Conservative Management of TFCC Injuries

Conservative Management of TFCC Injuries

Presented by Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

Course description:

This 4-hour webinar will explore the clinical problem-solving involved with evaluating a patient with complaints of ulnar wrist pain and determining the optimal plan of care. Many TFCC injuries are a result of distal radius fractures. This course covers both the problem-solving when patients present with forearm rotation limitations as well as for those with isolated TFCC injuries without a limit in motion. Sharpen your skills with clinical testing and treatment for the ulnar side of the wrist!

Contact Hours: 4 (CBOT approved)

Registration: NOT AVAILABLE

For any inquiries about CE certificates, please e-mail [email protected].


  1. Integrate knowledge of the biomechanics of the forearm and the TFCC to apply to rehab principles with conservative management.
  2. Through the use of surface anatomy, distinguish key bony and soft tissue structures at the wrist needed for testing of ulnar wrist instability.
  3. Prioritize impairments from the clinical exam and special tests to determine to optimal plan of care.
  4. Apply manual therapy techniques to address PRUJ and radial-sided wrist hypomobility, which can contribute to increased stress at the ulnar side of the wrist.
  5. Select specific rehab strategies to use for a TFCC injury using the proprioceptive rehab model.

Course outline:

  • Anatomy and kinesiology of the forearm, relationship between the TFCC and DRUJ
  • Bony surface anatomy of the wrist
  • Clinical exam of the ulnar wrist with special tests
  • Clinical problem-solving with forearm rotation limitations
  • Rebalancing the wrist using a manual therapy approach
  • Putting it all together: Progression of treatment with TFCC tears without a limitation using a proprioceptive rehab model

Presenter Bio:

Ann Porretto-Loehrke is a skilled clinician with a passion for teaching and clinical treatment of upper extremity disorders. She has been practicing for 28 years and teaching continuing education courses for the past 18. She is 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) for treatment of the upper quadrant through the International Academy of Orthopedic Medicine (IAOM). Ann received a bachelor’s degree in physical therapy from Marquette University in 1994 and completed a post-professional Doctorate in Physical Therapy (DPT) degree from Drexel University with a specialty in hand and upper quarter rehabilitation in 2007. She is also certified in dry needling through Myopain Seminars, as a Certified Myofascial Trigger Point Therapist (CMTPT). Ann is a lead instructor who co-developed the Hand & Upper Extremity Track through IAOM, a set of 6 manual therapy courses designed specifically for hand and upper extremity specialists. She co-authored a chapter in Rehabilitation of the Hand & Upper Extremity on nerve compression syndromes of the elbow and forearm, as well as published two peer-reviewed articles entitled “Clinical Manual Assessment of the Wrist” and “Taping Techniques for the Wrist” in the 2016 Journal of Hand Therapy’s special edition of the wrist. Ann serves as the planning committee chair for the Wisconsin Hand Experience conference and has presented at American Society of Hand Therapists (ASHT) annual conferences, Canadian Society of Hand Therapist Annual Conference, Philadelphia meeting, TRIA Hand Conference, and Teton Hand Conferences. She also teaches online courses for MedBridge education.

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