My new paradigm for neurodynamic bias movements is as pre and post test only. Even only 2 years ago, I was using neurodynamics as a primary treatment.
Moving away from causing discomfort in any treatments, I started using neurodynamics to pre and post test under a few conditions
- if symptoms did not centralize with repeated loading of the spine
- if peripheral complaints were chronic in nature, resembling tendinosis or chronic sprains
Prior to testing for neurodynamic dysfunction, you should check
- if repeated motions of the spine centralize the complaints
- remember passive overpressure in the directional preference
- if all of the joints in the periphery you are checking have the capacity for normal movement passively
The last point is important. I have been fooled in the past, using neurodynamic movement testing for a "positive" (limited and painful/symptoms reproducing) movement; it turns out the shoulder had limited motion in ER passively. The other important point about all joints having full motion, is that you know this patient is a Rapid Responder. If all joints have full and pain free passive motion, in one session, there should be some sort of novel input you can introduce to the system to make the neurodynamic test have full and pain free motion.
My go to treatments for this would be
- repeated loading of the spine in the directional preference to centralize the complaints
- IASTM along the neural container
- first in neutral, and progressing to with movement if needed
- EDGE Mobility Band compressive wrapping to modulate stretch perception
- joint mobs of the periphery to introduce novel input along the entire chain, reducing threat
Below is a quick example of IASTM with movement for neurodynamics. The patient had a strong perception of stretch with wrist/finger extension and forearm supination, so the movement and light scraping is in and out of the threatened range which mitigated the threat and restore full motion rapidly.
Interested in more? Check out the OMPT Channel, or use this link to subscribe to MedBridge, get CEUs and watch my 2 part The Eclectic Approach to Clinical Neurodynamics! The link saves $225/year, normally $425, subscribing through my site gets you all the CEUs you cand handle for $200/year!
Keeping it Eclectic....