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Massage Today
March, 2001, Vol. 01, Issue 03

Pain and Injury Assessment

By Ben Benjamin, PhD

Resisted extension of the elbow. - Copyright – Stock Photo / Register Mark Resisted extension of the elbow. Question: True or False: The purpose of passive and resisted testing procedures in a clinical assessment is to isolate and discriminate one structure from another, to identify the source of pain.

Answer: True.

Passive and resisted testing procedures help the practitioner isolate, identify and discriminate one structure from another, so that the damaged structure can be separated from unaffected, healthy tissues:

  • Resisted tests primarily test muscles and tendons.
  • Passive tests primarily test structures that do not initiate movement.

Resisted tests are like isometric exercises; they test only muscles and their attached tendons.

When a tensile force is exerted, this places pressure on the muscle tendon unit being stressed.

Passive flexion of the elbow. - Copyright – Stock Photo / Register Mark
Passive flexion of the elbow.

Passive extension of the elbow. - Copyright – Stock Photo / Register Mark Passive extension of the elbow. Passive tests are used to assess passive structures, which do not by themselves cause movement. In a passive test, the practitioner moves the client's body while the client remains totally relaxed. Ligaments, bursas and joints are examples of passive structures that can be tested effectively by passive testing procedures.

For example, if the triceps muscle tendon unit is injured and painful, resisted extension of the elbow will cause pain, but passive movements will not. If the elbow joint is inflamed, passive flexion and passive extension of the elbow will be painful, but resisted tests will cause no pain at all.

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