The Neurodynamics of Peripheral Nerves

"What I’ve learned is that when a muscle becomes wasted, its not just because of a lack of impulses from the nerve into the muscle, its not just a lack of activity, it’s being told by a trophic factor produced by the nerve to get wasted"
We speak with physiotherapist Michael Shacklock (DipPhysio, MAppSC, FACP, NDS Instructor and founding director) about neurodynamics, nerve dysfunction, the anatomy and physiology of the nervous system, diagnosis and treatment of peripheral nerve disorders, and patient education.
Check out the summary video we did with Michael on Why Do Nerves Become Hypersensitive?
To find out more about Michael, visit his website, Twitter, Facebook and Instagram.
Shownotes:
 
Reliability of clinical tests to evaluate nerve function and mechanosensitivity of the upper limb peripheral nervous system
Neural Mobilization: Treating Nerve-Related Musculoskeletal Conditions
  Ectopic sensory discharges and paresthesiae in patients with disorders of peripheral nerves, dorsal roots and dorsal columns.
 
00:29 Can we have you introduce yourself?
02:05 Can you explain what neurodynamics are?
03:22 Are there any terms that are important to understand when discussing neurodynamics?
04:12 Can you provide a layman’s explanation of the function of nerves and how structure relates to its function?
05:17 What are the mechanical properties of nerves?
06:54 How much mechanical load can a nerve tolerate?
07:35 How do nerves become injured or sensitive? What is the physiological response in the nerve?
08:41 How about with ischemic injuries?
09:52 How does the nervous system respond to movement and why is movement effective?
12:13 Clinically can you determine elongation values?
13:14 Can you describe the difference between a sensitive nerve and a damaged nerve?
14:37 Do neurodynamic tests and medical tests if there’s a nerve condition look at the same thing?
15:37 What medical tests or subjective history may point to a nerve issue?
16:17 What constitutes a positive neurodynamic test?
18:40 Can neurodynamic tests selectively load or bias a specific nerve or nerve root?
19:45 What exactly is occurring in the body when you perform a sensitizing movement?
21:45 Can you explain what double crush syndrome is?
23:38 What has been the evolution in the treatment of nerve issues?
26:53 How important is treating the mechanical interface?
28:22 How long does it take a sensitive nerve to return to normal?
29:36 Can you discuss chemical irritation a bit more?
30:46 What are some common misconceptions surrounding nerves and nerve pain?
There are some common explanations that you hear when clinicians explain nerves, and we’d like your opinion on them:
32:34 - a nerve is like a telephone wire.
33:07 - Your nerve is stuck?
35:46 - When you’re doing neurodynamic exercises you’re stretching nerves
36:37 Can you give an example of how you would explain a nerve issue?
37:24 When hearing the word swollen, do some patients think that they have a big inflammatory response in the body and should be taking anti-inflammatories to calm it down?
38:36 What can be done for patients with severe nerve pain in a clinic?
39:35 What are some common mistakes patients make when performing neurodynamic exercises?
40:14 Are there any signs and symptoms of severe medical issues when dealing with nerve issues, where patients should be referred for medical evaluation? 41:14 How common are neurogenic disorders?
42:10 What questions are you hoping future research will help answer?
44:01 Where can people find out more about you?