Orthopedic special tests not of any value?

September 10, 2018

Orthopedic special tests (OST’s) may not be as valuable as we once thought. This provides some challenges as we advance in trying to find the most appropriate diagnosis, and thus treatment for a patient. This was recently illustrated in a study looking at MDT and OST in the shoulder ("Consistency of commonly used orthopedic special tests of the shoulder whenused with the McKenzie system of mechanical diagnosis and therapy" 2018).

Most of these clinicians (like myself) used these tests as baseline measures only, not to guide treatment. We, collectively, use symptomatic response obtained using the MDT (Mechanical Diagnosis and Therapy) assessment to guide our treatment. It has been shown that positive OST’s can often turn negative and stay negative after applying the correct exercise to the patient (in this example the shoulder) (Kidd 2013) so using it guide a treatment would be ineffective. I found this to be true as well with the shoulder patient I saw who had 4 weeks of pain resolve in essentially 72 hours (see attached paper).

Not all Physical Therapy is the same. Different training results in different approaches and this results in different outcomes. MDT is based on tissue loading and putting you the patient in charge of the treatment and recovery. That is both the beauty and simplicity of it. Learn more by visiting our office page at www.IPTalaska.com.


J. Kidd Treatment of shoulder pain utilizing mechanical diagnosis and therapy principles
J. Man. Manip. Ther., 21 (3) (2013), pp. 168-173

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