Michael Shacklock

University of Eastern Finland | UEF · Physical and Rehabilitation Medicine

Aims: Perform a pilot study of a static nerve root foramen opening protocol for lumbar radiculopathy from disc hernia in an emergency hospital setting to establish if patients could execute the protocol, consistency would occur across outcomes, superior outcomes would occur in the experimental group, and if the protocol would be safe. Methods: P...

Background The straight leg raise test (SLR) is one of the most utilized and studied physical tests in patients with low back pain (LBP) for the detection of lumbar disc herniation (LDH), showing high sensitivity and heterogeneous or low specificity. The high incidence of asymptomatic ‘pathologic’ findings in the magnetic resonance imaging (MRI) sc...

The first of the primary mechanical events in the nervous system is the generation of tension. It allows peripheral nerves to withstand approximately 18-22 % strain before failure. From Clinical Neurodynamics 2005 by Michael SCHACKLOCK http://www.neurodynamicsolutions.com/ movie by Bernard Delalande (somasimple 2016-2021)

Background: The straight leg raise test (SLR) is one of the most utilized and studied physical tests in patients with low back pain (LBP) for the detection of lumbar disc herniation (LDH), showing high sensitivity and heterogeneous or low specificity. The high incidence of asymptomatic ‘pathologic’ findings in the magnetic resonance imaging (MRI) s...

Background It is important to establish if mechanical testing for physical problems in the human is specific or non-specific for structures - e.g. muscle and nerve. The median nerve at the wrist can be moved in preference to its adjacent flexor digitorum longus muscle, but it is necessary to know if this specificity extends to the elbow. We therefo...

Background The straight leg raise (SLR) is the most commonly applied physical tests on patients with sciatica, but the sensitivity and specificity ratings for disc hernia and neural compression leave areas for improvement. Hip internal rotation tensions the lumbosacral nerve roots and ankle dorsiflexion tensions the sciatic nerve along its course....

Background: The straight leg raise (SLR) is the most commonly applied physical tests on patients with sciatica, but the sensitivity and specificity ratings for disc hernia and neural compression leave areas for improvement. Hip internal rotation tensions the lumbosacral nerve roots and ankle dorsiflexion tensions the sciatic nerve along its course....

Introduction A key issue in neurodynamic testing is whether a manoeuvre designed to produce differential biomechanical behaviour (structural differentiation) of nerve compared to adjacent muscle is mechanically accurate. The aim of this study was to investigate the capacity of cervical contralateral lateral flexion to produce differential biomechan...

Image of a spinal cord (terminal cone) used to show how neurodynamics solutions works on nerve roots. I will make movies to show the different available progressions of NDS. https://www.youtube.com/watch?v=gXF0rq0yx88&feature=emb_logo

Background A structural differentiation maneuver has been proposed to differentiate between muscle and nerve involvement during the straight leg raise test. However, to date, the mechanical specificity of this maneuver for the tibial nerve at the posterior knee has not been tested. The aim of this study was to investigate the specificity of ankle d...

Introduction: In hamstrings injuries, sciatic nerve and muscle disorders can coexist. Therefore, differential diagnosis to include or exclude nerve involvement is an important aspect of evaluation. The objective of this paper is to investigate the mechanical behaviour of the sciatic nerve and biceps femoris muscle in the proximal thigh with the an...

Study design: A controlled radiologic follow-up study. Objective: The aim of this study was to ascertain whether changes in cord excursion with straight leg raise test (SLR) at 1.5-year follow-up time accompany changes in clinical symptoms. Summary of background data: Lumbar intervertebral disc herniation (LIDH) is known to be a key cause of s...

From Clinical Neurodynamics 2005 by Michael SCHACKLOCK http://www.neurodynamicsolutions.com/ movie by Bernard Delalande (somasimple 2016)

Study design: Cross-sectional study. Background: The carpal tunnel is a clinically important fibro-osseous conduit for the median nerve and associated tendons. It is mechanically dynamic and therapeutic manual techniques that appear to move and change tunnel shape is part of clinical practice. Objectives: To measure changes in dimensions of th...

BACKGROUND CONTEXT Lumbar intervertebral disc herniation (LIDH) is known to be a key cause of sciatica. Previously we found a significant limitation of neural displacement (66.6%) with the straight leg raise test (SLR) on the symptomatic side of patients with sub-acute single level posterolateral LIDH. PURPOSE To ascertain if changes incord excurs...

Objectives: The purpose of our study was to examine the characteristics, distribution, and behavior of sensory responses of the straight leg raise (SLR) test in asymptomatic individuals. We hypothesized that: 1) the sensory response would be along the sciatic nerve distribution and its distal tributaries, and 2) no significant difference in sensory...

Introduction: The carpal tunnel is a clinically important fibro-osseous conduit for the median nerve and associated tendons. It is mechanically dynamic, such that the dimensions of the tunnel and median nerve change with position, movement and application of externally applied force with mechanical devices. Therapeutic manual techniques that appea...

Background: Morphology of the carpal tunnel changes with varying wrist postures and compressive forces applied to the wrist. These changes may affect the morphology and pressure on the median nerve and could be used as part of the treatment of the carpal tunnel syndrome patients. Reliability of the ultrasonographic measurements of the median nerve...

Objective: The purpose of this randomized trial was to compare the efficacy of manual therapy, including the use of neurodynamic techniques, with electrophysical modalities on patients with mild and moderate carpal tunnel syndrome (CTS). Methods: The study included 140 CTS patients who were randomly assigned to the manual therapy (MT) group, whi...

This article focuses on specific mechanisms of neurodynamics for application to patients with acute lumbar radicular pain. New studies show that, contrary to popular belief, tension in the lumbar contralateral nerve roots and dura reduces when neurodynamic tests such as the SLR and slump tests are performed. This is shown with a newly validated ‘cr...

The purpose of this investigation was to provide a full set of normal data describing neural biomechanics within the vertebral canal in all three planes with unilateral and bilateral SLR tests to allow for clinical comparison with clinical cases. This is done following the notion that, due to neural continuum, tensile forces are transmitted through...

Background: Normal displacement of the conus medullaris with unilateral and bilateral SLR has been quantified and the "principle of linear dependence" has been described. Purpose: Explore whether previously recorded movements of conus medullaris with SLRs are i) primarily due to transmission of tensile forces transmitted through the neural tissu...

Study design: Part 1: Randomized single blind study on the effect of contralateral knee extension on sensations produced by the slump test (ST) in asymptomatic subjects. Part 2: Cadaver study simulating the nerve root behavior of part 1. Objective: Part 1: Test if contralateral knee extension consistently reduces normal stretch sensations with t...

Controlled radiologic study. Verify (i) whether conus medullaris displacement varies with range of hip flexion ii) if the acquired data support the "principle of linear dependence". We have previously quantified normal displacement of the conus with unilateral and bilateral SLR have and described the "principle of linear dependence". However, we ha...

It has been shown that the conus medullaris displaces significantly and consistently in response to both unilateral and bilateral SLRs. Point of interest is represented by whether the magnitude of this displacement can be predicted in asymptomatic subjects. The purpose was to investigate whether any correlations existed between demographic and anth...

CLINICAL REASONING AND NEURODYNAMICS MICHAEL SHACKLOCK DipPhysio, MAppSc, FACP Director, Neurodynamic Solutions, Adelaide, South Australia Clinical Consultant, Flex Rehabilitation Clinic, South Australia Invited Professor, Faculty of Medicine, Barcelo University, Buenos Aires. ABSTRACT Therapists seem to think that neurodynamics is simply the cu...

It is generally accepted that muscles may activate via the common nociceptive flexion reflex (NFR) in response to painful stimuli associated with tensile or compressive forces on peripheral nerves. Following the basic assumption that the radial nerve may be stressed around the elbow during the execution of the Mills manipulation, two positions cons...

Study Design. Controlled radiologic study.Objective. Ascertain if a difference exists in the mechanical effects on the cord between the unilateral and bilateral SLR and to verify whether the effect on the spinal cord may be cumulative between the two.Summary of Background Data. To the author's knowledge these are the first data on non-invasive, in-...

Study design: Controlled radiological study. Objective: To investigate noninvasively in vivo spinal cord displacement in the vertebral canal during the passive straight leg raise (SLR) in asymptomatic subjects. The basic assumption is that the cord follows L5 and S1 nerve roots displacement by similar magnitude and direction (principle of linear...

Introduction: Carpal tunnel syndrome (CTS) is the most common and most commonly described neuropathy of the peripheral nervous ¬system. Epidemiological data suggests that it is responsible for 90% of compression neuropathy cases. Purpose: The main objective of the study was to evaluate the effectiveness of physiotherapy based on manual therapy and...

Mechanical treatment of neural tissues in physiotherapy have been in existence for quite some time now (Grieve 1970, Elvey(1979, Butler and Gifford 1989), Butler, 1991, Elvey and Hall 1999). In the early stages of the neural approaches, many of the techniques were based on only a small number of mechanisms and many aspects of a potentially new appr...

To investigate the effect of isolated muscular variance, side and hand dominance on elbow-extension range-of-motion (EE-ROM) of the median nerve upper limb neurodynamic test (ULNT1). This study analyzes these variables potential to influence ULNT1 EE-ROM symmetry and the possible consequences for clinical practice and research. Controlled laborator...

The author presents his system for treating various neurodynamic disorders. The key points are etiologic mechanisms, diagnostic categories, and progressive treatment in response to patients’needs and to clinical characteristics. Previous publications on the subject are available. Level of evidence: not applicable

This article presented key issues in relation to diagnosis of neurodynamic testing ; what exactly is a positive test, false positive and false negative results, mechanosensitivity, structural differentiation, normal and abnormal neurodynamic tests. Clearly it is necessary for the clinician to understand these key points in order make diagnosis and...

The neurodynamic approach created by the author results from progress in nerve mobilization and stretching compared with former methods. Progress has concerned nerve gliding, differences in mechanical pressure, intraneuronal blood flow and sensitivity (physiology) of the nervous tissues. Diagnosis and treatment are seen from the point of view of mu...

Mobilisation of the nervous system is an approach to physical treatment of pain. The method relies on influencing pain. The method relies on influencing pain physiology via mechanical treatment of neural tissues and the non-neural structures surrounding the nervous system. Previous description of this method has not clarified the relevant mechanics...

Firstly, I congratulate Ellis and Hing for performing this systematic review on therapeutic efficacy in clinical neurodynamics. It is an early and essential step in going beyond ‘anecdotal evidence’, a much needed move in this exciting area. What I like about it is that it is methodical, candid and claims no more than there is evidence for. As I se...

This article describes the application of the concept of clinical neurodynamics with manual therapy to a patient with low back pain and radicular symptoms. The causal mechanisms have been carefully analyzed with emphasis on diagnostic categories and in the continue reevaluation that creates the progressions in the different treatment techniques.The...

Several misconceptions in clinical diagnosis with neurodynamic (neural tension) tests have existed for some time. This paper attempts to resolve these problems and proposes various ways of linking the basic and clinical sciences to application and interpretation of neurodynamic tests in clinical practice. This is so that the approach can be more sc...

Die Arbeit beschreibt die Anwendung des neuen Konzepts der Klinischen Neurodynamik im Rahmen Manueller Therapie bei einer Patientin mit Kreuzschmerzen und radikulären Symptomen. Bei der Behandlung der ursächlichen Mechanismen spielen diagnostische Kategorien und systematische Progression eine wesentliche Rolle. Die Techniken können auf die spezifis...

Das neue System klinischer Neurodynamik bezieht sich auf neurale Störungen, die mit muskuloskelettalen Dysfunktionen zusammenhängen. Es umfasst Mechanik und Physiologie des Nervensystems, Neuropathodynamik sowie Diagnose- und Behandlungsprinzipien.

A groundbreaking approach to neural mobilization, this one-of-a-kind resource draws on the established Maitland movement diagram to present a completely new system for mobilization of the neural and musculoskeletal systems. The text guides readers through the complex subject of neurodynamics and the basic mechanisms in movement of the nervous syste...

Central pain mechanisms are deeply embodied in the psychophysical problem of pain. They are located in the brain and spinal cord and are becoming increasingly recognised as playing a major role in the generation and maintenance of pain and disability associated with neuromusculoskeletal problems. Central mechanisms participate in all pain states, a...

Treatment of central pain mechanisms is a new horizon for manual therapists. This paper presents key points about central pain mechanisms and how they can be treated by the manual therapist. Included are facets of conditioning, memory and learning; some types of central problems and cognitive-behavioural and physical techniques for use by manual th...

Mobilisation of the nervous system is an approach to physical treatment of pain. The method relies on influencing pain physiology via mechanical treatment of neural tissues and the non-neural structures surrounding the nervous system. Previous descriptions of this method have not clarified the relevant mechanics and physiology, including interactio...