How often do you regain digital motion only to be unable to maintain it? This course explores unique and effective treatment approaches for common finger stiffness problems based on accurate knowledge of anatomy and kinesiology.

A comprehensive review of digital anatomy and its kinesiology is followed by a hands-on lab to review accurate methodology for evaluating and quantifying interosseous tightness, the most common cause of digital stiffness. Further course dialogue includes the scientific basis for treating stiffness, the role of motor cortex remapping, and the rationale for digital edema reduction. The course centerpiece is introduction of a systematic method to determine the primary and secondary causes of stiffness allowing the therapist to establish a logical and sequential treatment approach. Introduction to the theory of CMMS (Casting Motion to Mobilize Stiffness-a treatment technique developed by Ms. Colditz) as well as innovative techniques for gaining active and passive joint motion and specific tendon glide at the site of adherence are incorporated. Discussion clarifies when CMMS versus other treatment methods are indicated. Innovative treatment techniques for interosseous and lumbrical muscle tightness as well as many other causes of digital stiffness will be presented. A hands-on plaster of Paris lab provides introductory skills in digital serial casting and application of the most common design of a CMMS cast. 

This course is for hand therapists who are familiar with mechanics of the hand but want to reduce digital stiffness with greater specificity and effectiveness. Be ready for this course to challenge some long-held assumptions with this innovative approach to stiffness, whether impending or chronic. After this course you will approach all hand patients differently. Visit HandLab.com for course objectives.
 

Experience Level - Intermediate/Advanced 

Course Objectives 

At the completion of this two-day course, the participant will be able to:

1. Recognize the detailed anatomy of the dorsal apparatus of the finger. 
2. Understand the biomechanics of normal and abnormal digital motion.
3. Understand how to differentially test interosseous and lumbrical tightness and how to elongate each muscle-tendon unit.
4. Probe long-held assumptions about the priority of first gaining MP flexion.
5. Discuss principles of mobilizing digital stiffness.
6. Consider the role of lymphatic recruitment in mobilizing the stiff hand.
7. Study the effect of cyclical active motion to mobilize stiff joints.
8. Discuss the importance of re-patterning the somatosensory cortex to retain gains made in joint motion.
9. Demonstrate application of a plaster of Paris CMMS cast and a digital serial cast.
10. Review a systematic method of evaluating digital stiffness
11. Experience the application of a digital serial cast and a CMMS cast 

Innovative Solutions For Digital Dilemmas (14 Contact Hours)