Thoracic Springing Test: Assessing Spinal Mobility

The Thoracic Springing Test, also known as Central PA (Postero-Anterior) Pressure, is a fundamental manual therapy assessment used to evaluate the stiffness and pain response of individual thoracic vertebrae.

[Image of Thoracic Springing Test procedure]

1. Purpose

The primary purpose of the Thoracic Springing Test (Central PA Pressure) is to **assess for joint mobility** (hypomobility/hypermobility) and **pain provocation** in the thoracic spine. It helps identify segmental dysfunction.

2. How to Perform

1. The patient is positioned in prone (lying on their stomach).
2. The examiner stands at the side of the patient.
3. The examiner places the pisiform or hypothenar eminence of their hand directly over the spinous process of the thoracic vertebra to be tested.
4. The examiner reinforces this hand with the other hand.
5. The examiner applies a gentle but firm anteriorly directed springing force (pushing straight down) on the spinous process.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive finding indicates dysfunction at that segment:

• Reproduction of the patient's familiar pain.
• A feeling of stiffness or resistance (hypomobility) compared to adjacent segments.
• Excessive movement (hypermobility), often accompanied by a feeling of instability.

Negative Sign (Test is NEGATIVE):
A negative test is a normal springy recoil end-feel with no pain reproduction.