Acute Effects of Neurodynamic Stretching on Muscle-tendon Complex

Neurodynamic mobilization techniques are widely applied in rehabilitation and physiotherapy to enhance the mobility and function of peripheral nerves. Two main approaches are distinguished. Nerve tensioning and nerve flossing. They both involve proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding these techniques. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography).

Neurodynamic mobilization techniques are frequently applied in rehabilitation settings to enhance the mobility and function of peripheral nerves, particularly in the management of neuropathic pain such as carpal tunnel syndrome, radiculopathies, or sciatica. Two main approaches are distinguished. Nerve tensioning involves maintaining the nerve stretched at the end of the joint range of motion with relatively limited excursion. It is similar to a static stretching intervention but with distal (ankle) and proximal (cervical) tensions. Nerve flossing (also termed gliding or sliders), consists of alternating proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding the acute effects of the different possible neurodynamic techniques on sciatic nerves, particularly in healthy tissues. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Performed in patients, healthy or athletes, no study has compared both tensioning or flossing techniques. Moreover, because these techniques involved nerve mobilisation, the intensity should have a main effect of its efficiency. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE). This method has been shown reliable to provide non-invasive real-time assessments of soft tissues elastic properties. The secondary aim was to determine the effects of stretching intensity (at the point of pain threshold or below).