Assessment and Treatment of Adverse Neural Tension That Occurs During Active Shoulder Abduction

To assess for adverse neural tension on the right side of the neck:

• Assess translational mobility of the cervical spine from right to left with your right hand contact on the articular pillars of the cervical spine.
• If you find multiple levels are restricted for right to left translation, then translate the level of greatest restriction to the left with your right hand contact on the articular pillar of the cervical vertebrae.
• Hold this translation and ask the patient to slowly abduct or slide their right arm up along the table.
• Ideally the patient should be able to fully abduct the arm without the therapist feeling the articular pillar pushing back toward the right against their R hand contact.
• When there is adverse neural tension in the R brachial plexus the cervical spine will be drawn to the R side by the hypertonic R scalenes and even more so during active R shoulder abduction.
• Repeat on the left side and note any difference.