Cyriax Release (Seated)
Assesses for thoracic outlet syndrome (TOS).
Indication:
Upper extremity numbness, tingling, weakness, and/or radiating pain
Technique:
Patient Position
Seated
Examiner Position
Standing behind the patient
Steps Of Performance
1. Examiner begins by grasping the patient’s forearms, just below the elbows, and flexing the elbows to 80°. The forearms, wrist, and hands are kept in a neutral position.
2. Examiner reclines the patient’s trunk posteriorly, 15°, and passively elevates the patient’s shoulder girdle through superiorly directed force at the elbows.
3. Passive should girdle elevation is held for thirty seconds to three minutes.
Alternative Methods:
Patient’s shoulder girdles may be held elevated by placing their forearms on padded armrests.
Mechanism:
Prolonged detension and decompression of the thoracic nerve plexus during the performance of Cyriax Release allows for restoration of neuronal blood flow, which can cause spontaneous firing of the previously ischemic sensory fibers. As these sensory fibers normalize their function, the patient my experiences symptoms such as numbness or paresthesia, otherwise known as a “release phenomenon.”
Interpretation:
Positives:
Paresthesias and/or numbness
Thoracic outlet syndrome (TOS)
Recreation of familiar symptoms
Thoracic outlet syndrome (TOS)
References:
Brismee J-M, Gilbert K, et al. Rate of false positive using the Cyriax release test for thoracic outlet syndrome in an asymptomatic population. JMPT 2004;12(2):73-81.
Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer PS Jr. Thoracic outlet syndrome: a controversial clinical condition. Part 1: anatomy, and clinical examination/diagnosis. J Man Manip Ther. 2010;18(2):74-83. doi:10.1179/106698110X12640740712734
Cyriax J. Textbook of Orthopedic Medicine: Volume 1, 8th edition. Philadelphia: Bailliere Tindall; 1982: 37-8.