Neurodynamics

Original Editor - Rachael Lowe

Top Contributors - Evan Thomas, Kim Jackson, Lucinda hampton, Admin, Rachael Lowe, Laura Ritchie, Joshua Samuel, Shaimaa Eldib, Claire Knott and Rucha Gadgil

Neurodynamics

Neurodynamics refers to the communication between different parts of the nervous system and to the nervous systems relationship to the musculoskeletal system. It has been shown that the nerves move independently from other tissues. The term Neurodynamics first made an appearance in 1989 and has since been further developed over the last 30 years. Neurodynamics is now seen as an important part of injury assessment and treatment.

Neurodynamics in the sense implied here is the mobilisation of the nervous system as an approach to physical treatment of pain. The treatment and or assessment relies on influencing pain physiology via the mechanical treatment of neural tissues and non-neural structures surrounding the nervous system. This mobilisation activates a range of mechanical and physiological responses in nervous tissues. eg neural sliding, pressurisation, elongation, tension and changes in intraneural microcirculation, axonal transport and nervous impulse movements.

The video below gives a good full description of the principles of neurodynamics

Neural mobilization to treat neurodynamic dysfunction to date is still needing justiifcation through research of high quality homogenous studies. To date however most studies have shown positive therapeutic effects through the use of neurodynamic treatment.

Neural Basics

To apply the principles of neurodynamics a good understanding of the neural basics, as defined below, is needed.

• Neuroanatomy
• Neurophysiology
• Neurobiomechanics
• Neuropathology

1.Neural (Traditional) Examination

• Neural Subjective
• Dermatomes
• Myotomes
• Reflexes
• Neural Palpation
• Romberg’s Test
• Babinski’s Reflex

2.Neural Provocation Tests

• ULTT1 (median nerve bias)
• ULTT2a (median nerve bias, alternate positioning)
• ULTT2b (radial nerve bias)
• ULTT3 (ulnar nerve bias)
• PNF (Lhermitte’s Test)
• SLR (sciatic, tibial, and peroneal nerve biases)
• PKB (femoral nerve bias)
• Slump (dura)
• Saphenous Neural tension test
• Musculocutaneous nerve tension test
• Axillary nerve tension test
• Suprascapular nerve tension test
  

Conditions with neurodynamic involvement

A few examples

• Ankle sprain

• Cervical and Lumbar Nerve Root Injury
• Colles Fracture
• Carpel Tunnel Syndrome
• Failed Back Surgery Syndrome
• Hamstring Injury
• Meralgia Paresthetica
• Myelopathy
• Plantarfasciitis
• Post Lumbar Surgery
• Whiplash Associated Disorders
• Thoracic Outlet Syndrome
• Sciatica
• Cyclists Palsy
• Double crush syndrome
• Tarsal Tunnel Syndrome

Presentations

Upper Limb Neurodynamics This presentation, created by Mark Kargela as part of the Evidence In Motion OMPT Fellowship, discusses the upper limb neurodynamics. View the presentation

Adverse Neural Dynamics Related to Cervicothoracic Disorders and Symptoms This presentation, created by Damian Rodriguez, Allison Rose, David Self, Blake Spoon; Texas State DPT Class. View the presentation

Adverse Neural Dynamics: Treatment Considerations for Neck and Arm Pain This presentation, created by Jason Grandeo, as part of the Evidence In Motion OMPT Fellowship, discusses the adverse neurodynamics in the upper quadrant. View the presentation

Adverse Neural Dynamics - Upper Extremity Examination This presentation, created by Jason Grandeo, as part of the Evidence In Motion OMPT Fellowship, reviews indications for using upper-limb neurodynamic tests, describes normal sensory responses for each of the upper limb neurodynamic tests, reviews the validity of the upper limb neurodynamic tests, and describes positive findings with upper limb neurodynamic tests. View the presentation