Modern Orthopaedic Manual Therapy - Musculoskeletal Medicine |

Modern Orthopaedic Manual Therapy - Musculoskeletal Medicine

Orthopaedic Medicine Cyriax : a bit "oldfashioned" or rather alive and kicking ?


Modern Orthopaedic Manual Therapy - Musculoskeletal Medicine deals with mechanical diagnosis and conservative treatment of soft tissue lesions of the locomotor system. The system of orthopaedic medicine that Dr. Cyriax described has been upgraded considerably and consists of two major elements : 

Achieving a useful diagnosis is our first goal

This can be obtained by means of a thorough interrogation of the patient, followed by an inspection, a functional or clinical examination and finally (if necessary) a palpation.

Local diagnostic infiltration, using a procaine solution, can also be very usefull from a differential diagnostic perspective. In the field of soft tissue lesions of the locomotor system there are several different ways to reach a diagnosis.

Several methods (e.g. Mulligan, McKenzie, Maitland...) use different examination approaches.

  • Is "the" diagnosis always reliable or is it just "wishful thinking" ? 
  • We constantly have to ask ourselves whether the way in which we reach a diagnosis can be trusted : are the questions we ask relevant ? 
  • Are the tests we carry out as objective as possible ? 
  • Do those examination procedures have a good inter-tester and intra-tester reliability ? 
  • Is there enough specificity, if possible ?
    When it comes to diagnosing a soft tissue lesion, then the updated orthopaedic medicine Cyriax method is a very usefull method which enables us to reach a relevant and objective diagnosis. It is also very compatible with e.g. the McKenzie approach ; treatment techniques don’t need to be used in isolation but, when indicated, combinations with some e.g. Maitland, Kaltenborn and Mulligan techniques are interesting.

Treatment strategy 

Once a diagnosis has been obtained we should look for, if possible, an efficient treatment strategy.

  • What could be an optimal treatment for this patient (taking into account the personality of the patient, type, duration and localization of the lesion) ? 
  • Within the updated Cyriax method, there are different treatment options : infiltration, injection, deep transverse massage or friction massage, manipulation (spine and extremities), mobilization and traction. This can easily be combined with self treatment elements and/or home exercise programs as well as techniques described by e.g. McKenzie, Maitland and Mulligan.

 ETGOM has incorporated some important updates into the Cyriax Continuing Education program :

Besides the regular modular courses which are offered world wide, we also offer the unique Master Mind Private Training in Orthopaedic Medicine, a exclusive course for 5 participants only.

The most recent scientific developments are incorporated into the training program ; participants always receive a powerpoint summary of the latest scientific references on certain topics .

The way in which the examination and treatment techniques are being taught and executed has changed a great deal : some techniques have been modified in order to become even more therapist and patient friendly. Other techniques have been abandonned in favour of more efficient ones ; sometimes, in specific situations, we advise to explore the symbiosis with other approaches.

Elements that ETGOM values a lot are : how can a therapist think as clinically as possible, how does he reach a diagnosis and how can he start a safe and comfortable treatment ? In order to help you achieving this goal, ETGOM has created standardized examination protocols for each joint, the "Cyriax Assessment Forms".

The updated Cyriax method represents an important and valueble starting point in the clinical reasoning process, always keeping in mind that investing in broad knowledge only offers advantages.

Flying above the clouds gives a wonderful free feeling, but, flying without knowing exactly how to run, could make the landing quite painful.  Have a safe flight and a good landing, invest in Modern Orthopaedic Medicine Cyriax.

Me and my team go for YOUR success in orthopaedic medicine !

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