Abstract
Adverse neural tension is the inability for a nerve to glide freely in its mechanical interface. Studies demonstrate that there is relationship between muscular facilitation and adverse neural tension in the upper extremity and in the posterior thigh, but few examine a potentially similar interaction in the anterior hip. The purpose of this study was to determine the relationship between femoral nerve tension and hip flexor muscle tightness. The Prone Knee Bend test and the Thomas test were performed on a group of 20 normal subjects (40 unilateral lower extremities) without back pain or dysfunction, and on a group of 12 patients (21 unilateral lower extremities) treated with physical therapy for low back pain. The results demonstrated a significant correlation for the control and patient groups combined (r=0.530; p=0.0001); for the control group only (r=0.322; p=0.043) and the patient group only (r=0.601; p=0.002). This study indicates a correlation between the Thomas Test and the Prone Knee Bend Test suggesting a relationship between adverse neural tension of the femoral nerve and muscle length of the iliopsoas muscle. Increased femoral nerve tension may influence hip tightness in normal and patient populations. Likewise, adaptive shortening of the hip flexors may lead to adverse femoral nerve tension.
Highlights
Current neurodynamic concepts can be traced to Cyriax’s work on dural pain and theories on adverse neural tension (ANT) as described by Maitland, Elvey and Butler
Pearson’s correlations were computed to quantify the deficit was observed in the Thomas Test. These findings suggest that individuals with ANT of the femoral nerve may display guarding or facilitation of the iliopsoas musculature
The Thomas Test and the Prone Knee Bend Test were significantly correlated for the control and patient groups combined (r=0.530; p=0.0001); for the control group only (r=0.322; p=0.043) and the patient group only (r=0.601; p=0.002)
Summary
Current neurodynamic concepts can be traced to Cyriax’s work on dural pain and theories on adverse neural tension (ANT) as described by Maitland, Elvey and Butler. If a nerve is not able to slide or glide freely within this mechanical interface, adverse neural tension may result [1,2]. ANT has been described in many ways. Butler defines it as “an abnormal physiological and mechanical response produced from nervous system structures when their normal range of movement and stretch capabilities are tested” [3]. Controversy still exists regarding the cause of the decrease in range of movement. Elvey et al suggest it may be a result of secondary protective muscle spasm due to increased stimulation of the nerve prior to motion [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
