James Cyriax (1904-1985) was born in London, England, the son of Edgar and Annyuta Kellgren, who were both physicians. Cyriax qualified to practice medicine in 1928 after attending University College School in Gonville, Caius College in Cambridge, and St. Thomas Medical College in London. He commenced his practice at St. Thomas Hospital in 1929. Early in his career, Cyriax observed that orthopaedic surgical diagnosis was based almost entirely upon palpation and radiographic findings that often proved to be fairly accurate. Conversely, the diagnosis of soft tissue lesions appeared to present a greater challenge to the physician. Cyriax concluded that the discipline of orthopaedic medicine lacked a well-developed system for diagnosis of such disorders as tendinosis, ligamentous sprains, and capsulitis. Over the subsequent 12 years, Cyriax developed a system of examination and intervention that was designed to address nonsurgical, soft tissue lesions.

In his private practice on Wimpole Street in London, Cyriax collaborated with physical therapists in the development of this new approach. From its inception, a major component of this approach was the concept of selective tissue tension (STT), which is designed to aid in the identification of specific soft tissue lesions. Cyriax's intervention approach focused primarily on the use of three types of nonsurgical procedures. These intervention procedures are manipulation (high-velocity thrust), and deep friction massage (DFM), traction, and injection. Cyriax believed that most, if not all, musculoskeletal impairments could be effectively managed through the use of one, or a combination, of these three procedures.