Median Nerve

Patient Position and Procedure. Begin with the patient supine; sequentially apply shoulder girdle depression, then slightly abduct the shoulder, extend the elbow, laterally rotate the arm, and supinate the forearm. Wrist, finger, and thumb extensions are then added; finally, the shoulder is taken into greater abduction. The full stretch position includes contralateral cervical side flexion. While maintaining the stretch position, move one joint at a time a few degrees in and out of the stretch position, such as wrist extension and flexion or elbow flexion and extension.
This maneuver is beneficial when examining and treating symptoms related to median nerve distribution, problems with shoulder girdle depression (e.g., thoracic outlet syndrome), and carpal tunnel syndrome.

Radial Nerve

Patient Position and Procedure. Begin with the patient supine; sequentially apply shoulder girdle depression, then slightly abduct the shoulder, extend the elbow, then medially rotate the arm and pronate the forearm. Keep the elbow in extension and add wrist, finger, and thumb flexion, and finally ulnar deviation of the wrist. The full stretch position includes contralateral side flexion of the cervical spine. While maintaining the stretch position, move one joint at a time a few degrees in and out of the stretch position, such as wrist extension and flexion.
This maneuver is important when examining and treating symptoms that are related to shoulder girdle depression, radial nerve distribution, and disorders such as tennis elbow and deQuervain’s syndrome.7

Ulnar Nerve

Patient Position and Procedure. Begin with the patient supine. Sequentially apply wrist extension and forearm supination followed by elbow flexion (full range); then add shoulder girdle depression. Maintain this position and add shoulder lateral rotation and abduction. In the final position the patient’s hand is near his or her ear with fingers pointing posteriorly. In the full stretch position, contralateral side flexion of the cervical spine is added. While maintaining the overall stretch position, move one joint at a time a few degrees in and out of the stretch position, such as elbow extension and flexion.
This maneuver is important when symptoms are related to the C-8 and T-1 nerve roots, lower brachial plexus, ulnar nerve, and disorders such as medial epicondylitis.

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