Peripheral Nerve Biomechanics: Application To Neuromobilization Approaches

Abstract

Neuromobilization is a therapeutic technique that has received favorable acceptance as a management approach for neurogenic pain syndromes. As reported in the literature, anatomy of peripheral nerve and its connective tissue structure profoundly influence both spinal and extremity movement. The physical therapist needs to develop a clear understanding of peripheral nerve anatomy and mechanics in order to better understand nerve physiology. Anatomical and biomechanical review of peripheral nerve includes: nerve mobility and stress/strain characteristics in both the upper and lower extremities; and mechanisms and consequences of trauma on nerve microcirculation as well as influence on axoplasmic and lymphatic flow within peripheral nerve. Physical therapy management of peripheral nerve dysfunction as reported by Elvey and Butler is reviewed. Guidelines for appropriate principles of clinical examination and treatment are outlined as well as possible areas for future clinical research.