Wrist Instability Part I: Anatomy and Biomechanics

Presented by Mirka Normand

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The growing need for a more efficient health delivery model is driving a greater number of direct referrals from primary care physicians to certified hand therapists. For that reason, hand therapists must be prepared to perform in-depth evaluations of the wrist and determine if conservative management is warranted prior to seeking surgical consult. This course sets out to establish solid anatomical and biomechanical foundations necessary for a clear understanding of the wrist stability and movement.

This is Part I of a three-part series.

CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).
  • Wrist Instability Part I: Anatomy and Biomechanics (1.5 hours)
  • Wrist Instability Part II: Analysis of Movement and the Features of Instability (1.5 hours)
  • Wrist Instability Part III: Assessment and Special Tests (1.5 hours)


  • Meet your instructor

    Mirka Normand

    Ms. Normand graduated with a Bachelor of Science in Occupational Therapy from Laval University in Québec, Canada. She completed a Hand Therapy Fellowship with Baylor College of Medicine and Texas Woman's University in 1999, in Houston TX and was certified as a hand therapist that same year by the Hand Therapy Certification…

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    Chapters & learning objectives

    Carpal Anatomy

    1. Carpal Anatomy

    This chapter presents an overview of the bony and ligamentous structures of the carpus. Close attention is directed toward the architecture of the proximal and distal carpal rows as well as the resulting radiocarpal and midcarpal joints' arthrokinematics, followed by a detailed look at the ligamentous system and its specific characteristics.

    Distal Radioulnar Joint (DRUJ) Anatomy

    2. Distal Radioulnar Joint (DRUJ) Anatomy

    This chapter presents an overview of the bony and ligamentous structures of the distal radioulnar joint (DRUJ) as well as its extrinsic stabilizers. Analysis of the composition and dynamic functionality of the triangular fibrocartilage is included.

    Biomechanics

    3. Biomechanics

    This chapter explores the carpal kinematics, or how the wrist moves, through the observation of its four interdependent carpal elements and how they interact during motion. Additionally, the chapter will analyze the carpal kinetics, or how the wrist sustains load, including the multifaceted stabilizing mechanism that delivers the essential underpinning of wrist stability.