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  • We’ve seen lots of hype about Blood Flow Restriction, or BFRin social media, but how does it work? Join us as Jim Wagner, seasoned handtherapist and powerlifter as he brings to light the physiologic benefits of BFRand how this can be incorporated into your hand therapy practice!

    Jim Wagner has been practicing for 30 years with clinicalexperience of the UE in orthopedics. He received his post professional doctorate from Rocky Mountain University of Health in hand therapy. He’s certified in PAMs and is a Certified Strength and Conditioning Specialist (CSCS). He’s a team leader at Guthrie Hand Center in New York state and serves as an adjunct professor at both Keuka and Ithaca College OT programs. He's beeninvolved in competitive powerlifting and bodybuilding for 35 years. He’s nationally known for instructing cupping, IASTM, orthotic fabrication, blood flow restriction and kinesiology taping. Jim has spoken at Georgia Hand Society Special Interest Group, Wisconsin Hand Experience, and many other therapyrelated venues. He’s published in the practice forum section of the AJOT and serves on the Education Division of the ASHT. Jim recently became a Certified Orthopedic Manual Therapist (COMT) through the International Academy of Orthopedic Medicine (IAOM-US).

    How to reach Jim:

    Email: [email protected]

    IG handle: cht_power71

    B Strong Blood Flow Restriction Training | BFR Bands | B Strong

    Products (bstrong.training)

  • Open wound? Don’t panic, Nora is here to help! Join us withNora Barrett discussing how to evaluate, cleanse, dress and document alldifferent types of wounds. Nora organizes all the products that she recommendsfor various types of wounds seen in a hand clinic. You will not be disappointedin the takeaways and clinic pearls after listening.

    Nora Barrett OTR/L, CHT, WCCgraduated from the Program in Occupational Therapy at Washington University inSt. Louis in 1997. She has been a practicing occupational therapist since 1998and a certified hand therapist since 2006. She spent her early career as aninpatient therapist at rehabilitation centers, acute care hospitals and burnunits in Boston, MA and Washington, DC before focusing in outpatient handtherapy in Washington, DC, Baltimore, MD and Bend, OR. Nora joined the HandTherapy Team at the University of Virginia Physicians Group in 2021 where sheworks in the Hand Center and in an outpatient hand therapy practice. Shereceived her Wound Care Certification in 2020 and is an active member of theAmerican Society of Hand Therapists (ASHT) and the American Association forHand Surgery (AAHS). Nora co-authored the Wound Classification and ManagementChapter in the 7th edition of Rehabilitation of the Hand and Upper Extremitytextbook and the Physiology of Wound Healing & Burns Chapter in the 4th Editionof ASHT’s Test Prep for the CHT exam.

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  • “The arm bone is connected to the wrist bone”….. come on now, we all know this song! Well, it’s a fact, everything is connected. Derek Clewley, DPT, PhD., not only details us through examination of an injury, he clues us in on treatment of the kinetic chain. Join us as we discuss looking proximal to the cervical spine when we are treating conservative lower arm issues such as ulnar wrist pain or lateral epicondylitis. Just imagine upping your game in the clinic treating proximally, how that will impact pain levels distally with minimal hands-on. We hope you enjoy this episode as much as we did!

    Dr. Clewley is a graduate of Shenandoah University with his DPT and a PhD. from Rocky Mountain University of Health Professionals. His area of expertise and training is in orthopedics and manual physical therapy. He achieved board certification in orthopedics and is recognized as a fellow of the American Academy of Orthopaedic Manual Physical Therapists.

    His PhD is primarily in research interests including dry needling, manual physical therapy, and pain sciences. Dr. Clewley has extensive experience in the development of continuing education, residency, and fellowship post-graduate training programs.

    He is the associate editor of BMC Musculoskeletal Disorders and a AAOMPT Board Member.

    He’s published in 44 articles and has received several Merritt Awards and Clinical Instructor of the year awards.

  • Stuck on you! Have you ever used Kinesiotape before? Wheredid you put it and for what purpose? Did you know there’s different degrees oftension when applying the tape? Well, all these are questions you may not havethought of when using Kinesiotape. Listen up, we have all these ponderingthoughts answered in this podcast. Teresa Casagrande, PT, CHTfrom Sturgeon Bay, WI energetically greets us to discuss various kinds of tapeand purposes of each brand of tape. She details out numerous diagnoses, tensionand length of time Kinesiotape should be applied. Hope you enjoy our 30thepisode brought to you by Hand to Shoulder Center of Wisconsin-Appleton!

    Teri Casagranda earned her Master of Science in PhysicalTherapy at the University of North Florida in Jacksonville and Doctor ofPhysical Therapy degree from Boston University. She became a CertifiedHand Therapist in 2007, Certified Kinesio Taping Practitioner in 2011 andCertified Kinesio Taping Instructor in 2017. She worked at the Hand toShoulder Center of Wisconsin from 2002 until 2013, when she moved to SturgeonBay and is currently employed as a Casual Call therapist for Door CountyMedical Center.

    Karwacińska, J., Kiebzak, W., Stepanek-Finda, B., Kowalski, I. M., Protasiewicz-Fałdowska, H., Trybulski, R., & Starczyńska, M. (2012). Effectiveness of kinesio taping on hypertrophic scars, keloids and Scar Contractures. Polish Annals of Medicine, 19(1), 50–57. https://doi.org/10.1016/j.poamed.2012.04.010

    Klein, H., Brockmann, R., & Assmann, A. (2015). Pain-diminishing effect of Kinesio taping in patients after sternotomy. Journal of Cardiothoracic Surgery, 10(S1). https://doi.org/10.1186/1749-8090-10-s1-a76

  • Motor Neuron Deficits: Lesions leading to lost function! Join Hand to Shoulder with Cassie and Shelly as we dissemble motor neurons and variations of symptoms, which in turn, lead to ALS. This very energetic podcast with Cynthia Ivy out of Phoenix, AZ, will open your mind to neurological deficits and the role of a hand therapist with someone who presents with hand or upper limb weakness. We hope you gather several takeaways from this complex topic.



    Cindy Ivy OTD, M.Ed., CHT began working as adjunct faculty at NAU, Phoenix Biomedical Campus in 2014 and joined the faculty in August of 2015 as Associate Clinical Professor and Residency coordinator. She is studying the effects of carpometacarpal stabilization exercises on pain from osteoarthritis of the first carpometacarpal joint. Her research interests also include studying functional outcomes of the use of finger orthoses versus injection for stenosing tenosynovitis (trigger finger) and studying quality of life and positive effects on function and independence in persons with Amyotrophic Lateral Sclerosis (ALS). In addition to ALS, She is also studying interventions to improve independence in people with Parkinson's Disease.
    Dr. Ivy carries a bachelor’s degree in occupational therapy from the University of Wisconsin, Madison and a Master’s of Education in Counseling Psychology from Northern Arizona University. Her post professional clinical doctorate in occupational therapy, Hand therapy emphasis is from Rocky Mountain University of Health Professions.
    Cindy Ivy has a passion for teaching and has taught in many capacities over the past 30 years while working as a hand therapist and occupational therapist



    Susan M Smith, C. C. (2015). Upper Extremity orthoses use in amyotrophic lateral sclerosis/motor neuron disease: A systematic review. International Journal of Physical Medicine and Rehabilitation, 03(02). https://doi.org/10.4172/2329-9096.1000264


    Ivy, C. C., Smith, S. M., & Materi, M. M. (2014). Upper Extremity orthoses use in amyotrophic lateral sclerosis/motor neuron disease: Three case reports. HAND, 9(4), 543–550. https://doi.org/10.1007/s11552-014-9626-x








  • Is your wing broken? How much do you know about shoulder surgeries involving the GHJ and surrounding soft tissue? Well, here is an episode for you. Join Cassie Schuh and Shelly Somers as they dissect shoulder surgeries with Dr. Shawn Hennigan, where together, they discuss procedures, immobilization time and rehab. Learn cutting edge surgery techniques that are completed for capsular, noncapsular, tendonous, ligamentous, and bony issues of the shoulder.  You won’t be disappointed!
    Dr. Shawn Hennigan, M.D. is a board-certified orthopedic surgeon, with a subspecialty focus on shoulder and elbow surgery. As a subspecialist, he sees a large volume of problems ranging from relatively simple to very complex. He has a special interest in treatment of shoulder arthritis and rotator cuff injuries. Dr. Hennigan performs a high volume of total and reverse total shoulder replacement, rotator cuff repairs, as well as joint sparing salvage procedures for irreparable rotator cuff tears.
    Dr. Hennigan joined Hand to Shoulder Center of Wisconsin in 2020, but practiced most recently in Green Bay, WI. He is originally from Philadelphia, PA where he completed medical school at Temple University. He went onto complete his orthopedic surgery residency at Rush University in Chicago, IL. After his residency, Dr. Hennigan completed his fellowship in Shoulder and Elbow Surgery at University of Pennsylvania. Since completing his training in 2020, he has chosen to focus the scope of his surgical practice to caring for patients with shoulder and elbow problems.

  • In this episode Shelly and Steve are joined by Theresa Parry OTR, CHT, COMT to discuss common wrist pain exercises found on YouTube. The five most common exercises are discussed. Are these exercises appropriate? When should they be given out? What considerations need to be made before prescribing these exercises? What modifications could be made? It is all here in this episode!

  • My pollex is not cooperating! Have you noticed when treating CMC arthritis or LRTI/arthroplasty patient’s that they just can’t control both MP and IPJs when it comes to motion or strengthening? Well, their stability and neuromotor control has gone haywire with poor pinching habits over the years. Tune in with Virginia O’Brien from Madison, WI to listen how to tease out these control patterns via evaluation and treatment techniques, to improve neuromotor control and stability. Hang tight with us till the end for splinting recommendations.
    Virginia O’Brien is a graduate of the University of Wisconsin-Madison and Rocky Mountain University of Health Professions (Provo, Utah), Virginia became interested in hand architecture during her fieldwork days. She is actively involved in clinical and biomechanical research of the thumb and the wrist, is a member of the AOTA Evidence Exchange committee and a member of the ASHT Research Committee, is a published author in the Journal of Hand Therapy (JHT), a contributing editor for the Yearbook of Hand and Upper Limb Surgery since 2012 and is a reviewer for JHT and Journal of Hand Surgery. Virginia owns her own business, O'Brien Upper Limb Consulting LLC. She recently moved back to Madison, WI from the Twin Cities, where she is consulting with local hospitals in Madison and coordinating internships. She was a recent speaker at the October 2022 ASHT conference. She’s presented at a variety of hand related conferences to therapists and physicians locally, nationally, and internationally since 2005

    O'Brien, V. H., & Giveans, M. R. (2013). Effects of a dynamic stability approach in conservative intervention of the carpometacarpal joint of the thumb: A retrospective study. Journal of Hand Therapy, 26(1), 44–52. https://doi.org/10.1016/j.jht.2012.10.005

    Cantero-Téllez, R., Pérez-Cruzado, D., Villafañe, J. H., García-Orza, S., Naughton, N., & Valdes, K. (2022). The effect of proprioception training on pain intensity in thumb basal joint osteoarthritis: A randomized controlled trial. International Journal of Environmental Research and Public Health, 19(6), 3592. https://doi.org/10.3390/ijerph19063592


  • Take a look in the mirror! Have you ever used mirror box therapy to help restore normal movement patterns? Join us where we reunite with Miranda Materi OTD, OTR/L, CHT from Phoenix, AZ discuss how Mirror Box Therapy can help with many different diagnoses from amputations to CRPS and even just stiffness. Miranda dives into how Mirror Box Therapy can be built at home in a “do it yourself” fashion or references where to buy a Mirror Box Kit. Please refer below for newer research articles found to support use of Mirror Box Therapy with your hand patients!

    CRPS and Mirror Box

    G. Lorimer Moseley, Alberto Gallace, Charles Spence,
    Is mirror therapy all it is cracked up to be? Current evidence and future directions,
    PAIN,Volume 138, Issue 1,2008,Pages 7-10, ISSN 0304-3959 https://doi.org/10.1016/j.pain.2008.06.026.
    (https://www.sciencedirect.com/science/article/pii/S0304395908003710)

    Amputees and Mirror Box

    Timms, Jason, and Catherine Carus. "Mirror therapy for the alleviation of phantom limb pain following amputation: A literature review." International Journal of Therapy and Rehabilitation 22.3 (2015): 135-145.

    Stroke and Mirror Box

    Thieme H, Morkisch N, Mehrholz J, Pohl M, Behrens J, Borgetto B, Dohle C. Mirror therapy for improving motor function after stroke. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No.: CD008449. DOI: 10.1002/14651858.CD008449.pub3. Accessed 05 October 2022.

    Hand Trauma and Mirror Box

    Grünert-Plüss, Nicole, et al. "Mirror therapy in   hand rehabilitation: a review of the literature, the St Gallen protocol for   mirror therapy and evaluation of a case series of 52 patients." The   British Journal of Hand Therapy 13.1 (2008): 4-11.

  • The internet can be a great place to go when looking for exercises or information on treating patients. We have everything at our fingertips -  we are seeing more patients come to into the clinic with a self-prescribed home program they got from Youtube. Youtube can be an excellent resource for exercises and information. However, is it appropriate for everyone? Are the exercises addressing the impairments? The most important thing....is, is it patient specific? Cassie and Steve sit down with previous guest Andrew Walquist, as they discuss the most common exercises seen on Youtube for tennis and golfers elbow. They give their thoughts on these exercises and suggest what they might do or change. 

  • From your mouth to your feet, the hinge that feeds you and puts your socks on. What could go wrong and how to “fix it”.  Join Hand to Shoulder and Dr. Boyd Lumsden, M.D with Hand to Shoulder Center of Wisconsin to discuss several diagnoses of the elbow joint, a surgeon’s perspective and recommendations for therapy.
    Dr. Boyd C. Lumsden, M.D. is one of our very own skilled surgeons who joined Hand to Shoulder Center of Wisconsin in 2004. He is a board-certified orthopedic surgeon with a Subspecialty Certification in Surgery of the Hand. Dr. Lumsden provides complete comprehensive care to the upper extremity including the hand, wrist, elbow, and shoulder. He has a special interest in arthroscopic procedures involving the wrist, elbow, and shoulder.
    Dr. Lumsden is a Missouri native who attended Southeast Missouri State University where he received his Bachelor of Science degree. He completed his medical degree from Northwestern University Medical School where he was respectfully a part of the Alpha Omega Alpha Honor Society. His orthopedic surgery residency program took him to the University of South Alabama and the University of Wisconsin Hospitals and Clinics in Madison, WI. He holds a fellowship in Hand, Upper Extremity and Microvascular Surgery from Wake Forest University Baptist Medical Center in Winston-Salem, NC. In 2003 he was the recipient of the Leonard Marmour Surgical Arthritis Foundation Award.
    Boyd Lumsden, M.D. is married with two children. His outside interests include fly fishing, hunting, archery, snow skiing, and golf. He is also an active participant in many community events and holds a special association with the Mile of Music, a 4-day summer music festival in Appleton, WI.

  • Do you struggle prescribing exercises? Have that one patient who is not responding to the same exercise that helps every other patient? Have you ever thought about testing a one rep max as a part of some's rehab? In this episode Ryan and Steve are joined by Mark Gallant DPT, OCS, FAAOMPT to discuss progressions, dosage, and loading for exercises. Mark gives case examples with shoulder and elbow exercise progressions in this episode. 

    More about this episodes guest:

    Dr. Mark Gallant is a physical therapist, board-certified orthopedic specialist, Fellow of the American Academy of Manual Physical Therapist, and certified in dry needling in Richmond, VA. Mark received his Doctorate in Physical Therapy from Old Dominion in 2012 and Bachelor of Science from Virginia Tech in 2008 where he graduated summa cum laude. In 2017, Mark graduated from Evidence in Motion’s Orthopedic Residency program and passed his Orthopedic Specialist Exam. He immediately enrolled in Evidence in Motion’s manual therapy fellowship program which he completed in the fall of 2019.

    In addition to owning and operating Onward Richmond, Mark serves as a teaching assistant for the Institute of Clinical Excellence (ICE), where he travels the country teaching how to better manage neck and back pain, as well as advanced manual therapy courses, such as spinal manipulation. Mark has been thoroughly trained through ICE and has a unique treatment style, combining the use of skilled hands-on techniques, as well as progressive exercise, in order to help you achieve your goals and improve your overall well-being. Outside of the clinic, you can find Mark attending live music with his wife Liz and hanging with his dog Remus.

  • Have you ever gone to the internet to look for exercises to prescribe for your patients? Have you treated somebody who has come into the clinic and already has a self prescribed home program they got from Youtube? Youtube can be an excellent resource for exercises and information. However, is it appropriate for everyone? Are the exercises addressing the impairments? Steve sits down with previous guests Andrew Walquist and Chad Burnham, as they discuss the most common exercises seen on Youtube for shoulder pain. They give their thoughts on these exercises and suggestions as to what they might do or change. 

  • Where do you start when someone comes in with shoulder pain? Is it really the shoulder causing the pain? In this episode Ryan Holewinski, PT, DPT joins the show to co-host as we sit down and chat with Chad Burnham, DPT, FAFS, CSCS to discuss treating conservative shoulder pain. 

  • One LIMB at a time…..have you ever worked with a patient who is in need of a prosthetic? Today, Shelly Somers, PT, DPT, CHT, ATC, CMTPT, joins the podcast in a great conversation with Jennifer Peterson, MA, PT and Patrick Prigge, CP, FAAOP(D) from Arm Dynamics in Maple Grove, MN. We discuss the process of obtaining a prosthetic for an amputee and the proper steps needed to get him or her measured, fitted and trained with a new prosthetic. Join us as we break down these steps to restore function one limb at a time.

  • Have you ever treated someone with numbness and tingling and you couldn't quite figure it out or help them the way you wanted? Have you ever thought about starting your exam proximally? Oftentimes with nerve compression conditions, we see proximal involvement in addition to the distal presentation, which unlocks a whole new realm of treatment possibilities for positive outcomes. Join us on today's podcast as we learn about the symptoms, clinical examination, and rehabilitation of Thoracic Outlet Syndrome.

    Our Guest, Ann Porretto-Loehrke graduated with a BS in PT from Marquette University in 1994 and a post-professional DPT from Drexel University in 2007. She became a CHT in 2002 and earned a manual therapy certification in 2003. Ann has a passion for learning and clinical teaching and has been continuing education instructor for the 16 years. From her manual therapy training, Ann uses a systematic approach to evaluating and treating her patients, which is illustrated in the “Clinical Manual Assessment of the Wrist” published in the 2016 Special Edition on the Wrist in the Journal of Hand Therapy and Chapter 55: “Therapist Management of Compression Neuropathies of the Elbow” in the most recent edition of the Rehabilitation of the Hand and Upper Extremity, published in 2021. She has been practicing at the Hand to Shoulder Center of Wisconsin for the past 20 years.

  • Got a TWITCH...... Join us as we explore how a taut band trigger point forms, chemical breakdown and what occurs to the band as a muscle is dry needled. Jan Dommerholt, President of Myopain Seminars, interviews with us discussing logistics, principles and current concepts of dry needling. He answers important questions on this hot topic and when this treatment technique is a warranted adjunct and when it's contraindicated. See remaining show notes for current research articles Jan references in the interview

    Ball, A., Perreault, T., Fernández-de-las-Peñas, C., Agnone, M., & Spennato, J. (2022). Ultrasound confirmation of the multiple loci hypothesis of the myofascial trigger point and the diagnostic importance of specificity in the elicitation of the local twitch response. Diagnostics, 12(2), 321. https://doi.org/10.3390/diagnostics12020321
    Fernández-de-las-Peñas, C., & Dommerholt, J. (2017). International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: A delphi study. Pain Medicine, 19(1), 142–150. https://doi.org/10.1093/pm/pnx207
    Ghannadi, S., Shariat, A., Ansari, N. N., Tavakol, Z., Honarpishe, R., Dommerholt, J., Noormohammadpour, P., & Ingle, L. (2020). The effect of dry needling on lower limb dysfunction in poststroke survivors. Journal of Stroke and Cerebrovascular Diseases, 29(6), 104814. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104814
    Khalifeloo, M., Naghdi, S., Ansari, N. N., Dommerholt, J., & Sahraian, M. A. (2021). Dry needling for the treatment of muscle spasticity in a patient with multiple sclerosis: A case report. Physiotherapy Theory and Practice, 1–7. https://doi.org/10.1080/09593985.2021.1978118
    Pourahmadi, M., Dommerholt, J., Fernández-de-Las-Peñas, C., Koes, B. W., Mohseni-Bandpei, M. A., Mansournia, M. A., Delavari, S., Keshtkar, A., & Bahramian, M. (2021). Dry needling for the treatment of tension-type, cervicogenic, or migraine headaches: A systematic review and meta-analysis. Physical Therapy, 101(5). https://doi.org/10.1093/ptj/pzab068
    Voss, M. R., Donnay, R. L., & Homa, J. K. (2021). The effects of dry needling on the thumb: A case report. Hong Kong Journal of Occupational Therapy, 34(2), 132–136. https://doi.org/10.1177/15691861211043687

  • Hand to Shoulder Center sits down with Dr. Donald LaLonde from St. Petersburg, Nova Scotia, Canada where he describes the evolution of wide awake, local anesthesia, no tourniquet procedures, specific to flexor tendon repairs. Dr. LaLonde is a current practicing plastic surgeon who continues to develop new research and is an icon speaker internationally. He provides excellent clinical pearls for tendon healing and progression of tendon gliding with use of splinting. Tune in to listen to a great discussion with Dr. LaLonde. (Please excuse our audio on this specific podcast, we did our best during editing, however, Dr. LaLonde is hard to hear at times)

  • The rule of thumb…many have experienced the uncomfortable sensation of pain at the base of their thumb at some point in life, especially therapists! Let’s learn from Mirka Normand, out of Connecticut, to unpack the multitude of factors that lead to CMC arthritis. Learn how to address it from our evaluation strategies to treatment and splinting options.
    Mirka 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 Commission. She received her Advanced Master's degree with hand therapy emphasis in 2003 from Texas Woman's University. She was certified as an orthopedic manual therapist through The International Academy of Orthopedic Medicine-US (IAOM-US) in 2006, and soon after joined their faculty for the creation of a specialty Hand and Upper Extremity Track. Mirka works full time as a clinician for Yale New Haven Health System-L&M Hospital on the eastern coast of Connecticut, and lectures nationally for IAOM-US. She is known through Medbridge with instruction on the wrist. She recently submitted her synthesis for her PhD. And will be defending this in the near future, after many months in the lab and reading research. Congratulations to Mirka on these accomplishments.

    DeMott, L. (2017). Novel isometric exercises for the dynamic stability programs for thumb carpal metacarpal joint instability. Journal of Hand Therapy,  30, 372-375. http://dx.doi.org/10.1016/j.jht.2016.09.005

    Book:
    Albrecht, Jan OTR/L, CHT (2004). Caring for the Painful Thumb, More Than a Splint. 1st ed.  North Mankato, Minn. ISBN: 0-976117-0-X

  • Lateral elbow pain…..ughhh… the low back pain of the upper extremity. Jim Wagner, OTD, OTR/L, CHT, CPAM, CSCS from upstate New York, sits down with the Hand to Shoulder Center to discuss his approach to the lateral elbow. Jim provides a top down approach from the neck to the hips, how movement patterns from other areas of the body can cause lateral elbow pain. Clinical pearls for evaluation, treatment and splinting techniques discussed. Jim is not only entertaining, but full of energy that will keep you engaged. We promise you will enjoy this great discussion. Click to listen about different techniques to address lateral elbow pain.

    Jim Wagner has been practicing over 28 years with clinical experience of the UE in orthopedics. He received his post professional doctorate from Rocky Mountain University of Health in hand therapy. He’s certified in PAMs and is a CSCS. He’s a team leader at Guthrie Hand Center and an adjunct professor at both Keuka and Ithaca College OT programs. He's been involved in competitive powerlifting and bodybuilding for 35 years, participating in 28 competitions. He’s nationally known for instructing cupping, IASTM, orthotic fabrication, blood flow restriction and kinesiology taping. Jim has spoken at Georgia Hand Society Special Interest Group and many other therapy related venues. He’s published in the practice forum section of the AJOT and serves on the education division of the ASHT. He is listed on the docket to speak in Milwaukee for our very own Milwaukee Hand Experience in May of 2022.