ULNT3 Neurodynamics Assessment

ULNT3 Neurodynamics Assessment

Ulnar Nerve Assessment – ULNT3

Ulnar nerve (C6-T1)

Starting position:

  1. Patient฀lays฀supine,฀arms฀by฀the฀side,฀and฀shoulder฀close฀to฀the฀ edge of the examination table, no pillow if possible, and body straight.
  2. Therapist฀facing฀the฀patient’s฀head฀and฀presses฀near฀hand฀on฀the฀ table above the patient’s shoulder in either a knuckles or fist position (this time, applying a downward or caudad pressure on the superior aspect of the patient’s shoulder to achieve shoulder girdle depression).
  3. With฀the฀other฀hand,฀the฀therapist฀holds฀the฀patient’s฀hand฀palm฀ against palm and the elbow starts in extension.

Movement sequence:

  1. Wrist฀and฀ingers฀extended฀as฀the฀elbow฀is฀flexed.
  2. Forearm฀is฀then฀pronated฀and฀the฀shoulder฀taken฀into฀lateral฀rotation and abduction.
  3. Glenohumeral฀external฀rotation฀to฀available฀range฀(generally฀stopped at 90 degrees if the patient is very mobile)
  4. Elbow฀extension฀should฀be฀done฀gently฀and฀with฀care฀not฀to฀cause฀any shoulder motion, especially adduction (which would ease off developing neurodynamic test).

Structural differentiation:

  1. Based฀on฀where฀the฀symptoms฀(if฀any)฀are฀located.
  2. Add฀in฀cervical฀contralateral฀lateral฀flexion฀or฀shoulder฀girdle฀depression.

Palpable areas:

  1. Pisiform area at the wrist
  2. At the elbow and in the upper arm

Common entrapments / syndromes:

  1. Guyon’s canal
  2. Cubital tunnel