Effect of ankle dorsiflexion on displacement and strain in the tibial nerve and biceps femoris muscle at the posterior knee during the straight leg raise: Investigation of specificity of nerve movement

Bueno-Gracía, Elena; Estébanez-de-Miguel, Elena; López-de-Celis, Carlos; Shacklock, Michael; Polo, Santos Caudevilla; González-Rueda, Vanesa; Pérez‐Bellmunt, Albert

doi:10.1016/j.clinbiomech.2020.105003

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…The SLR showed increased tension in neural structures both in vivo and in vitro [ 37 , 38 , 39 , 40 ]. In addition, ankle dorsiflexion has been shown to increase strain and produce distal excursion of the sciatic nerve without affecting muscle structures such as the biceps femoris muscle [ 22 , 25 ]. Due to the differential behaviour observed between the nerve and the muscle at the posterior thigh, ankle dorsiflexion has been proposed as an excellent manoeuvre for a differential diagnosis of posterior thigh pain [ 22 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, ankle dorsiflexion has been shown to increase strain and produce distal excursion of the sciatic nerve without affecting muscle structures such as the biceps femoris muscle [ 22 , 25 ]. Due to the differential behaviour observed between the nerve and the muscle at the posterior thigh, ankle dorsiflexion has been proposed as an excellent manoeuvre for a differential diagnosis of posterior thigh pain [ 22 , 25 ]. In the present study, 77.1% of the subjects showed a neural response during ankle dorsiflexion in the SLR stretching.…”

Section: Discussionmentioning

confidence: 99%

“…In clinical practice, a structural differentiation manoeuvre is performed to discriminate whether the tension produced during a neurodynamic test arises from muscle or neural tissue [ 21 , 22 ] This manoeuvre can be head flexion, internal rotation, and/or adduction of the hip or dorsiflexion of the ankle. This manoeuvre will depend on the location of the symptomatology.…”

Section: Introductionmentioning

confidence: 99%

“…This phenomena is related to the anatomical continuous nature of the nervous system, which allows the tension generated at a point of the system to transmit to great distances to more distant areas [ 24 ]. Ankle dorsiflexion used as structural differentiation has been shown (in cadaveric studies) to produce changes in the strain and excursion of the sciatic nerve at the upper thigh and tibial nerve at the posterior knee at different degrees of hip flexion during the SLR [ 22 , 25 ]. In contrast, ankle movement did not affect the biceps femoris muscle in some locations.…”

Section: Introductionmentioning

confidence: 99%

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Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort—A Randomised Cross-Over Trial

López-de-Celis

Izquierdo-Nebreda

González-Rueda

et al. 2022

Life

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Background: Stretching techniques for hamstring muscles have been described both to increase muscle length and to evaluate nerve mechanosensitivity. Aim: We sought to evaluate the short-term effects of three types of hamstring stretching on hamstring length and report the type of response (neural or muscular) produced by ankle dorsiflexion and perceived sense of effort in asymptomatic subjects. Methods: A randomised cross-over clinical trial was conducted. A total of 35 subjects were recruited (15 women, 20 men; mean age 24.60 ± 6.49 years). Straight leg raises (SLR), passive knee extensions (PKE), and maximal hip flexion (MHF) were performed on dominant and non-dominant limbs. In addition, the intensity of the applied force, the type and location of the response to structural differentiation, and the perceived sensation of effort were assessed. Results: All stretching techniques increased hamstring length with no differences between limbs in the time*stretch interaction (p < 0.05). The perceived sensation of effort was similar between all types of stretching except MHF between limbs (p = 0.047). The type of response was mostly musculoskeletal for MHF and the area of more neural response was the posterior knee with SLR stretch. Conclusions: All stretching techniques increased hamstring length. The highest percentage of neural responses was observed in the SLR stretching, which produced a greater increase in overall flexibility.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort—A Randomised Cross-Over Trial

López-de-Celis

Izquierdo-Nebreda

González-Rueda

et al. 2022

Life

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“…Die Bewertung der Auswirkungen struktureller Differenzierungsmanöver (z. B. Nackenflexion, Dorsalflexion des Fußgelenks oder Hüftadduktion) auf die in der SLR-Position hervorgerufenen Symptome kann dazu beitragen, Symptome im Zusammenhang mit der Reizung neuraler Gewebe von solchen zu unterscheiden, die mit der Reizung nicht neuraler Gewebe zusammenhängen 5 6 7 . Geeignete strukturelle Differenzierungsmanöver zielen darauf ab, das Nervensystem weiter zu be- oder entlasten, ohne die Belastung nicht neuraler Strukturen zu verändern, die Quellen von SLR-bezogenen Symptomen sein könnten.…”

Section: Zusammenfassungunclassified

Zuverlässigkeit des Straight-Leg-Raise-Tests bei Verdacht auf lumbale radikuläre Schmerzen: Ein systematisches Review mit Meta-Analyse

2022

physioscience

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Minimizing risk of iatrogenic nerve injury during peroneus longus tendon autograft harvest: a cadaveric study at different ankle or knee positions

Rothrauff

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate the distances using ultrasound between the supericial peroneal nerve (SPN) and sural nerve along the peroneus longus tendon (PLT) autograft harvest path at diferent ankle or knee positions in order to minimize risk of iatrogenic nerve injury during PLT autograft harvest. Methods Twenty-four fresh-frozen human cadaveric lower extremities were used to harvest a full-thickness PLT autograft with a tendon stripper. Four specimens were utilized to validate correct identiication of nerves under ultrasound. Sonographically guided perineural injections were performed at the start point and end point of the PLT harvest path using coloured latex, followed by dissection with gross inspection. Using ultrasound, the distance from the peroneus brevis muscle to the sural nerve at diferent ankle positions (20° dorsilexion, neutral, and 20° plantarlexion) was measured, and the distance from the end of the tendon stripper to the SPN at diferent knee positions (full extension and 90° lexion) was also measured. Measurements were performed by two separate observers using ImageJ software. Results Cadaveric dissection showed the presence of latex around nerves in all four specimens. The average distance from the brevis muscle to the sural nerve increased signiicantly from dorsilexion to plantarlexion. The shortest distance from the tenodesis site to the sural nerve was 5.8 ± 1.7 mm. There was no signiicant diference from the end of the tendon stripper to the SPN between full extension or 90° lexion of the knee. Conclusion When harvesting the PLT, it is recommended to place the ankle at plantarlexion. The knee at full extension or 90° lexion had no efect. Joint positions at the time of graft harvest should be monitored to reduce risks of iatrogenic nerve injury.

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Effect of ankle dorsiflexion on displacement and strain in the tibial nerve and biceps femoris muscle at the posterior knee during the straight leg raise: Investigation of specificity of nerve movement

Cited by 9 publications

References 34 publications

Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort—A Randomised Cross-Over Trial

Short-Term Effects of Three Types of Hamstring Stretching on Length, Neurodynamic Response, and Perceived Sense of Effort—A Randomised Cross-Over Trial

Zuverlässigkeit des Straight-Leg-Raise-Tests bei Verdacht auf lumbale radikuläre Schmerzen: Ein systematisches Review mit Meta-Analyse

Minimizing risk of iatrogenic nerve injury during peroneus longus tendon autograft harvest: a cadaveric study at different ankle or knee positions

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