What are the selective tissue tension tests used by physical therapists?

The selective tissue tension (STT) exam was designed by Dr. James Cyriax, an orthopedic surgeon who is often called the "father of orthopedics."

STT consists of range of motion (ROM), resistive tests, and palpation or feeling the tissues. ROM is both active (the patient moves the body part) and passive (the therapist moves the body part with the patient relaxed).

Each test looks at a specific part of the joint or soft tissues in and around the joint. Palpation is used to look for any signs of deformity or inflammation. When the patient has pain is an important part of the exam. Is it before movement? During movement? Or only after resistance is given to the movement?

Each bit of information helps the therapist identify where the problem is and how to treat it. The STT system is a logical way to assess large joints like the shoulder, hip, and knee. It can be used for other joints as well.

Reference: 

Nigel C. A. Hanchard, MSc, et al. Diagnosis of Shoulder Pain by History and Selective Tissue Tension: Agreement Between Assessors. In Journal of Orthopaedic & Sports Physical Therapy. March 2005. Vol. 35. No. 3. Pp. 147-153.

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