Tensioners and Sliders

Prepared by

Dr.Aparna Kulkarni(PT)

Dr.Meena Nair(PT)

Neural Mobilization

  • Mobilization of nervous system is an approach to physical treatment of pain.
  • This technique propose to reduce Mechano-sensitivity by improving the ability of neural tissue to tolerate mechanical force during movement (NEE et al 2011)
  • Neural mobilization techniques are used to decrease adverse mechanical tension on the nerve
  • This technique frees up the nerves which so that it can slide in it’s sheath.

Physiological effects of Neural Mobilization

  • Restore the dynamic balance between the relative movement of neural tissues and surrounding mechanical interfaces
  • Facilitation of nerve gliding
  • Reduction of nerve adherence (viscoelastic properties),
  • Dispersion of noxious fluids,
  • Increased neural vascularity (intraneural bloodflow), and
  • Improvement of axoplasmic flow

Two types of techniques are commonly used treating patient with nerve related pain

1. Tensioners.
It’s a neurodynamic test that produces tension in the neural structure
2. Sliders.
Neurodynamic manoeuvre to produce sliding movement of neural structure relative to their adjacent tissues.

Effects of Tensioner

  • Involve elongation of nerve bed.
  • Beneficial effects by pumping action of nerve.
  • Reduce intraneural pressure and improve circulation. (Coppieters et al 2008)
  • Produces tension in neural structure but does not surpass the elastic limit.
  • Activate viscoelastic, movement related and physiological function in nervous system.

Effects of Sliders

  • Involve combination movement at different joint.
  • Elongation of one nerve bed is balanced by reduction in length of nerve bed at another joint.
  • Less aggressive technique.
  • Appropriate for acute conditions and post-operative management.
  • Reduction in nerve tension limit the possibility of causing nerve irritation and inflammation. (Coppieters et al 2008)

Indication

  • Used in non irritable condition ( Neuropathic/ Neurogenic)
  • For patho-mechanical causes.
  • Fibrosis
  • Connective tissue adhesion.
  • Restriction of normal tissue mobility.

Contraindication

  • Malignancies of the nervous system or vertebral column
  • Acute inflammatory infections.
  • Areas of instability.
  • Spinal cord injuries.
  • Suspected disc lesions.
  • Cauda equina lesions.
  • Dizziness related to VBI.
  • Any central nervous system disorder( Spina bifida, MS)

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