What is the first step in the carpal LVHA technique described for targeting the radiocarpal joint?

• A. Position the Wrist in Extreme Flexion
• B. Place Palms Over the Dorsal Surface and Squeeze
• C. Grasp the Hand with Both Hands, Placing Palms Over Anterior and Posterior Surfaces of the Radiocarpal Joint
• D. Interlock Fingers and Apply Compression

Answer: (C)

The first move is to grasp the hand with both hands, placing the palms over the anterior and posterior surfaces of the radiocarpal joint. This dual-surface contact creates a stable grip and precise control of the joint, which is essential before any LVHA thrust or oscillation is applied. By covering both sides, you stabilize the carpal bones relative to the radius, establish a clear alignment, and have solid fulcrums to direct the mobilization safely and accurately. Starting with only a dorsal surface contact or with extreme flexion would reduce control and increase the risk of slips or misdirection, and interlocking fingers changes the compression pattern rather than establishing that initial stable joint contact.