NDS Global Workshops
NDS runs practical workshops on Clinical Neurodynamics globally and can come to your area.
NDS News
- Feature: A New Model for Investigating Effects of Neural Techniques On Muscle Function During Manual Therapy
- Feature: Asymmetry and Diagnosis
- NDS Instructor Brian Yee joins our team.
- Alfio Albasini has joined Neurodynamic Solutions International as Senior Instructor.
- Tarlov's cysts are relatively rare but, when present, they typically occur in the lumbosacral region.
- Ms Jutta Bauer: NDS Instructor for Austria, Germany and Switzerland.
- Wrist Technique during Median Neurodynamic Testing
- Trouble Shooting with Scapular Stabilisation
- Sciatica: Is Extension the Right Choice? - FEATURE
- Neural Aspect to Patellofemoral Pain Syndrome - FEATURE
- NDS in the USA
- NDS Braves Atlanta for Its New USA Hub
- Michael Shacklock Receives Academic Position at Georgia State University
- New American Instructor joins NDS
- Biography Russell Foley
- NDS Teaches in Savannah, Atlanta and Denver
- Neurodynamics gets Standing-Room-Only Reception
- NDS España Developing Rapidly
- NDS India Opens with Successful First Course in Bangalore
- Feature Article - The Sporting Nerve Part 2
- Feature Article - The Sporting Nerve Part 1
- How effective can Neurodynamic Testing really be in Diagnosis?
- NDS is Going Global - European/Nordic Instructors' Meeting held in Spain
- Sensitivity of Neural Tissue to Movement (Mechanosensitivity)
- Alf Breig Memorial Lecture in Sweden
- NDS Goes Viking
- Michael Shacklock receives Award for Book 'Clinical Neurodynamics'
- New NDS Book Release – Biomechanics of the Nervous System: Breig Revisited
- Feature Article - Heel Pain/Plantar Fasciitis and Neurodynamics
- Are Nerve Root Dysfunctions Visible on Radiological Investigation?
- New Painless Cervical Nerve Root Mobilisations: taking tension off the system for nerve root pain
- Neuroscientist with Attitude: who was Santiago Ramón y Cajal?
- NDS Receives Gifts from Spanish Parliament
- NDS España
- Can Nerve Root Tissue move relative to its Meningeal Sheath? Dr. Alf Breig does it again.
- Piriformis Syndrome as a Cause of Sciatica
- Cadaver Dissection - Diane Jacobs
- Spanish Translation of Book Released
- Portugal: First NDS Course held in Braga
- Neurodynamic Solutions shoots hoops with the Chicago Bulls - no bull
- Blame it on Rio
- NDS Course with Athletico
- Gregory Grieve Memorial Lecture presented by Michael Shacklock
- Original Founder of Adverse Neural Tension passes away
- NDS Global Teaching Program
- Are you interested in teaching Neurodynamics or are you teaching Neurodynamics?
The Sporting Nerve Part 1 | The Sporting Nerve Part 2 | Piriformis | Contralateral Tests
Sciatica: Is Extension the Right Choice? | Trouble Shooting with Scapular Stabilisation
Wrist Technique during Median Neurodynamic Testing | Tarlov's Cysts
Asymmetry and Diagnosis: Are We Neurodynamic Mirror Images?
Trouble Shooting with Scapular Stabilisation
Scapular depression is one of the most important movements of the upper limb neurodynamic tests. The movement exerts significant elongation effects on the brachial plexus (Adams and Logue 1971) and regularly produces significant changes in symptoms during the median neurodynamic test 1 and ulnar neurodynamic test.
One of the most common problems with technique of the upper limb neurodynamic tests (median 1 and ulnar) is control of the scapula. This is one movement which, if not well controlled, can profoundly influence the result of the test. The key is stability - no depression, no elevation. The following are some possible trouble spots with technique:
- poor blocking of elevation - the test will fail to express itself accurately in the final movement because of inconsistency. This can allow increased movement and a lack of sensitivity, therefore may be predispose the test to a false negative result
- excessive depression - this will produce a more restricted range of motion and may provoke more than necessary
- inconsistency between test applications - this will produce variations in the responses which may then lead to inaccurate diagnosis and assessment of progress.
Solutions in Technique
Figure 1 AFigure 1 A. Poor blocking of elevation. The hand is not in the best position to control cephalad/caudad movement of the scapular and, if pressed on strongly, is often uncomfortable for the patient. The therapist uses their latissimus dorsi and pectorals to control the scapula, not very efficient and making it difficult for the therapist to relax. In patients with strong elevation contractions, this produces a 'wrestling' effect between the therapist and patient. The therapist's wrist must remain as straight as possible so as to produce maximum control
(see Figure 1 C.).
Figure 1 BFigure 1 B. Flexed wrist. This can produce less control of the scapular and places unnecessary force on the therapist's wrist joint.
Figure 1 CFigure 1 C. Straight wrist position - this allows the therapist to apply direct pressure on the plinth, using friction of the knuckles on the plinth to prevent caudad and cephalad sliding. This is a very efficient and stable posture for both therapist and patient. No caudad pressure is exerted on the scapula. The therapist's hand simply remains stable, gently placed against the skin over the patient's acromion. The therapist positions themself over the patient so it is easy to apply pressure down their straight arm and wrist to the plinth. This technique ensures accuracy with efficiency.
REMEMBER: Technique is important!
REFERENCES
Adams C, Logue V 1971 Studies in cervical spondylotic myelopathy, 1 Movement of the cervical roots, dura and cord, and their relation to the course of the extrathecal roots. Brain 94: 557-568/em>
Shacklock M 2005 Clinical Neurodynamics. Elsevier, Oxford.
