Bilateral dorsal foot pain in a young tennis player managed by neurodynamic treatment techniques

A systematic review of the efficacy of neural mobilisation in sport: A tool for the neural tension assessment

INTRODUCTION

Any sport places great physical demands on the lower limbs and lumbar spine. Sport can lead to nerve entrapment syndromes, making nerve tissue a target for therapeutic intervention.

METHODS

A systematic review of clinical trials and cohort studies using neurodynamics as a method of assessment and treatment in sports patients was conducted. Risk of bias was assessed using the PEDro and NOS scales.

RESULTS

Ten studies were eventually included in this study. Age ranged from 18 to 33 years. Neural tension is underappreciated in sport as a risk factor for injury. Treatment of nerve tissue included glide/tension type neural mobilisations. Studies ranged from 3 to 8 sets, 5 to 20 repetitions, with a time of 60 s and 1-6 weeks of treatment.

CONCLUSIONS

Neurodynamics manoeuvres proves to be most beneficial in increasing range of motion and decreasing perceived muscle tension in the athlete population. A significant effect was also observed in the monopodal jump test, the 6-m jump test and the cross-jump test. There is also limited and scarce evidence on the use of neural testing in sports injuries.Further studies on the application and assessment of neural stress in sport are warranted.

Neurodynamic mobilization in a collegiate long jumper with exercise-induced lateral leg and ankle pain: A case report

STUDY DESIGN

Case Report.

BACKGROUND

The purpose of this case report is to describe nerve mobilization in the treatment of lower extremity neuropathic pain in a female collegiate long jumper.

CASE DESCRIPTION

A 21 year-old long jumper presented 7 months after onset of ankle and leg pain. She complained of "aching" pain over the lateral ankle, radiating proximally to just superior to the lateral knee. Neurodynamic testing of the sural and superficial branch of the fibular nerves was positive. Interventions/Outcomes: Persistent neuropathic pain which impeded sport participation in a collegiate athlete did not improve using traditional rehabilitation intervention, but did ameliorate as a result of an intervention which included self-administered, supervised nerve mobilization of the sural and superficial branch of fibular nerve. The patient improved in all outcome measures including the Lower Extremity Functional Scale (LEFS), Numerical Pain Rating Scale (NPRS), and the Global Rating of Change (GROC).

DISCUSSION

In a female collegiate athlete with persistent neuropathic pain, initial improvements were achieved with traditional rehabilitation, but her pain continued. Considerable additional improvements were achieved following the addition of self-administered, supervised nerve mobilization. Neurodynamic testing should be performed on patients with possible peripheral nerve involvement and treatment commenced if positive.