Neurodynamic/Neural Tension Testing

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Neurodynamic/Neural Tension Testing:

Indicated for foot and lower limb pathology that do not fit typical patterns to identify if there is any adverse neural tension.

Contraindications – acute problems; low back & neck pathology; arthritic conditions; joint stiffness; incontinence

Straight leg raise (SLR):
• patient supine, leg is elevated by clinician with hand under calcaneus; put other hand on anterior knee to keep leg straight; do symptom free side first
• should be able to flex 50-120 degrees
• pain on the stretch can be produced in the posterior aspects of the hamstrings, knee and calf – pain anywhere else is an abnormal finding
• could add ankle dorsiflexion and eversion  tension in tibial nerve
• ankle plantarflexion and foot inversion will add tension in sural nerve
• ankle plantarflexion and eversion  common peroneal nerve

Slump test:
Central and peripheral nervous system are maximally tensioned.

• patient can do on own first (clinician can add force next)
• patient sitting with legs slightly flexed; hands behind back
• patient is asked to ‘slump’ – flex thoracic and lumbar spine and bring chest to chin; should not lead forward
• extra force by clinician can be applied to further flex thoracic spine
• knee extended and foot dorsiflexed (one leg at a time)
• clinician can assists with dorsiflexion
• symptoms noted
• patients slowly extends neck and symptom response noted

Most subjects will have some discomfort, especially posterior knee and neck

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