This neurodynamics techniques DVD and book has been produced bythe Neuro Orthopaedic Institute Australasia, with contributionsfrom our international faculty. It is expected that users will behealth professionals, and thus will have an existing knowledge ofneuroanatomy and neuro orthopaedic assessment plus knowledge ofrelevant pathology, precautions and contraindications.
Here's a free download of Michael Shacklock's original paper on the proposal that we should move toward a neurodynamics approach, including more mechanisms and scientific cornerstones that ever before.
Neurodynamic mobilization techniques are often used clinically for restoring nerve mobility39 and decreasing pain.43,53,54 In the lower extremity, neurodynamic techniques incorporate ankle range of motion for neurodynamic testing2,4,29,40,41,55,56 and treatment.57 Moreover, repetitive ankle motion (e.g. ankle dorsiflexion and plantar flexion) is often used clinically to assist in fluid dispersion in the presence of generalized ankle swelling, as well as increase ankle joint mobility regardless of effects on nerve mobility. Despite anecdotal reports of positive treatment outcomes when using neurodynamic techniques,5,43,53,54,57 the mechanisms responsible for these outcomes remain unclear. The reduction of neural edema has been cited as a possible benefit to neurodynamic mobilization techniques43 but has not been demonstrated.
The clinical importance of limiting intraneural pressure is supported by the results of studies that demonstrated the detrimental effects of increased levels of intraneural pressure on neural tissue.15,23 Maintaining healthy nerve function using neurodynamic techniques may occur by promoting uninterrupted axonal transport, thereby preventing deposition of mechanosensitivity elements, the presence of which results in pain and limited neural movement.8,22 In the early stages of stretch injury or compression, the ability to prevent or at least reduce edema may prevent or slow the inhibition of blood flow,15,23 thus preventing the sequelae leading to impaired axonal transport,18,20 demyelination,11,24 loss of elasticity due to fibrosis or adhesions,46,63 and ultimately to alteration in nerve structure and function.19,24,27 The ability to promote fluid dispersion using range of motion may provide a means to break the cycle of edema formation leading to fibrosis,50 which may in turn lead again to edema formation. These findings may be even more important when considering interventions for previously damaged nerves64,65,66,67 or nerves compromised by pathology such as diabetes.68
In a recent pilot study involving 28 male soccer players, our research team was able to demonstrate that a neurodynamic sliding intervention led to a short-term increase in hamstring flexibility . Findings from that study were limited by a small sample size, inclusion of young males only, and also because the experimental group was compared to a control group that received no intervention. Despite these shortcomings, the study did suggest that neurodynamic treatment can significantly increase hamstring flexibility in a young male athletic population and proposed that future research compares neurodynamic techniques with other interventions in a broader population of subjects.
Therefore, the aim of this study was to examine the immediate effects of a neurodynamic sciatic sliding technique, hamstring stretching, and placebo control intervention in asymptomatic subjects with decreased hamstring flexibility or short hamstring syndrome. We hypothesized that an isolated neurodynamic sciatic sliding technique would improve range of motion, assessed by passive straight leg raise test (SLR), greater than hamstring stretching or placebo in the short term. Findings from this study may provide further the evidence for the relevance of neural tissues in determining range of motion and may indicate benefits for adding neural mobilization techniques to the rehabilitation and/or prevention of hamstring injuries.
The results of this study demonstrate a mean increase in the hip flexion range of the SLR for the neurodynamic group of 9.86° which compares favorably with other studies. Castellote-Caballero and others reported mean increases in SLR of 9.4° following a similar neurodynamic slider technique , and Aparicio et al. reported mean increases of 5.9° for the right SLR and 5.5° for the left SLR following application of the suboccipital muscle inhibition technique . Mendez-Sanchez and others completed a pilot study on young healthy male soccer players and found mean increases of only 3.7° in the right SLR and 2.2° in the left SLR after sustained hamstring stretching intervention . When they added a neurodynamic slider technique to the sustained hamstring stretching intervention, they found greater mean increases of 6.2° in the right SLR and 6.3° in the left SLR . Finally, Hopper et al. reported mean increases of only 4.7° in SLR after the application of massage techniques to the hamstring musculature .
Findings from this study indicate that a neurodynamic sliding intervention will increase short-term hamstring flexibility as measured by the passive SLR to a greater degree than static hamstring stretching in healthy subjects with short hamstring syndrome. Future research should look at longer term results and assess the effect of combining neurodynamic techniques with other interventions.
Background: Neurodynamics sliding technique (NDST) and Mulligan bent leg raise technique (MBLR) both have been individually advocated for increasing hamstring flexibility but comparison of these techniques have not been found in studies. The purpose of the study was to find immediate effect of neurodynamic sliding technique versus mulligan bent leg raise technique on hamstring flexibility in asymptomatic individuals.Methods: An Experimental study designs, with two group 80 asymptomatic normal subjects were randomized 40 subjects into each NDST group and MBLR group. NDST group received Neurodynamic sliding technique and MBLR group received Mulligan bent leg raise technique; passive straight leg raise was taken as outcome measure pre and post intervention.Results: When means of post intervention were compared there is statistically significant difference in means of passive SLR ROM within the groups but there is no statistically significant difference in post intervention means between the groups.Conclusion: It is concluded that both NDST and MBLR technique are effective on improving hamstring flexibility for asymptomatic individuals with limited SLR ROM. However there is no significant difference in improvement in hamstring flexibility between the groups.
The gold standard of neurological examination is nerve conduction studies. In many cases however there can be pathoneurodynamics without conduction loss within the nerve. Neurodynamic assessment techniques allow us to look for these changes, especially when neurological examination is normal. 2b1af7f3a8