Winchester physiotherapist research
Winchester physiotherapy keeps involved with the latest research. Catherine Summerhayes has published in the research journal clinical biomechanics. She combines this research in the field of neurodynamics into her physiotherapy practice in Winchester for people with whiplash injuries, disc problems, repetitive strain injuries, nerve injuries and upper limb aches and pains. Contact me and we can discuss your problems. Catherine@thewsc.co.ukClinical biomechanics Volume 22, Issue 7, Pages 774-779 (August 2007)
An in vivo investigation of ulnar nerve sliding during upper limb movements
Received 14 December 2006; accepted 2 April 2007. published online 26 May 2007.
Abstract
Background
Peripheral nerves straighten and stretch in order to accommodate increases in bed length during joint movements. The ulnar nerve is predicted to show large bed length changes, particularly on elbow flexion. The present study examines sliding of the ulnar nerve during limb movements, to determine how far these changes are accommodated by straightening and stretch.
Methods
Ultrasound imaging was used to measure longitudinal nerve sliding in the forearm and upper arm during 40° wrist extension, 90° elbow flexion and 50° shoulder abduction. Nerve trunk folding in the upper arm was measured from still ultrasound images taken in a series of limb positions from 40° shoulder abduction, elbow extended and wrist neutral to full elbow flexion, 90° shoulder abduction and wrist extension, a position designed to stretch the ulnar nerve.
Findings
Wrist extension led to clear nerve sliding in the forearm with movements of up to 4mm. However, shoulder abduction and elbow flexion caused remarkably little nerve movement. Images of the ulnar nerve showed considerable curvature with 40° shoulder abduction and elbow extension but a much straighter path with the elbow flexed.
Interpretation
The ulnar nerve appears unloaded and follows a wavy path in most functional upper limb positions. During elbow and shoulder movements, changes in bed length appear to be accommodated largely by straightening of the nerve path, with only modest stretch of the nerve itself when the elbow flexes. The ulnar nerve is thus well adapted for the large changes in bed length that occur during limb movements.