Module: Masterclasses

Elbow, Forearm, wrist and hand


When symptoms are produced from movement impairments in the elbow, forearm, wrist and hand, consistent patterns of altered motor recruitment are evident. These recruitment patterns present as aberrant recruitment synergies between the global stability and mobility muscles and motor control inhibition of local muscle function. This course details the evaluation of recruitment in the elbow, forearm and hand, the diagnosis of movement control impairments and retraining options for regaining control.

Course Outline

This two-day course reviews the functional anatomy and classification of elbow, wrist and hand musculature.  Local and global movement control systems have been identified for the elbow, forearm and hand.  Movement impairments that result in the development of elbow, forearm and wrist symptoms are discussed.  Based upon a systematic assessment of movement impairments, an integrated management approach is presented.  Specific tests of movement control function have been developed for mechanical musculoskeletal presentations of the elbow, forearm and hand along with strategies for both local and global system retraining and integration into function.  Analysis of movement control dysfunction is used to help highlight the involvement of proximal problems in elbow, forearm and hand symptoms.  
This course is orientated to a ‘hands on’ practical application movement control assessment and retraining using patient examples where possible.


Key Features

  • Elbow, wrist and hand function analysed from the perspective of restriction and compensation developing into uncontrolled movement
  • The development of patient specific retraining programmes to regain functional movement control of the elbow, wrist and hand based on a clinical reasoning framework


Learning Outcomes

At the end of this course the student should be able to:

  • Understand the development of movement control impairments
  • Analyse the inter-relationship between restriction and compensation in articular and myofascial tissues
  • Classify muscles roles based on function & dysfunction
  • Clinically assess motor control strategies at the elbow wrist and hand to identify and diagnose the uncontrolled movement
  • Identify and correct muscle specific imbalance in stabiliser - mobiliser function of the arm
  • Implement a retraining strategy based on a clinical reasoning process


Programme Outline

  • Review: Understanding Movement & Function - Concepts
  • Elbow, Forearm and Wrist Anatomy and Function:
  • Functional muscle classification 
Arm Global Control System – control of direction
  • Assess the site and direction of uncontrolled movement in the Elbow, Forearm, Wrist and Hand
  • Diagnose the type of arm movement control impairments based on the direction of uncontrolled movement and their relationship to pathology and symptoms
  • Re-train the active control the impairment and consider restrictions.
Arm Local Control System – control of translation
  • Assessment and Re-training of Local Stability System in the Neutral Position:
  • Positioning elbow, forearm, wrist and hand neutral
  • Assessment of the control function of the arm local stabilisers
  • Retraining low threshold recruitment of local stability system
Arm Global Control System – muscle specific retraining
  • Assessment and Correction of Global Stability System Imbalance between the Stabiliser and Mobiliser Synergists
  • Assessment of the ability of the global stabilisers to actively shorten and control limb load through the full available range of joint motion
  • Rehabilitation and progression of the stability role of the global stabilisers to control movement      throughout functional range
  • Assessment of the length and dominance of the global mobilisers and associated connective tissues
  • Lengthen and Inhibit Overactivity in the Dominant Global Mobilisers
Functional Integration of Rehabilitation Strategies
  • Integration and progression of local and global stability retraining into contemporary clinical frameworks


Course Highlights

  • Functional assessment of the elbow forearm and hand
  • Linking symptoms and uncontrolled movement
  • Movement and muscle specific retraining programme



'A new look at control symptoms in the arm'


Kinetic Control courses are designed for medical health professionals such as physiotherapists, osteopaths, chiropractors, podiatrists etc registered with the HPC. In exceptional circumstances experienced non medical health professionals may be allowed to attend Kinetic Control courses but these participants MUST be able demonstrate that the course material is within their scope of practice and that they have appropriate professional liability insurance to cover them for their attendance at the course and the course content.

This course has both theortical and practical elements. Please come prepared for the practical work.