Cyriax had a straightforward opinion about treating orthopae- empirical way by Cyriax.3 The concept of osteopathy was introduced by A. T. Still. This concept can aid in diagnosis. The mechanism by which Cyriax believed a high-velocity thrust technique to be effective relates to the ability of these. In the Cyriax concept, referred pain obeys certain rules. The inadequacy in the sensory cortex is structural and therefore can easily be.

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Capsular and Noncapsular Patterns

Distinctive feature of the Cyriax method is the capsular pattern. Knowledge of the capsular pattern improves diagnostic abilities. A capsular pattern refers to a particular sequence of passive limitation of motion in a joint controlled by muscles; this pattern affects the whole joint.

Each joint has its own distinctive capsular pattern. Either pattern will be consistent on repeated exam from one day to the next.

James Cyriax – Wikipedia

Even acute conditions affecting only the synovium cause a capsular limitation of motion because of the muscular spasm protecting the capsule. When the entire capsule is shortened or inflamed, or if the synovial membrane lining the capsule by itself is inflamed, as in an acute sprain, passive testing of the joint demonstrates a proportional limitation of motion for that particular joint. Capsular pattern has proven to be extremely useful in determining probable arthritis and capsular involvement.

Capsular pattern Cervical spine Equal limitation of extension, both side flexions and both rotations. Flexion is the best movement. Capsular pattern Shoulder Limitation of abduction, more limitation of lateral rotation, less limitation of medial rotation. Capsular pattern Lower radio-ulnar joint Pain on passive pro- and supination, no limitation.


Capsular pattern Trapezio-first metacarpal joint Limitation of abduction and extension, no limitation of flexion. Capsular pattern Hip Gross limitation of medial rotation and abduction ; flexion more limited than extension. Capsular pattern Talocalcanean joint Increasing limitation of varus, in the end fixation in full valgus.

Capsular pattern First metatarsophalangeal joint Limitation of plantiflexion with more limitation of dorsiflexion. Capsular pattern II-V metatarsophalangeal joints Variable.

Orthopaedic Medicine Cyriax, Part I |

Fixation in extension with flexed IP-joints. As a young doctor he observed that his teachers could not delineate how they arrived at a musculoskeletal diagnosis nor specify what the problems were. He proceeded to develop a series of simple objective clinical exams that would effectively diagnose soft tissue musculoskeletal lesions.

His collected results, after many years of trial and error, coalesced into a set of systematic simple clinical exams for each joint and a treatment system for the soft tissue lesions around each joint. The basic principles of Orthopaedic Medicine are: Most sources of pain in the musculoskeletal system can be localized to a specific tissue. We look carefully in a systematic manner to isolate cyrix cause of pain, and then treat it specifically.

A specific diagnosis leads cyriwx successful treatment. In the Cyriax concept, referred pain obeys certain rules.

You are commenting using your WordPress. You are commenting using your Twitter account. You are commenting using your Facebook account. Notify me of new comments via email. The different capsular patterns Capsular pattern Jaw Increasing limitation of mouth opening. Capsular pattern Elbow Limitation of extension, more limitation of flexion. Capsular pattern Wrist Equal limitation of flexion and extension. Capsular pattern Thumb and finger joints Flexion more limited than extension.


Capsular pattern Thoracic spine Equal limitation of both rotations. Capsular pattern Lumbar spine Equal limitation of extension and both side flexions. Capsular pattern Knee Limitation of extension, more limitation of flexion. Capsular pattern Ankle joint Ckncept of dorsiflexion, more limitation of plantiflexion. The pillars of his system are: Examination by selective tissue tension. Isometric contractions test the function of the contractile tissues Passive movements test the function of the inert structures Capsular patterns differentiate between joint conditions and other inert structure lesions.

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