1. Neuro Anatomy
Lumbar Spine

2. Neuro Anatomy Important for neurological assessment
Helps with tension testing and neurodynamic treatments
Knowing anatomy will help identify potential causes of radicular pain or radiculopathy
E.G paraesthesia in the hand- is this in a dermatome pattern or a peripheral nerve pattern

3. Spinal Nerves

4. Spinal Nerves

5. Lumbar Plexus

6. Lumbar Plexus

7. Femoral Nerve

8. Obturator Nerve

9. Lumbosacral Plexus

10. Lumbosacral Plexus

11. Sciatic Nerve

12. Peroneal Nerve

13. Tibial Nerve

14. Sural Nerve

15. Dermatomes and Myotomes Vs Peripheral Nerve
Remember the cutaneous and motor distribution of a peripheral nerve IS NOT the same as dermatome and myotome patterns
Nerve roots will progress into multiple peripheral nerves
E.g C8 nerve root is present in ulnar, median and radial peripheral nerves

16. Neurodynamics
Lumbar Spine

17. The Neurodynamic System
Interaction of 3 components
Mechanical Interface
Neural Structures
Innervated Tissues

18. Abnormal Neurodynamic System
Can be the result of one or a combination of:
Dysfunctional Tension
Dysfunctional Sliding
Dysfunctional Compression

19. Tension

20. Sliding

21. Compression

22. Movement of the Neural System
The nervous system will generally slide towards the moving joint distally and proximally to increase the available slack

23. Femoral Nerve Testing

24. Sciatic Nerve Testing

25. Peroneal Nerve Testing

26. Tibial Nerve Testing

27. Sural Nerve Testing

28. Slump Testing Upper Lumber Nerve Roots

29. Look for…..
Pain
ROM
Paraesthesia or Numbness

30. Structural Differentiation
Perform the test
Make a change 2 joints away from the symptoms
Does it increase or decrease symptoms?
Does it make no change?

31. Dermatomes

32. Dermatomes

33. Dermatomes

34. Myotomes L2 L3

35. Myotomes L4 L5

36. Myotomes S1 S1

37. Myotomes
S1 - 2

38. Management Soft tissue release Joint mobilisations
Sliders and Tensioners

39. Sliders

40. Tensioners

41. Manual Therapy Corkskrew

42. Home Exercise Programme Leg Swings

43. Home Exercise Programme Heel To Sky

44. Home Exercise Programme Femoral Nerve

45. Home Exercise Programme Cranio Cervical Flexion Straight Leg Raise

46. Home Exercise Programme Seated Slump Part 1

47. Home Exercise Programme Seated Slump Part 2

48. Home Exercise Programme Seated Slump Part 3

49. Home Exercise Programme Seated Slump Part 4

50. Neurodynamic Treatments
Be inventive
Decide on what aspect of the nerve you need to target
Decide whether you need to perform a slider or a tensioner
Decide if you want to tension the entire spinal cord and dura mater
HEP or Manual Therapy? Eg MTrP release in neural load, Hip distraction mobilisations in neural load