Still Technique & Integrative OMT
Comprehensive OMT reference hub, interactive cheat sheets, and board review notes for COMLEX Level 1, 2-CE, and 3.
Key Takeaway
Still Technique (developed by Dr. Andrew Taylor Still) is a PASSIVE modality that STARTS INDIRECT (placed in ease) and ENDS DIRECT (smoothly arced through the restrictive barrier into freedom) while maintaining a continuous vector force (compression or traction).
Still Technique Mechanics
Still Technique is unique because it transitions from indirect to direct during execution. The tissue is initially unloaded in its position of ease, a vector force is introduced to quiet hyperactive proprioceptors, and the joint is smoothly guided through its restrictive barrier.
| Step Phase | Action Taken | Biomechanical Rationale |
|---|---|---|
| 1. Assessment | Evaluate somatic dysfunction (TART criteria & motion barriers). | Identifies both direction of ease and restrictive barrier. |
| 2. Indirect Placement | Place segment into position of maximum EASE in 3 planes. | Unloads hyperactive muscle spindle afferents. |
| 3. Vector Force Application | Apply axial compression or traction (approx 5-10 lbs force). | Establishes a lever vector that runs straight through the affected joint. |
| 4. Arc Through Barrier | Smoothly sweep segment through barrier into FREEDOM. | Resets joint mechanoreceptors as tissue is taken through barrier. |
| 5. Release & Retest | Release vector force, passively return to neutral, re-evaluate. | Verifies restoration of symmetrical motion. |
Comparing FPR vs. Still Technique
| Feature | Facilitated Positional Release (FPR) | Still Technique |
|---|---|---|
| Starting Position | INDIRECT (Position of ease after flattening curve). | INDIRECT (Position of ease). |
| Ending Position | NEUTRAL (Returns passively after hold). | DIRECT (Arced completely THROUGH restrictive barrier). |
| Vector Force | Compression or Traction added at start. | Compression or Traction added at start and maintained during arc. |
| Hold Time | 3 to 5 SECONDS hold. | NO HOLD — continuous fluid motion through barrier. |
High-Yield Board Traps & Practice Drills
Q: Does Still Technique start direct or indirect?
A: Still Technique STARTS INDIRECT (in ease) and ENDS DIRECT (arced through the barrier).
Q: Is there a 90-second or 5-second hold in Still Technique?
A: NO HOLD. Still Technique is a continuous, smooth arcing motion through the barrier while maintaining the vector force.
Source
Based on the publicly available table of contents and topic organization of OMM Review: A Comprehensive Review of Osteopathic Medicine. All notes are original; no copyrighted text, figures, or full source material is included.