Straight Leg Raise (SLR) Test
Straight Leg (SLR) Test
Indications
•Pain and altered sensation related to nerve roots L3-S3.
•Muscle dysfunction ( weakness or overactivity ) in myotomes supplied by these nerve roots ( foot dorsiflexion , extension hallux , eversion of foot , contraction buttock , knee flexion , toe standing ).
• Pain in the area of the sensory supply of the sciatic , tibial or peroneal nerve.
• Muscle dysfunction of muscle supplied by the sciatic nerve (semitendinosus , semi-membranosus , biceps femoris , hamstring part of adductor magnus ), tibial nerve ( gastrocnemius , soleus , plantaris , popliteus , tibialis posterior , FDL , FHL ) or peroneal nerve ( peroneus longus and brevis , EDL , tibialis anterior , EHL , peroneus tertius , EDB ).
• Symptoms related to sitting , driving , sprinting , hurdling , kicking , bending.
• Pathologies such as lumbar spine pathologies , sacroiliac joint pathologies , hamsting and calf muscle strainss , Achilles , peroneal and tibial tendon injury , ankle ligament sprains and plantar fascilitis.
• Generally , the slump test is used because it puts greater mechanical load on neural tissues and so allows for greater sensitivity.
• SLR might be chosen over the slump test if tissue is percieved to be highly irritable and sensitive to load.
Technique
Start the test with the patient supine position . stand to the side of the patient you are about to perform the test on, facing towards their head.
Place one hand just above their knee and the other under their Achilles tendon with your palm over their foot .
Position of the patient
Perform the test by lifting their leg ,bringing their hip into flexion while maintaining the extended knee until the end-of-range or until the patient indicates a reproduction of pain/ symptoms.
Lifting the Leg
Structural differentiation
Structural differentiation by getting patient to side flex their trunk to the contraletaral side.
Sensitising man-oeuvre
You can sensities the test by adding plantar flexion and inversion of foot ( sensitive for common peroneal nerve ) or Adding ankle dorsiflexion ( sensities for the tibial nerve ).
Modification of SLR : Peroneal , sural , tibial nerve test
Indications
• Pain and altered sensation related to nerve roots L3-S3.
• Muscle dysfunction ( weakness or over activity ) in myotomes supplied by these nerve roots ( foot dorsiflexion , extension hallux , eversion of foot , contraction buttock , knee flexion , toe standing ).
• Pain in the area of the sensory supply of the sciatic , tibial or peroneal nerve.
• Muscle dysfunction of muscle supplied by the sciatic nerve (semitendinosus , semi-membranous , biceps femoris , hamstring part of adductor magnus ), tibial nerve ( gastrocnemius , soleus , plantaris , popliteus , tibialis posterior , FDL , FHL ) or peroneal nerve ( peroneus longus and brevis , EDL , tibialis anterior , EHL , peroneus tertius , EDB ).
• Symptoms related to sitting , driving , sprinting , hurdling , kicking , bending.
• Pathologies such as lumbar spine pathologies , sacroiliac joint pathologies , hamsting and calf muscle strainss , Achilles , peroneal and tibial tendon injury , ankle ligament sprains and plantar fascilitis.
Achilles Causes
Technique
Peroneal
Start the test with the patient supine position . stand to the side of the patient you are about to perform the test on, facing towards their feet.
Place one hand just above their knee and the other under their foot, placing your fingers on their toes to bring the foot into plantar flexion and inversion.
foot inversion and plantar flexion
Perform the test by lifting their leg ,bringing their hip into flexion while maintaining the extended knee and plantar flexed / inverted foot until the end-of-range or until the patient indicates a reproduction of pain/ symptoms.
Sural
Start the test with the patient supine position . stand to the side of the patient you are about to perform the test on, facing towards their feet.
Place one hand just above their knee and the other under their foot.
Place the other hand around their foot into dorsiflexion , inversion position.
Perform the test by lifting their leg ,bringing their hip into flexion while maintaining the extended knee and plantar flexed / inverted foot until the end-of-range or until the patient indicates a reproduction of pain/ symptoms.
Tibial
Start the test with the patient supine position . stand to the side of the patient you are about to perform the test on, facing towards their feet.
Place one hand just above their knee and the other under their foot.
Place the other hand around their foot into dorsiflexion , eversion position.
Perform the test by lifting their leg ,bringing their hip into flexion while maintaining the extended knee and plantar flexed / inverted foot until the end-of-range or until the patient indicates a reproduction of pain/ symptoms.
Structural differentiation
Structural differentiation by getting patient to side flex their trunk to the contraletaral side.
Tags:
physiotherapy