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Structure and Biomechanics of Peripheral Nerves: Nerve Responses to Physical Stresses and Implications for Physical Therapist Practice

KS Topp, PT, PhD, is Associate Professor, Department of Physical Therapy and Rehabilitation Science and Department of Anatomy, University of California, San Francisco, 1318 7th Ave, Box 0736, San Francisco, CA 94143-0736 (USA) (toppk{at}ptrehab.ucsf.edu). Address all correspondence to Dr Topp
BS Boyd, PT, MSPT, is Staff Physical Therapist, Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco

The structural organization of peripheral nerves enables them to function while tolerating and adapting to stresses placed upon them by postures and movements of the trunk, head, and limbs. They are exposed to combinations of tensile, shear, and compressive stresses that result in nerve excursion, strain, and transverse contraction. The purpose of this appraisal is to review the structural and biomechanical modifications seen in peripheral nerves exposed to various levels of physical stress. We have followed the primary tenet of the Physical Stress Theory presented by Mueller and Maluf (2002), specifically, that the level of physical stress placed upon biological tissue determines the adaptive response of the tissue. A thorough understanding of the biomechanical properties of normal and injured nerves and the stresses placed upon them in daily activities will help guide physical therapists in making diagnoses and decisions regarding interventions. [Topp KS, Boyd BS. Structure and biomechanics of peripheral nerves: nerve responses to physical stresses and implications for physical therapist practice.]

Key Words: Adaptation • Compression • Excursion • Force • Inflammation • Neurodynamics • Physiology • Plasticity • Sprains and strains • Stress

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