Slump (long sitting) Test 4 – Spinal Cord, Sciatic Nerve, Cervical, and Lumbar Nerve Root Bias

Purpose of Slump (long sitting) Test 4: To determine if the tension along the spinal cord, sciatic nerve, and cervical and lumbar nerve roots contribute to the neurologic symptoms associated with radiculopathy.

Patient position: Long sitting on the examination table (as upright as tolerated) with hands behind the back.

Examiner position: Standing beside the patient, at the side of the limb to be tested.

Procedure: Perform the limb/joint positioning sequence in the following order:

1. Slouch at the lumbar and thoracic spine (with the examiner’s one hand over the patient’s shoulder girdles), while the patient is looking forward,
2. Cervical spine flexion/rotation (1) (with the examiner’s hand over the patient’s occiput),
3. Hip flexion (slightly more than 90 degrees, lean forwards),
4. Ankle dorsiflexion (with the examiner’s other hand at the forefoot), while maintaining the cervical spine flexion/rotation (1),
5. Sensitizing position: Cervical spine flexion or extension (2).

Outcome: This test is positive if (a) the limb/joint positioning sequence reproduces symptoms associated with radiculopathy, (b) the sensitizing position reproduces symptoms, and (c) there is a repeatable and measurable asymmetry between both sides along with the reproduction of symptoms.

Reference:

1. Magee DJ. Orthopedic Physical Assessment: Elsevier Health Sciences; 2013.
2. Shacklock M. Clinical neurodynamics: a new system of musculoskeletal treatment: Elsevier Health Sciences; 2005.