Faculty Advisor(s)

G. Noel Squires

Document Type

Course Paper

Publication Date



© 2014 Brent Manley


Background and Purpose: Adverse mechanical tension on one’s nervous system can impair a nerves ability to mobilize in relation to its interfacing tissues and lead to sensations of pain, paresthesia and numbness. The impairment is typically treated by managing the interfacing tissues in addition to mobilizing the nerve through the use of gliders and tensioners. The purposes of this case report were to (1) provide overview of adverse mechanical tension and (2) to report a case describing specific physical therapy management approaches and outcomes during outpatient rehabilitation for a patient with adverse mechanical tension. Case Description: The patient was a female in her 50’s with work related cervicobrachial pain and paresthesia with activity of 1 week in duration. The patient was a professor with a history of repetitive upper extremity use. Her symptoms limited her ability to work. The patient received 9 sessions of physical therapy over 5 weeks. The initial examination revealed impairments of pain, range of motion, and strength. The procedural interventions included therapeutic exercise and manual therapy. The outcome measures included range of motion, strength, numeric rating scale and the QuickDASH. Outcomes: The patient’s QuickDASH decreased 43.14 points and Numeric Rating Scale decreased 5 increments. The patient’s improved strength, range of motion, and posture enabled a pain-free, restriction-free return to work. Discussion: Physical therapists have challenges when referring to research regarding rehabilitation of individuals with adverse mechanical tension related to the variety of presentations, outcome measures and the paucity of information on, and protocol for, nerve gliders and tensioners. Patient motivation levels, adherence to therapy, age, daily activities and psychological stress may have played a role in the outcomes of a patient with adverse mechanical tension.


The case report poster for this paper can be found here: http://dune.une.edu/pt_studcrposter/11/.



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