The SLUMP test is a highly sensitive test that can elicit positive neural tension in even asymptomatic individuals. The test can be used in conjunction with other neural tension testing (straight leg raise) and is often a great concordant (asterisk) sign to demonstrate within treatment progress. Due to the complexity of this test, consistency is key. To ensure you are performing the SLUMP correctly, you must be systematic. Perform the same order of events with every patient, every time.
Proper Start Position (left picture above):
1) The patient sits upright with their popliteal creases against the back of the plinth.
2) The therapist presses the knees together and releases them to maintain a neutral position of the lower extremities
3) The patient folds their arms behind their low back
*These 3 steps are to maximize consistency
Performing the Test (Right picture above):
1) Have the patient slowly slouch from their thorax spine (this will also create lumbar flexion)
2) SLOWLY flex the head toward the sternum
3) SLOWLY begin extending the knee*
4) SLOWLY dorsiflex the ankle*
5) Extend the cervical spine (move a distant component)
*In steps 2, 3, and 4, I emphasize SLOWLY because the test is intended to pick up adverse neural tension. Many individuals will push past the onset of neural tension and confound the results of the examination. Remember, neural tension is only positive if their is a side to side difference, reproduces their primary complaint of pain, and if symptoms change by moving a distant component.
Turn the Test into a Treatment:
Fortunately, setup and treatment for positive neural tension findings can be very similar. Check out our HEP program page on Slump Sciatic Nerve Glides to improve your intervention selection. Additionally, for more information on neurodynamic testing and treatment check out our guest post from Darrin Staloch.