I’m on paternity leave right now, which means I’ve mastered the art of holding a baby in one arm and a cup of coffee in the other. Somewhere between naps, I’ve had time to revisit the research around neurodynamics and think about how those studies translate into what I see every day in the clinic — real people, real movement, and real goals, not just numbers on a page. Also this time has allowed me to  evaluate where this tool fits into the best evidence based practices and make sure that the use of this tool still aligns with our goals for patients as well as remains an educated viable option to include in treatment plans. 

So here goes a mini literary review/explanation of Neurodynamics:

At Apex Spine and Performance, we don’t just look at muscles and joints. We look at how your nervous system moves, tolerates load, and adapts over time. That’s the foundation of how we help people get back to running, lifting, skiing, working, and doing whatever makes them feel like themselves again here in Bend.

This is where neurodynamics, neuromobilization, and nerve mobilization live in our world.

What Is Neurodynamics?

Neurodynamics is just a fancy word for a simple idea:
Your nervous system is a moving, adaptable tissue, not a static cable.

Every time you bend, reach, step, or rotate, your nerves have to:

• Slide through surrounding tissues

• Tolerate changes in length and pressure

• Keep sending and receiving signals clearly

When that system gets sensitive — after injury, flare-ups, long periods of sitting, or sudden spikes in training — even normal movement can start to feel like a threat instead of something safe.

Our job isn’t to “free a stuck nerve.”
Our job is to help your system trust movement again.

What Is Nerve Mobilization?

You’ll hear it called:

• Neuromobilization

• Neural mobilization

• Nerve mobilization

• Nerve sliders, glides, or neuro drills

Different words, same concept:

Using specific movements and positions to gradually expose your nervous system to motion and load in a way it can handle and adapt to.

At Apex, this is never random. It’s layered into your strength work, your daily movement, and your real-world goals — not just something you do on a table for five minutes and forget about.

Why Would a Nervous System Need Training?

Because it lives in the real world.

Long drives. Desk jobs. Ski days. Heavy deadlifts. Toddler carries. Missed sleep. Old injuries. New hobbies you probably weren’t ready for but tried anyway.

Just like muscles and tendons, your nervous system can become protective and deconditioned when it hasn’t seen certain movements in a while. Then when you finally ask it to perform, it responds with pain, tightness, or that “zingy” nerve feeling people love to describe.

Nerve mobilization gives us a way to scale movement back in instead of jumping straight from zero to full send.

How We Actually Use This at Apex

This is the part I really care about, because this is where a lot of rehab goes sideways.

We don’t start with the most aggressive thing we can think of. We start with positions and movements that make your system feel safer, then build up from there.

Here’s how we think about it in simple terms:

1. Sliders (most commonly perscribed) 

You've probaly seen these before they are widely used in the the PT/Chiropractic spaces. Sliders focus on helping the nerve move and slide without adding much overall tension. One part of the body increases demand while another part decreases it.

These are:

• Early-phase tools

• Flare-up friendly

• Great for sensitive or guarded systems

They remind your nervous system that movement itself is okay again.

2. Offloading Positions

These are positions where symptoms tend to settle down.

We use them to:

• Reduce perceived threat

• Calm sensitive areas

• Give you a reliable “home base” when things feel spicy

Sometimes progress starts with simply knowing where your body feels safe.

3. Openers (Providing Space)

Openers are about creating space through the system.

Instead of increasing tension, these positions and movements aim to:

• Reduce compression around sensitive neural and joint regions

• Improve how tissues share load

• Give the nervous system more “room” to operate

We use openers when someone feels jammed up, compressed, or stuck in one posture all day — especially in the neck, shoulder, spine, or hip.

Think of these as space-makers before load-makers.

4. Closers

Closers gently bring the body back toward positions that increase demand and compression in a controlled way.

This is where we:

• Start rebuilding tolerance

• Teach the system that it can handle closing down space again

• Prepare you for real-life positions like lifting, sitting, reaching, and sport

5. Tensioners

These are the higher-level drills.

Tensioners increase how much load and stretch the nervous system tolerates across multiple joints and regions at once.

We use these when:

• Symptoms are calmer

• Movement confidence is higher

• You’re getting closer to training, work, or performance demands

This is where rehab starts to look a lot more like performance prep than “treatment.”

What the Research Lines Up With

The research world tends to agree on one big thing:
Nerve mobilization works best when it’s part of a bigger plan, not a magic trick.

Studies consistently show it can be helpful for:

• Neck and arm pain with nerve involvement

• Low back pain that travels into the leg

• Carpal tunnel–type symptoms

• Persistent nerve sensitivity

But the strongest outcomes tend to show up when it’s combined with:

• Strength training

• Movement coaching

• Education

• Gradual return to real-life activity

Which is good, because that’s exactly how we run Apex.

The Apex Philosophy in One Paragraph

Nerve mobilization isn’t a party trick.
It’s one tool inside a bigger system built around assessment, movement, strength, and long-term adaptation.

Our goal isn’t to make you feel better for the afternoon.
It’s to help you build a body and nervous system that can handle your life — whether that’s trail running in Bend, lifting heavy, chasing kids, or all three in the same day.

Final Thought From a Sleep-Deprived Rehab Chiropractor

You’re not fragile.
Your nervous system isn’t broken.

It might just need the right movements, in the right positions, at the right time, in the right amount.

That’s what we do at Apex.

Now if this baby stays asleep, I might write another one of these.

References (Evidence Behind the Approach)

 

1. Basson A, Olivier B, Ellis R, Coppieters M, Stewart A, Mudzi W. (2017).
   The Effectiveness of Neural Mobilization for Neuromusculoskeletal Conditions: A Systematic Review and Meta-analysis.
   Journal of Orthopaedic & Sports Physical Therapy, 47(9), 593–615.
   https://pubmed.ncbi.nlm.nih.gov/28704626/

2. Paraskevopoulos E, Koutsopoulos D, Billis E, et al. (2022).
   The Effectiveness of Neuromobilization in Patients With Cervical Radiculopathy: A Systematic Review With Meta-analysis.
   Physical Therapy in Sport, 55, 100–113.
   https://pubmed.ncbi.nlm.nih.gov/36395760/

3. García-Juez S, Fernández-de-Las-Peñas C, Navarro-Santana MJ, et al. (2025).
   Effectiveness of Articular and Neural Mobilization for Managing Cervical Radicular Pain: A Systematic Review With Network Meta-analysis.
   Journal of Orthopaedic & Sports Physical Therapy.
   https://pubmed.ncbi.nlm.nih.gov/40576779/

4. Lin L-H, Li X, Xu Y, et al. (2023).
   Neural Mobilization for Reducing Pain and Disability in Lumbar Radiculopathy: A Systematic Review and Meta-analysis.
   Life, 13(12), 2255.
   https://www.mdpi.com/2075-1729/13/12/2255

5. Ballestero-Pérez R, Plaza-Manzano G, Urraca-Gesto A, et al. (2017).
   Effectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome: A Systematic Review.
   Journal of Manipulative and Physiological Therapeutics, 40(1), 50–59.
   https://pubmed.ncbi.nlm.nih.gov/27842937/

6. Bittencourt JV, Callaghan MJ, Cury RC. (2024).
   Neural Mobilisation Effects in Nerve Function and Nerve Structure of Patients With Peripheral Neuropathic Pain: A Systematic Review With Meta-analysis.
   PLOS ONE, 19(1), e0313025.
   https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0313025

7. Coppieters MW, Alshami AM, Hodges PW. (2008).
   Do “Sliders” Slide and “Tensioners” Tension? An Analysis of Neurodynamic Techniques and Nerve Movement.
   Manual Therapy, 13(3), 213–221.
   https://pubmed.ncbi.nlm.nih.gov/17398140/

8. Ellis RF, Hing WA. (2008).
   Neural Mobilization: A Systematic Review of Randomized Controlled Trials With an Analysis of Therapeutic Efficacy.
   Journal of Manual & Manipulative Therapy, 16(1), 8–22.
   https://pubmed.ncbi.nlm.nih.gov/19119380/

9. Butler DS, Gifford LS. (1989).
   The Concept of Adverse Mechanical Tension in the Nervous System. Part 1: Testing for “Dural Tension.”
   Physiotherapy, 75(11), 622–629.

10. Nee RJ, Butler DS. (2006).
    Management of Peripheral Neuropathic Pain: Integrating Neurobiology, Neurodynamics, and Clinical Evidence.
    Physical Therapy in Sport, 7(1), 36–49.