Slump Test

Slump Test Purpose of Test: The slump test is used to screen for nerve root compression. The slump test may be preferable to the straight leg raise test when symptoms are mild or only reproduced in loaded or seated positions. Step 1: 0:18 With the patient sitting upright on the edge of the table, begin by screening each of the following joint motions independently: - Passive dorsiflexion of the ankle - Active cervical flexion - Active thoracic/lumbar flexion with a neutral cervical spine (the slump) Each of these motions must be pain free in isolation to ensure that no joint or muscle pain is contributing to the results of the test. Note: It is not necessary to screen isolated knee extension, as this will produce significant neural tension concurrently and confound the results Step 2: 1:11 Now you will combine these motions together. From the slumped position, add cervical flexion. Step 3: 1:25 Maintain this position and passively dorsiflex the patient’s ankle. Keep one hand on the patient's back, and have them hold the table to prevent them from sitting up and coming out of the slump. Step 4: 1:41 Holding the ankle in dorsiflexion, SLOWLY extend the patient’s knee until their symptoms are reproduced. Because many patients may have pain/discomfort due to limitations in hamstring length, you must next differentiate between pain from muscle shortness vs true neural tension. Step 5: 2:02 Holding the patient in the position where symptoms had just increased, have the patient look up to create cervical extension. Ask the patient if this makes their pain better, worse or the same. If cervical extension makes their pain better with the leg held just in pain, this indicates that the patient’s symptoms are coming from increased neural tension rather than muscle stretch, thus confirming your finding of a positive slump test.