Instructional Concurrent Session IV
Pain Guided Fracture Management: Driving Your Practice with Clinical Reasoning
This session is a clinical discussion on pain guided, early protected movement in K-wired fractures of the hand. Early protected movement, guided by pain, can decrease healing time and stiffness in our patient’s hands, just as it does with flexor tendon injuries. It can allow our patients to resume their everyday activities sooner. Use of wide-awake K-wire fixation guided by a fluoroscopy has allowed us to push the boundaries of how we can treat our hand fracture cases. Being able to see full range of motion with stable fracture fixation during surgery allows surgeon sand therapists to develop an individualized treatment plan using early, protected movement guided by pain on the day of the patient’s surgery.
- A brief review of the existing literature for the use of early protected movement in K-wired hand fractures.
- Explanation of how using wide awake hand surgery has helped to push the boundaries of early protected movement in finger fractures to create individual treatment programs, using clinical reasoning to treat our patients guided by their pain.
- Explanation of how to set your patient’s up to have success using pain guided early controlled active movement as a post-op tool (ie: get off all pain medication, learn to “listen to their pain”)
- Clinical case examples of how pain guided, early protected movement has been used to treat our clients with K-wired finger fractures.
Therapeutic Neuroscience Education and Conservative Management of Lateral Elbow Tendinopathy
The purpose of my course is to inform therapists on evidence-based practices in the management of lateral elbow tendonosis (LET). The course will educate therapists in the use of evdence-based interventions in managing chronic elbow pain by combining exercise and neuroscience education to improve clinical outcomes. It is the aim of my course to educate therapists on the management of LET when it is considered a chronic condition, and to advocate for the use of neuroscience education as a therapeutic intervention when combined with traditional intervention strategies. The instructional level of the course is appropriate for beginner, intermediate and advanced practitioners.
- Interpret the latest research on effective management of elbow tendinopathy.
- Utilize proper treatment strategies to improve functional outcomes of patients with elbow tendinopathy.
- Utilize clinical knowledge of pain education in the management of elbow tendinopathy.
Thumb Instability Evaluation and Treatment
Learners will develop an understanding of the anatomy of the thumb including bony, ligamentous and muscular structures and how they contribute to thumb stability. Clinical examination of the thumb will be covered. Treatment techniques including manual therapy, therapeutic exercise and orthosis fabrication will be addressed based on the latest evidence.
- Learners will be able to describe the unique anatomy of the thumb and how it contributes to stability/instability
- Learners will interpret the evaluation findings and select the best treatment option based on the current literature.
- Learners will identify common patterns of thumb instability
“Look Up!” Are Proximal Problems Causing Distal Symptoms?
As hand therapists, we are most comfortable addressing distal symptoms through comprehensive assessment and treatment focusing on this area. However, proximal dysfunction may contribute to stubborn distal symptoms and loss of function. This session will provide a systematic and comprehensive approach to screening, assessment and therapeutic treatment of common upper extremity conditions working from proximal to distal to address potential instability, weakness, compression, radiculopathy or tension present in the upper extremity. Attendees will learn/review functional anatomy, surface palpation, effective cervical screens, neural tension testing, biomechanics and posture assessment. The session will then expand attendees’ knowledge on a variety of intervention approaches to include the proximal upper extremity when addressing distal diagnoses. Attendees will leave this session with an increased competence to address and treat the proximal upper extremity’s contribution to distal symptoms.
- Identify and palpate muscular and skeletal anatomy that is important to providing proximal stability for distal UE mobility and function on self or a partner.
- Recognize common proximal musculoskeletal and nerve dysfunctions and their contributions to distal UE performance and function.
- Identify onset of cervical spine symptoms that warrant radiology or further precaution
- Identify basic cervical screens and tests to differentiate cervical radiculopathy diagnosis from upper extremity conditions.
- Recognize treatment interventions to help restore function of the proximal UE and truck to support distal UE performance and function.