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Picture

Neural Tension Points in the Body

11/21/2014

6 Comments

 
Tension points are areas of the body with little or no movement between the nervous system and it's surrounding structures. Tension points can occur peripherally (at the carpal tunnel or superior tibiofibular joints for example) and centrally within the spinal column. The three main tension points of the spine are C6, T6, and L4. Clinically, it is important to investigate tension points whenever the patient reports radiating symptoms to an extremity.  

Peripherally, tension points occur where the nervous system branches, at soft tissue or osseous tunnels, areas where the nervous system is relatively fixed, and areas where the nervous system passes closely to surrounding structures. Examples of each of these can be seen below.  
EXAMPLES OF TENSION POINTS
Nervous System Branches
-Sciatic N. branches into tibial and common peroneal nerve around the fibular head. 
Nervous System nearby 
Soft Tissue or Osseous Tunnels
-Median N. in the carpal tunnel
-Ulnar N. at Guyon's canal
-PIN as it passes through arcade of Froshe 
Nervous System is Relatively Fixed
-Suprascapular N. is suprascapular notch
-Peroneal N. at fibular head
-Dura Mater at L4

Nervous System close to Nearby Structures
-Radial N. as it passes through radial groove 
-Brachial plexus as it passes the 1st Rib
6 Comments
Sathish
11/21/2014 09:42:11 pm

What could be the physiotherapy management for neural tension point?

Reply
Rick
11/21/2014 11:46:06 pm

Where can I find more information about this? I second wanting to know about management, as well.

Reply
Vince
11/23/2014 07:52:08 am

Thanks for your posts!!!
David Butler and the NOI group do wonderful work with the nervous system and education of health professionals. We used one of Davids books as text at University while studying Osteopathy here in Australia.

Reply
Jim
11/24/2014 10:37:43 am

Thank you all for the comments! In general, management of tension points is neural mobilization, soft tissue mobilizations, and manipulation to restore function/ mechanics to the area. There is no rocket-science to the treatment and management of these tension points, but recognizing them will make you more aware of potential complications that could arise.

Let me know if you would like more information,

Jim

Reply
Steve link
11/27/2014 03:10:39 am

Notice how the neural points are right near junctional zones. C6 is just above the CT junction and L4 is just about the LS junction. I believe these get sticky because junctional zones are notoriously stiff or hypo mobile while the motion segments above and below junctional zones tend to be hyper mobile and facilitated. The other one T6 probably happens because T6 is the apex of the thoracic kyphosis and with all the technology (laptops, cell phones, desk jobs) readily available, much of the population lives in a forward headed hyperkyphotic position. Hence why manipulations to the junctions are so helpful to get those areas moving while our core exercises help to support the hypermobile segments in between. You do that and then give some tensioner and sliders and you have a full meal deal. I know I need to study more about sliders and tensioners and I agree with Jim that butler is the pioneer in this area. Great post guys, it was fun reading this

Reply
Jo link
6/21/2020 09:48:07 am

Hi, I am looking for books/resources on Tension Point. Specifically a table or list of all of the tension points in the body. Do you have a resource/link for this?

Can you list sources/books to read more about this topic? I am unable to find any.

Reply



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        • POSH Test
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        • Prone Instability Test
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        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
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        • Standing Forward Flexion Test
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        • Horizontal Adduction Test
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        • Jobe Test
        • Ludington's Test
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        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
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          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
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        • Phalen's Test
        • Reverse Phalen's Test
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        • FAIR Test
        • Fitzgerald's Test
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        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
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        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
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        • Pivot-Shift Test
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        • Posterior Sag Sign
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        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
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        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
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        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test