Neurodynamics: is tension contentious?

Richard Ellis*, Giacomo Carta, Ricardo J. Andrade, Michel W. Coppieters

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Tensioning techniqueswere the first neurodynamic techniques used therapeutically in the management of people with neuropathies. This article aims to provide a balanced evidence-informed view on the effects of optimal tensile loading on peripheral nerves and the use of tensioning techniques. Whilst the early use of neurodynamics was centered within a mechanical paradigm, research into the working mechanisms of tensioning techniques revealed neuroimmune, neurophysiological, and neurochemical effects. In-vitro and ex-vivo research confirms that tensile loading is required for mechanical adaptation of healthy and healing neurons and nerves. Moreover, elimination of tensile load can have detrimental effects on the nervous system. Beneficial effects of tensile loading and tensioning techniques, contributing to restored homeostasis at the entrapment site, dorsal root ganglia and spinal cord, include neuronal cell differentiation, neurite outgrowth and orientation, increased endogenous opioid receptors, reduced fibrosis and intraneural scar formation, improved nerve regeneration and remyelination, increased muscle power and locomotion, less mechanical and thermal hyperalgesia and allodynia, and improved conditioned pain modulation. However, animal and cellular models also show that ‘excessive’ tensile forces have negative effects on the nervous system. Although robust and designed to withstand mechanical load, the nervous system is equally a delicate system. Mechanical loads that can be easily handled by a healthy nervous system, may be sufficient to aggravate clinical symptoms in patients. This paper aims to contribute to a more balanced view regarding the use of neurodynamics and more specifically tensioning techniques.

Original languageEnglish
Pages (from-to)3-12
Number of pages10
JournalJournal of Manual and Manipulative Therapy
Issue number1
Early online date16 Nov 2021
Publication statusPublished - 2022

Bibliographical note

Funding Information:
The author(s) reported there is no funding associated with the work featured in this article. Our thanks to Lilah Ellis for the provision of illustrations for Figure 1.

Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


  • carpal tunnel syndrome
  • mononeuropathy
  • Neurodynamics
  • neuropathic pain
  • polyneuropathy
  • radiculopathy
  • tensioning techniques


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