Wrist instability can be a difficult condition to treat.
Today’s episode covers the intricate mechanics of midcarpal instability and the two types of clinical presentations: midcarpal VISI (volar intercalated
segmental instability) and the less common midcarpal DISI (dorsal intercalated segmental instability). Clinical testing for each of these conditions will be covered as well as evidence-supported treatment interventions including
orthotic management, muscular engagement and the progression with proprioceptive training.

Ann Porretto-Loehrke is a skilled clinician with a passion
for teaching and clinical treatment of upper extremity disorders. She has been practicing for 30 years and teaching continuing education courses for the past 20. 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 and facilitated the development of the MedBridge CHT prep program launched in June of 2021.

Ann can be reached at:

Instagram: @anns_happy_hands 

Email: annshappyhands@gmail.com

Linked In: https://www.linkedin.com/in/ann-porretto-loehrke-dpt-cht-comt-cmtpt-1080b62a/