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Strain and excursion of the sciatic, tibial, and plantar nerves during a modified straight leg raising test
Author(s) -
Coppieters Michel W.,
Alshami Ali M.,
Babri Awais S.,
Souvlis Tina,
Kippers Vaughan,
Hodges Paul W.
Publication year - 2006
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.20210
Subject(s) - medicine , ankle , plantar fascia , straight leg raise , tibial nerve , anatomy , sciatic nerve , strain (injury) , cadaver , common peroneal nerve , plantar flexion , heel , plantar fasciitis , orthodontics , range of motion , surgery , stimulation
Abstract A modified straight leg raising (SLR) in which ankle dorsiflexion is performed before hip flexion has been suggested to diagnose distal neuropathies such as tarsal tunnel syndrome. This study evaluates the clinical hypothesis that strain in the nerves around the ankle and foot caused by ankle dorsiflexion can be further increased with hip flexion. Linear displacement transducers were inserted into the sciatic, tibial, and plantar nerves and plantar fascia of eight embalmed cadavers to measure strain during the modified SLR. Nerve excursion was measured with a digital calliper. Ankle dorsiflexion resulted in a significant strain and distal excursion of the tibial nerve. With the ankle in dorsiflexion, the proximal excursion and tension increase in the sciatic nerve associated with hip flexion were transmitted distally along the nerve from the hip to beyond the ankle. As hip flexion had an impact on the nerves around the ankle and foot but not on the plantar fascia, the modified SLR may be a useful test to differentially diagnose plantar heel pain. Although the modified SLR caused the greatest increase in nerve strain nearest the moving joint, mechanical forces acting on peripheral nerves are transmitted well beyond the moving joint. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res