In the Journal of Orthopaedic Research – September 2006, Coppieters MW, Alshami AM, Babri AS, et al measured the strain and excursion of the sciatic, tibial and plantar nerves with a modified straight leg raise (SLR) test. By bending the ankle into dorsiflexion first before raising the leg, nerve movement at the ankle, particularly the tibial nerve was greatly increased. Clinically, the diagnosis of ‘plantar fascitis’ can be caused by multiple sources, one being sensitization of the tibial nerve which is a branch of the sciatic nerve. Thanks to Dr. Coppieters, as well as other neurodynamic specialists like Michael Shacklock MAppSc, DipPhysio, we now know that movement of nerves occurs greatest where joints move first, a concept called ‘neurodynamic sequencing’. By sensitizing the tibial nerve through the SLR test, or even a slump test (picture shown) we can differentially diagnose plantar fascitis as a peripheral nerve disorder.
