Acute Effects of Neurodynamic Stretching on Muscle-tendon Complex (ELASTRETCH)

The Acute Effects of Neurodynamic Stretching the Shear Wave Velocity: on Application on Muscle and Nerve Tissues

Neurodynamic mobilization techniques are widely applied in rehabilitation and physiotherapy to enhance the mobility and function of peripheral nerves. Two main approaches are distinguished. Nerve tensioning and nerve flossing. They both involve proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding these techniques. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE, a form of ultrasonography).

Study Overview

• Status: Completed
• Conditions: Control Condition; Stretching
• Intervention / Treatment: Other: Maximal static stretching; Other: Maximal neurodynamic tensioning; Other: Maximal neurodynamic flossing; Other: Submaximal static stretching; Other: Submaximal neurodynamic tensioning; Other: Submaximal neurodynamic flossing

Detailed Description

Neurodynamic mobilization techniques are frequently applied in rehabilitation settings to enhance the mobility and function of peripheral nerves, particularly in the management of neuropathic pain such as carpal tunnel syndrome, radiculopathies, or sciatica. Two main approaches are distinguished. Nerve tensioning involves maintaining the nerve stretched at the end of the joint range of motion with relatively limited excursion. It is similar to a static stretching intervention but with distal (ankle) and proximal (cervical) tensions. Nerve flossing (also termed gliding or sliders), consists of alternating proximal and distal joint movements to induce greater neural sliding while avoiding excessive tensile stress. However, contradictory findings on neurodynamic techniques highlighted the current lack of consensus regarding the acute effects of the different possible neurodynamic techniques on sciatic nerves, particularly in healthy tissues. Moreover, neurodynamic techniques are of interest for patients, it appeared it could also be applied in healthy individuals and more particularly in athletes. Performed in patients, healthy or athletes, no study has compared both tensioning or flossing techniques. Moreover, because these techniques involved nerve mobilisation, the intensity should have a main effect of its efficiency. Accordingly, the primary objective of the present study was to determine the immediate effect of two neurodynamic mobilization techniques (flossing vs. tensioning) on the sciatic nerve and hamstring tissues using the shear wave elastography (SWE). This method has been shown reliable to provide non-invasive real-time assessments of soft tissues elastic properties. The secondary aim was to determine the effects of stretching intensity (at the point of pain threshold or below).

• Study Type: Interventional
• Enrollment (Actual): 21
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Dijon, France
    • Universite Bourgogne Europe - faculty of sports sciences

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• healthy
• physical active
• no injuries (lower limb or back pain) in the past 3 months

Exclusion Criteria:

• Specific lower limb (hamstring) injuries in the past 2 years
• Not restraining activity 24h before participation

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Single

Number of Arms

7

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Seated at rest during the same duration than the interventions
Active Comparator: Static stretching at pain threshold; Static stretching at pain threshold of the right hamstring muscles 5x60s with 20s rest	Other: Maximal static stretching; Static stretching was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. Static stretching mainly focused muscle-tendon tissues.
Experimental: Neurodynamic tensioning at pain threshold; Neurodynamic tensioning of the right hamstring muscles 5x60s with 20s rest at pain threshold	Other: Maximal neurodynamic tensioning; Neurodynamic tensioning was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Tensioning is maintaining the position.
Experimental: Neurodynamic flossing at pain threshold; Neurodynamic flossing of the right hamstring muscles 5x60s with 20s rest at pain threshold	Other: Maximal neurodynamic flossing; Neurodynamic flossing was applied at pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.
Active Comparator: Static stretching at submaximal intensity; Static stretching of the right hamstring muscles 5x60s with 20s rest at 10% below pain threshold	Other: Submaximal static stretching; Static stretching was applied 10% below pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. Static stretching mainly focused muscle-tendon tissues.
Active Comparator: Neurodynamic tensioning at submaximal intensity; Neurodynamic tensioning stretching of the right hamstring muscles 5x60s with 20s rest at 10% below pain threshold	Other: Submaximal neurodynamic tensioning; Neurodynamic tensioning was applied 10% below pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Tensioning is maintaining the position.
Active Comparator: Neurodynamic flossing at submaximal intensity; Neurodynamic flossing stretching of the right hamstring muscles 5x60s with 20s rest at 10% below pain threshold	Other: Submaximal neurodynamic flossing; Neurodynamic flossing was applied 10% below pain threshold on hamstring muscles and repeated 5 times during 60s at the point of pain. During the neurodynamic conditions, head and ankle movement permitted to mobilize nerve tissues. Flossing is the alternation of these movements every 2 seconds.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Nerve shear wave velocity using elastography	Shear wave velocity of the sciatic nerve will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is.	Before the intervention and at the end (immediately after) the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle shear wave velocity using elastography	Shear wave velocity of the biceps femoris muscle will be evaluated by using an ultrasound (echography) device with a specific mode called "shear wave elastography". Briefly, the ultrasound probe will deliver an ultrasound wave. The propagation speed (called '"shear wave velocity") will be measured by the same probe. The greater the velocity is, the harder the tissue is.	Before the intervention and at the end (immediately after) the intervention
Hamstring force	Maximal torque during a maximal voluntary hamstring contraction	Before the intervention and at the end (immediately after) the intervention
Biceps femoris activity	Electromyographic activity of biceps femoris muscle	Before the intervention and at the end (immediately after) the intervention
Semitendinosus activity	Electromyographic activity of semitendinosus	Before the intervention and at the end (immediately after) the intervention
passive knee extension	The final passive range of motion of the hamstring muscles	Before the intervention and at the end (immediately after) the intervention
Global flexibility	the stand and reach test to evaluate flexibility (in centimeters)	Before the intervention and at the end (immediately after) the intervention
Slump test	Seated flexibility using the slump test (in degrees)	Before the intervention and at the end (immediately after) the intervention
discomfort	rating of perceived discomfort during the intervention (from 1 to 10, no discomfort to maximal discomfort, respectively)	At the end (immediately after) the intervention

Collaborators and Investigators

• Sponsor: University of Burgundy
• Investigators: Principal Investigator: Nicolas Babault, PhD, Universite Bourgogne Europe - Sport Science Faculty

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2023
• Primary Completion (Actual): May 20, 2024
• Study Completion (Actual): June 15, 2024

Study Registration Dates

• First Submitted: December 1, 2025
• First Submitted That Met QC Criteria: December 12, 2025
• First Posted (Actual): December 26, 2025

Study Record Updates

• Last Update Posted (Actual): December 26, 2025
• Last Update Submitted That Met QC Criteria: December 12, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: muscle; stiffness; nerve; stretching; flexibility
• Other Study ID Numbers: CEP2204

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: data freely available in online websites

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No