NEURAL MOBILIZATION
Clinical Neurodynamics
Neural Mobilization is a treatment concept based on the anatomical, physiological, functional, and biomechanical properties of the nervous system, all of which are interrelated and have a close connection to the musculoskeletal system.
Anatomically relevant is the fact that the entire nervous system represents a continuous unit and can adapt to the mechanical requirements of all movements taking place in the trunk and extremities due to its capability of moving in between or along its adjacent tissues.
Our Neurodynamics can be negatively affected by various factors that may lead to changes in tension and circulatory conditions inside and outside of the affected nerves, and consequently result in pain, hypersensitivity, reduced muscle strength, or even muscle paralysis.
Neurodynamic Dysfunctions
Common causes of disturbed Neurodynamics are direct injuries to nerves due to overstretching or compression, post-traumatic or postoperative scarring as well as other forms of connective tissue adhesions, pathological constrictions of anatomical structures (e.g. in the carpal tunnel or spinal canal), bleedings (e.g. after a muscle fiber tear) or edema in overused and inflamed tissues due to uniform, persistent pressure under one-sided loads.
The indications for physiotherapeutic treatment of impaired or disturbed Neurodynamics through specific nerve mobilizations are manifold. Some examples are adhesion prophylaxis after intervertebral disc surgeries or peripheral nerve injuries, nerve compression syndromes (such as the piriformis syndrome, in which the sciatic nerve is affected), paralysis or peripheral nerve pain conditions.
Diagnosis & Treatment
In Physiotherapy and Manual Therapy, specific neurodynamic tests are first carried out to determine if the symptoms of the patient are indeed neurogenic (i.e. originating from the nervous system) and to exclude other possible causes in a differential diagnosis.
Preparatory measures like joint mobilizations, muscle stretches or functional cross-friction massages are often used in the treatment before applying specific nerve mobilizations. On the one hand, a distinction is made between so-called sliders in which the nerve structures are meant to move and glide in between or along their surrounding tissues, and tensioners on the other hand, which cause an increase in tension of the nerves to improve its elasticity and physiology.
The primary goals of these nerve mobilizations are the reduction of pain, an increase of metabolism (blood flow, oxygen supply, edema degradation, detoxification) within the nerve tissue, as well as the improvement of nerve function (reception and transmission of information) and biomechanics, in particular, its physiological ability of displacement to its adjacent tissues.