CMC 1 Pivot Manipulation

Position of the therapist:

• Standing at the long edge of the bench on the side to be treated
• Facing in caudal direction

Position of the patient:

• Supine lying position

Hand placement:

• Therapist grabs the patient’s thumb with the ipsilateral hand
• Top of therapist’s thumb rests on the 1st metacarpal close to the joint line
• Hypothenar of the other hand is placed on top of therapist’s thumb
• Patient’s arm is lifted off the bench to create traction
• Patient’s wrist placed into radial deviation and extension and the thumb into submaximal extension and abduction

Direction of the manipulation:

• Palmar