms up.
Which direction feels better? The first one. Yeah, there you go. So we can do it this way. Right, we can do it. And if you see, like she's tight right [00:12:00] here. You can see the line. Cool. of the skin and the fascia. It's like a little tight there. That feels good. And you could take it from here and move incrementally down and it helps to loosen up someone who's really tight forearm wise and you'll be surprised.
It'll loosen up their wrists. So it feel looser. Yeah. So then I'm going to check back to this. Oh yeah, this feels looser. It was like a rod down here. Let me check here. Does this feel looser? Yeah, it felt looser, right? Alright, relax.
It helped your shoulder, didn't it? A little bit. Alright.
