Chapter 7: Standard Neurodynamic Testing

This is a Chapter 7 summary of “Clinical Neurodynamics” by Michael Shacklock.

Passive Neck Flexion

With this test, the upper cervical tissues slide caudad, and the lower cephalid. The thoracic spine moves in a cephalid direction as well.

Normal responses ought to be upper thoracic pulling at end-range. Abnormal symptoms would include low back pain, headache, or lower limb symptoms.

Median Neurodynamic Test 1 (MNT1)

This test, also known as the base test, moves almost all nerves between the neck and hand.

Normal responses include symptoms distributed along the median nerve; to include anterior elbow pulling that extends to the first three digits. These symptoms change with contralateral lateral flexion and less often ipsilateral lateral flexion. Anterior shoulder stretching can also occur.

Ulnar Neurodynamic Test (UNT)

This test biases the ulnar nerve, brachial plexus, and potentially the lower cervical nerve roots.

Normal responses include stretching sensations along the entire limb, but most often in the ulnar nerve’s field.

Median Neurodynamic Test 2 (MNT2)

This version biases the lower cervical nerve roots, spinal nerves, brachial plexus, and median nerve.

Normal responses would be similar to MNT1.

Radial Neurodynamic Test (RNT)

This test looks predominately at radial nerve, as well as the nerve roots. It is uncertain if this test biases any particular nerve root.

Normal responses include lateral elbow/forearm pulling, stretch in the dorsal wrist.

Axillary Neurodynamic Test (ANT)

This test tenses the axillary nerve, though may not be specific.

Normal responses include posterolateral shoulder pulling with about 45-90 degrees of abducton.

Radial Sensory Neurodynamic Test (RSNT)

This test is used to rule out de Quervain’s disease as a neurodynamic problem.

Normal responses include intense pulling at the distal radial forearm.

Straight Leg Raise (SLR)

This test is performed with any posterior symptoms from the heel to the thoracic spine.

Active cervical flexion should not be used in this test because false results can occur from abdominal muscle contraction. This error may lead to posterior pelvic tilt, which reduces the hip flexion angle.

Normal response is pulling and stretching in the posterior thigh.

Tibial Neurodynamic Test (TNT)

This test is done for symptoms in the tibial nerve distribution.

Normal responses include stretching in the calf region that can go all the way to the plantar aspect of the foot.

Fibular Neurodynamic Test (FNT)

This test biases both the common and superficial fibular nerves.

Normal responses include stretching and pulling in the anterolateral leg and ankle and the foot dorsum.

Sural Neurodynamic Test (SNT)

This test biases the sural nerve, which can often be involved in a sprained ankle.

Normal responses include pulling in the posterolateral ankle region.

Slump Test

This test checks the peripheral and central nervous system, and can encompass symptoms from the head to the foot.

Normal responses vary depending on the sequence. Usually the movement performed earliest is where symptoms will occur.

Saphenous Neurodynamic Test (SAPHNT)

This test looks at medial knee, shin, and ankle.

Normal response is anterior thigh stretching.

Femoral Slump Test (FST) with Lateral Femoral Cutaneous Nerve and Obturator biases.

These movements bias the anterior-based nerve of the leg.

Shacklock normally performs the exam with the bottom leg in order to maximize gravity’s effects. The obturator can also be biased as such.

Normal responses includes pulling in the adductor region, anterior thigh, or lateral thigh depending on the bias.

Bias is okay in neurodyanamic testing.
Bias is okay in neurodyanamic testing.
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