The nervous system is not a fixed structure. Peripheral nerves must glide freely within their surrounding tissues as the body moves. When a nerve is compressed, restricted, or sensitised, it loses this capacity. Symptoms follow: pain that travels or radiates, tingling and numbness in predictable distributions, burning sensations that change with posture, and weakness that resists correction through exercise alone.
Neurodynamic testing assesses the mechanical behaviour of nerves under controlled, specific movement. By placing graduated mechanical stress through a nerve pathway and observing how symptoms respond, clinicians can determine whether a nerve is restricted, sensitised, or functioning normally. This is not a generalist assessment. Each test is designed to bias a specific nerve or nerve root, and the interpretation requires clinical precision.
At Myofitness, neurodynamic testing is integrated with a full neurological assessment, including dermatome sensory testing, myotome motor testing, and deep tendon reflex assessment. Together, these tools build a complete picture of where the nervous system is disrupted, at what level, and what treatment approach is required to address it effectively.
A healthy nerve adapts to movement without provoking symptoms. It glides within its surrounding tissue, tolerates stretch across its length, and transmits signals without distortion. A sensitised or mechanically restricted nerve does none of these things reliably, and the gap between its ideal and actual behaviour is precisely what neurodynamic testing is designed to reveal.
Testing is performed through specific, controlled joint positions that place graduated mechanical load through a target nerve pathway. The practitioner observes how symptoms respond at each stage: whether familiar sensations are reproduced, whether they change with sensitising or relieving movements, and whether the response is consistent with neural involvement at a specific level.
A test is considered positive when it reproduces the patient’s familiar symptoms and those symptoms change predictably with sensitising or relieving movements. This specificity is what makes neurodynamic testing clinically meaningful rather than merely symptomatic.
Neurodynamic tests are not interchangeable. Each is structured to load a specific nerve or nerve root through a defined movement sequence. The clinician’s interpretation depends on whether the test reproduces the patient’s familiar symptoms, and whether those symptoms change with sensitising or relieving manoeuvres added at the distal or proximal end of the nerve.
Identifying which nerve is involved, and at what point along its course the restriction or sensitivity occurs, is what allows treatment to be precise. Neural glides, neural loading progressions, and postural corrections are all selected based on which specific test was positive and what the response pattern suggested about the mechanism of involvement.
Neurodynamic tests are not interchangeable. Each is structured to load a specific nerve or nerve root through a defined movement sequence. The clinician’s interpretation depends on whether the test reproduces the patient’s familiar symptoms, and whether those symptoms change with sensitising or relieving manoeuvres added at the distal or proximal end of the nerve.
Identifying which nerve is involved, and at what point along its course the restriction or sensitivity occurs, is what allows treatment to be precise. Neural glides, neural loading progressions, and postural corrections are all selected based on which specific test was positive and what the response pattern suggested about the mechanism of involvement.
Four tests targeting the median nerve (ULTT1 and 2a), radial nerve (ULTT2b), and ulnar nerve (ULTT3) of the brachial plexus. Used for neck pain, arm pain, carpal tunnel symptoms, thoracic outlet syndrome, and postural nerve irritation. ULTT1 reproduces symptoms in up to 97% of confirmed cervical radiculopathy cases.
Assesses sciatic nerve and lumbar nerve root irritation (L4, L5, S1). The addition of ankle dorsiflexion and cervical flexion as sensitising manoeuvres confirms neural rather than hamstring involvement. Sensitivity up to 92% for lumbar disc herniation with nerve root compression.
Assesses lumbosacral nerve roots and sciatic nerve in positions that commonly reproduce sitting-related symptoms. Particularly useful when the SLR is negative but neural involvement is still suspected from symptom behaviour. High sensitivity for dural and neural tissue irritation in the lumbar spine.
Assesses the femoral nerve and upper lumbar nerve roots (L2, L3, L4). Used when anterior thigh pain, quadriceps weakness, or reduced knee extension reflex suggest upper lumbar nerve root involvement not captured by SLR or Slump testing.
Neurodynamic testing tells us how well the nerve moves. Neurological testing tells us how well it communicates. Both are needed to build a complete picture of neural involvement. A nerve can have normal mechanical behaviour but impaired signal transmission, or vice versa. Testing only one dimension gives an incomplete clinical picture.
At Myofitness, neurodynamic testing is routinely combined with a full neurological assessment. This includes dermatomal sensory testing to evaluate the afferent pathway from body to brain, myotomal strength testing to evaluate the efferent pathway from brain to muscle, and deep tendon reflex assessment to evaluate the integrity of the reflex arc at each spinal level.
When neurodynamic findings align with dermatomal sensory changes, myotomal weakness, and altered reflexes, the level of nerve root involvement is confirmed with high diagnostic confidence. This is the foundation for making treatment decisions that actually address the source of the problem rather than the location of the symptom.
Evaluates the sensory pathway from skin to brain. Assesses light touch, pressure, temperature, and pain perception across dermatomal maps to identify whether a specific nerve root is transmitting clear, accurate sensory information or producing distorted signals such as numbness, pins and needles, hypersensitivity, or burning.
Evaluates the motor pathway from brain to muscle. Identifies true neurological weakness by testing the specific muscle groups controlled by each spinal nerve root. Distinguishes neurological motor deficit from pain-inhibited movement, which requires a fundamentally different treatment approach.
Neurodynamic test positive at a specific spinal level, combined with dermatomal sensory change, myotomal weakness, and altered reflex response at the same level, confirms nerve root involvement with high diagnostic confidence and guides treatment directly to the source.
When neural involvement is confirmed, the treatment approach is fundamentally different from standard musculoskeletal care. Aggressive stretching, heavy loading, and deep tissue work applied over a sensitised nerve can provoke rather than resolve symptoms. The nervous system requires a different kind of clinical respect.
Treatment begins by reducing neural load, removing the mechanical factors compressing or restricting the nerve at the identified level. This is followed by carefully graded neural mobilisation techniques that restore gliding capacity without provoking sensitisation. Postural correction, ergonomic guidance, and a progressive loading program are built around the nerve’s tolerance, not a standard protocol.
The goal is not simply symptom relief. It is restoring the nerve’s capacity to move freely, transmit signals accurately, and tolerate the mechanical demands of daily life and activity without provoking protective responses. This is what produces outcomes that hold over time rather than temporarily easing and returning.
Neurodynamic tests, dermatome assessment, myotome testing, and reflex evaluation combined to identify the level and nature of nerve involvement before any treatment begins.
Address the postural, structural, and mechanical factors compressing or restricting the nerve at the identified level. Modify activity and positioning to reduce ongoing irritation while treatment progresses.
Graded neural gliding and neural mobilisation techniques applied in a specific direction and amplitude matched to the nerve’s current sensitivity. Progression is determined by symptom response, not a fixed timeline.
Progressive strengthening of the myotomal muscle groups, postural re-education, and a return-to-activity program built around the nerve’s recovering capacity to tolerate mechanical load without sensitisation.
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Radiating pain that follows a predictable path from the spine into a limb is one of the clearest indicators of nerve root involvement. The pain is not originating where it is felt. Neurodynamic testing identifies which nerve root is involved and at what level treatment needs to be applied.
These symptoms follow dermatomal distributions and are direct indicators of disrupted nerve signalling. They change with posture, movement, and position in ways that purely muscular symptoms do not. A neurodynamic assessment identifies the nerve involved and whether it is restricted, compressed, or sensitised.
Pain that worsens when looking over your shoulder, reaching overhead, sitting in certain positions, or lying in particular ways is behaving neurologically. Posture changes the mechanical load on specific nerve pathways, and symptoms that respond to this are telling the clinician exactly which nerve needs to be assessed.
If a muscle remains weak despite consistent training, the motor pathway between the brain and that muscle may be compromised at the nerve root level. Myotome testing identifies whether this is neurological weakness rather than deconditioning, and neurodynamic assessment identifies the mechanical driver.
Muscles have been worked on. Joints have been mobilised. The symptoms ease and return. When soft tissue and joint treatment produces only temporary relief, neural involvement is one of the most common unidentified reasons why. Neurodynamic assessment answers the question standard treatment has been unable to resolve.
Surgery disrupts neural pathways at and around the site of intervention. Persistent pain, altered sensation, weakness, or hypersensitivity following surgery often reflects incomplete neural recovery rather than ongoing tissue damage. Neurodynamic assessment identifies what the nerve needs to complete its recovery.
A sensory neurological assessment helps identify whether your pain, numbness, tingling, burning, weakness, or altered sensation is coming from a nerve. Your physiotherapist will assess sensation, reflexes, muscle strength, and nerve function to determine whether your symptoms are being caused by a pinched nerve, nerve irritation, spinal condition, or another neurological issue. It provides a clear diagnosis so treatment can target the actual source of your symptoms.
Dermatome testing checks the feeling (sensation) in areas of skin supplied by specific spinal nerves. Myotome testing assesses the strength of muscles controlled by those same nerves. Together, these tests help identify which nerve root may be affected and whether the problem is coming from the neck, lower back, or another part of the nervous system.
Structural pain is caused by an injury or irritation to tissues such as muscles, joints, ligaments, or nerves. Central sensitisation occurs when the nervous system becomes overly sensitive, meaning pain continues even after tissues have healed or pain feels much more intense than expected. Your assessment helps determine whether your symptoms are structural, neurological, centrally sensitised, or a combination of these, allowing treatment to be tailored appropriately.
No. The assessment is non-invasive and generally comfortable. It involves testing sensation, muscle strength, reflexes, movement, and nerve function. Some positions or movements may briefly reproduce your symptoms, but this provides valuable information to help identify the source of your pain.
No referral is required. You can book directly with one of our physiotherapists. If you have previous scans, specialist letters, or medical reports, bring them along as they can provide useful information, but they are not essential.
Depending on your circumstances, you may be able to claim through private health insurance, Medicare (with an eligible GP Management Plan), WorkCover, TAC, DVA, or the NDIS where physiotherapy is included in your plan. If you’re unsure what you’re eligible for, our reception team is happy to help before your appointment.
Neurodynamic and neurological testing for persistent pain at North Melbourne, Yarraville, and Surrey Hills. No referral required. Same-week appointments usually available.
