Did you miss Movement Debrief live yesterday? Though much more fun live, I have a video of what we discussed below.
This debrief was quite fun, as we had an impromptu viewer q&a. Thank you Alan Luzietti for the awesome questions! If you follow along live on Facebook or Youtube, I will do my best to answer any questions you ask.
Yesterday we discussed the following topics:
Why you should emphasize sagittal plane activities longer than you think
How to coach exercises to maximize client learning and compliance
Why detaching from your client encounters makes you a better clinician
Viewer Q&A – “centering from the chaos” & TFL Inhibition
Lastly, if you want the acute:chronic workload calculator I spoke about, click here.
You shed that mindset with the game on the line. You must do all in your power to get that player back on the court tonight, expediting the return process to the nth degree.
I had a problem.
Figuring out the most efficient way to treat an ankle sprain was needed to help our team succeed. I searched the literature, therapeutic outskirts, and tinkered in order to devise an effective protocol.
The result? We had 12 ankle sprains this past season. After performing the protocol, eight were able to return and finish out the game. Out of the remaining four, three returned to full play in two days. The last guy? He was released two days after his last game.
It’s a tough business.
The best part was we had no re-sprains. An impressive feat considering the 80% recurrence rate¹. Caveats aside, treating acute injuries with an aggressive mindset can be immensely effective.
When assessing neurodynamics, there is a general system that is used including the following tests:
Passive neck flexion (PNF).
Straight leg raise (SLR).
Prone knee bend (PKB).
4 different upper limb neurodynamic tests (ULNT).
I will demonstrate these tests for you in later chapters.
Many clinicians when discussing the lower extremity-biased tests deem that maybe only one or two of the tests need to be performed, however this assertion is erroneous. Slump, SLR, and PNF all need to be tested as a cluster. The reason being is that the clinical responses may often differ.
This difference is especially noticeable when comparing the SLR and the slump. These two are not equal tests for the following reasons:
Components are performed in a different order.
Spine position is different.
Patients may be more familiar with the SLR, therefore give more familiar responses.
The patient is in control during the slump, not in the SLR.
The slump is more provocative.
Rules of Thumb
When testing neurodynamics, here are the following guidelines:
1) Active before passive.
2) Differentiate structures – add/subtract other movements to see if symptoms can change.
3) Document the test order.
The positive testing here is a little dated based on what Butler’s group and the research says as of right now. Based on what I have learned from Adriaan Louw, having any of the following is what constitutes a positive test.
Gross range of motion asymmetry between sides.
Gross sensitivity asymmetry between sides.
There are several pieces to look at when determining potential sources of neural findings.
Area: Cutaneous zones generally nerve trunk; dermatome generally nerve root.
Motor loss: Reflex loss is usually the nerve root; specific motor loss can be the root or trunk.