Background: The etiology, management, and long-term outcome of Carpal Tunnel Syndrome (CTS) are frequently debated. Volar Dorsal Glide (VDG) of the carpus has been discussed infrequently in the literature and has never been addressed as a key component of normal carpal arthrokinematics. This study demonstrates that changes in VDG are consistent with PisoTriquetral Dysfunction (PTD) and Carpal Tunnel Syndrome (CTS). Methods: Carpal behavior during specified hand activities was studied with an image intensifier. Passive measurements registered VCT at rest determined by the point at which force displacement of the carpus reached mechanical null. DG was determined by the resistance incurred as the carpus glided dorsally a predetermined distance, registering the peak resistance of collective carpal ligament changes. Active measurements are the corresponding elevated VCTF in CTS that were obtained by measuring the force potential volar carpal translation in a static neutral carpal position. Results: Symptomatic patients diagnosed with CTS demonstrated excessive Volar Carpal Translation Force (VCTF) during hand opening and grasping, producing carpal shifting potential equivalent to 5-23 Kg. In asymptomatic people, a force potential shift of 2-3 Kg was demonstrated. Excessive VCTF, increased Volar Carpal Translation (VCT) and permissive Volar Glide (VG) of the carpus were present in all patients with a thorough diagnosis of CTS. Using the Diagnostic Instrument for Detection and Analysis of Carpal Tunnel Syndrome (DIDACTS), automated displacement of 7.62 mm Dorsal Glide (DG) of the carpus in CTS patients demonstrated 4.5-13.5 Kg. Repeated DG in CTS patients dramatically lowered DG values to levels found in asymptomatic controls of 2-4.5 Kg indicating the response of joint components to stabilizing forces. DIDACTS is an automated and programmable data logging system capable of extremely high resolution measurements of many features of VDG. Findings: Fluoroscan video visually documented the precise level of VCTF at the radial-lunate and the luno-capitate in a confirmed and recurrent CTS patient. An orthotic that simulated DG, visually improved PTD, stabilized excessive VG, facilitated carpal expansion and buffered VCTF. Conclusion: Stabilizing VDG as exemplified in a recurrent CTS hand promoted carpal expansion, carpal height, and pisiform excursion proximal and distal. Continued study of VDG may offer promising solutions.