Tackling the Intricacies of the Thumb and Wrist: Keys to Evaluation and Treatment

Rochester, MN US
September 13, 2025 to September 14, 2025

Course Directors: Stephanie Kannas, OTD, OTR/L, CHT and Maggie Malecha, MS, OTR/L, CHT

September 13 - 14, 2025 - Mayo Clinic - Rochester, Minnesota

This is a Live (in-person) only course for Mayo Clinic Personnel

This course is designed for therapists wanting to further improve their skills in the evaluation and treatment of the thumb and wrist.  It provides updated research regarding the anatomy and biomechanics to perform a concise clinical examination, apply joint-specific techniques to address patient impairments to achieve optimal outcomes! Day one focuses on the thumb and radial column biomechanics to gain a thorough understanding of issues commonly seen in both the orthopedic and neurologic population. Day two promotes a better understanding of wrist instability: understanding the biomechanics of instability within the proximal row (dissociative instability) and between the rows (nondissociative instability). Therapists will perform a clinical manual assessment of the wrist including specific stability testing, joint mobilization techniques to address local limitations as well as treatment techniques to address pre-dynamic/occult wrist instability. This course is essential for therapists looking to deepen their experience with these diagnoses. Participants need to complete the MedBridge prerequisite courses two weeks prior to the start of the in-person course.

Target Audience

Occupational therapists, occupational therapy assistants, physical therapists, and physical therapist assistants.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Utilize a systematic approach to determine impairments at the thumb to develop an appropriate treatment plan.
  • Integrate occupation-based joint-specific treatment techniques to address a capsular pattern at the thumb CMC joint to improve functional performance in daily activities.
  • Demonstrate specific manual techniques to address issues at the radial column of the wrist, which can be involved with hypermobility at the thumb CMC joint.
  • Develop an understanding of when it is appropriate to perform joint mobilization techniques directly to the thumb CMC joint.
  • Become familiar with the latest research regarding the primary stabilizers of the thumb carpometacarpal (CMC) joint as well as muscular support to provide stability for patients to return to pinching tasks as needed to perform activities of daily living.
  • Explore carpal kinetics and kinematics to enhance understanding of carpal instability: Volar Intercalated Segmental Instability (VISI) and Dorsal Intercalated Segmental Instability (DISI) both within the proximal row (dissociative) and midcarpal joint (nondissociative).
  • Gain an understanding of various therapeutic techniques to address pre-dynamic/occult wrist instability for issues within the proximal row as well as midcarpal joint.
  • Create a treatment plan to optimize functional outcomes for VISIs and DISIs within the proximal row and at the midcarpal joint to facilitate the patient returning to previous occupations.

Attendance at any Mayo Clinic course does not indicate or guarantee competence or proficiency in the skills, knowledge or performance of any care or procedure(s) which may be discussed or taught in this course.

Course summary
Available credit: 
  • 13.50 AOTA Contact Hours
  • 13.50 PT
Event starts: 
09/13/2025 - 7:50pm
Event ends: 
09/14/2025 - 2:45pm

Saturday September 13, 2025

Time

Topic

7:30-7:50 am (CST)

Continental breakfast

7:50-8:00 am

Welcome to Day 1

8:00-10:00 am

Thumb: anatomy and kinesiology of the thumb and radial column

10:00-10:15 am

Break

10:15 -11:15 am

Surface anatomy of the thumb and radial column

11:15-12:00 pm

Clinical examination of the thumb

12:00-12:30 pm

Lunch

12:30-1:45 pm

Joint specific treatment for capsular pattern of the thumb CMC

1:45-2:30 pm

Thumb: joint specific treatment: addressing non-capsular pattern of the thumb: radial column techniques & orthotic considerations

2:30-2:45 pm

Break

2:45-3:15 pm

Complete radial column techniques & orthotic considerations

3:15-4:30 pm

Manual therapy techniques to address finger stiffness

4:30 pm

Adjourn

 

Sunday September 14, 2025

Time

Topic

7:30-7:50 am (CST)

Continental breakfast

7:50-8:00 am

Welcome to Day 2

8:00-10:00 am

Clinical manual assessment of the wrist, including stability testing

10:00-10:15 am

Break

10:15-12:00 pm

Joint-specific treatment to address a capsular pattern at the wrist: row techniques to improve flexion and extension at the radiocarpal joint (RCJ) and radial column techniques to improve midcarpal joint (MCJ) motion

12:00-12:30 pm

Lunch

12:30-1:15 pm

Treatment for scapholunate (SL) instability (predynamic dissociative DISI): protection, joint-specific techniques to address scaphoid-on-radius &trapezoid-on-scaphoid articulations, and muscles to engage with proprioceptive training

1:15-1:45 pm

Treatment for lunotriquetral (LT) instability (predynamic dissociative VISI): protection and muscles to engage

1:45-2:15 pm

Treatment for a midcarpal VISI (predynamic nondissociative VISI): protection and muscles to engage

2:15-2:30 pm

Treatment for midcarpal DISI (predynamic nondissociative DISI): protection and muscles

2:30-2:45 pm

Proprioceptive training: techniques to promote dynamic stability via conscious and unconscious stages of rehab

2:45 pm

Adjourn

 

Mayo Clinic
200 First Street SW
Siebens Building, Rooms 10-21 and 10-30
Rochester, MN 55905
United States

All travel and lodging expenses are the sole responsibility of the individual registrant.

Coure Director

Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT, is an accomplished clinician and educator specializing in upper extremity disorders. With 30 years of clinical experience and two decades of teaching continuing education courses, she currently serves as the Clinical Development Coordinator at the Hand to Shoulder Center in Appleton, Wisconsin. Ann is a certified hand therapist (CHT) and a certified orthopedic manual Therapist (COMT), recognized for her expertise in upper quadrant treatment through the International Academy of Orthopedic Medicine (IAOM). She earned her bachelor's degree in physical therapy from Marquette University in 1994 and later completed a post-professional Doctorate in Physical Therapy (DPT) from Drexel University in 2007, focusing on hand and upper quarter rehabilitation. In addition to her clinical work, Ann is a lead instructor and co-developer of the Hand & Upper Extremity Track through IAOM, which includes a comprehensive set of manual therapy courses tailored for specialists. She has co-authored a chapter in Rehabilitation of the Hand & Upper Extremity on nerve compression syndromes of the elbow and forearm, and has published notable peer-reviewed articles, including “Clinical Manual Assessment of the Wrist” and “Taping Techniques for the Wrist” in the 2016 Journal of Hand Therapy special edition. Ann has presented her work at prominent conferences such as the American Society of Hand Therapists (ASHT) annual meetings, Canadian Society of Hand Therapists Annual Conferences, and various regional hand conferences. She also teaches online courses for MedBridge Education and has played a significant role in developing MedBridge’s CHT prep program, contributing to the advancement of hand therapy education. She serves as the planning chair for the Wisconsin Hand Experience conference and co-hosts the Hand to Shoulder podcast.

Accreditation Statement
In support of improving patient care, Mayo Clinic College of Medicine and Science is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.



Credit Statement(s):

Physical Therapy
Sponsored by the Program in Physical Therapy, College of Medicine, Mayo Clinic. This course meets the criteria for up to 13.50 category I Continuing Education Units per Minnesota Physical Therapy Rules 5601.2400, 5601.2500.

Occupational Therapy
Mayo Clinic - Rochester Campus is an approved provider of continuing education by the American Occupational Therapy Association #5660. PD activity approval number 12661 . This live course offers 1.350 CEUs, and 13.50 contact hours, educational level, intermediate. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by the AOTA. At the conclusion of this conference, participants will be awarded a certificate for up to 14.25 contact hours or 1.425 AOTA CEUs.

For disclosure information regarding Mayo Clinic School of Continuous Professional Development accreditation review committee member(s) and staff, please go here to review disclosures.

Available Credit

  • 13.50 AOTA Contact Hours
  • 13.50 PT
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Course participants must complete the following learning modules in MedBridge (7.25 hours) prior to attending the course.

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