{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:14:17Z","timestamp":1747188857840,"version":"3.40.5"},"reference-count":30,"publisher":"Human Kinetics","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Context<\/jats:bold>:<\/jats:italic> Foot\/ankle pain is common among runners. Inadequate management of runners with foot\/ankle pain can lead to lost training time, competition removal, and other activity limitations. Neurodynamics, which refers to the integrated biomechanical, physiological, and structural function of the nervous system during movement, can be overlooked in patients with foot\/ankle pain. Although a link between the cervical spine, neurodynamics, and upper quarter pain has been studied, less is known about the relationship between the lumbar spine and lower quarter. This case series describes the successful management of 3 runners with foot\/ankle pain. <jats:italic><jats:bold>Case Presentations<\/jats:bold>:<\/jats:italic> Three female runners (ages 23, 24, and 45\u00a0y) presented to physical therapy with foot\/ankle pain and difficulty running. Each patient had positive examination findings with local foot\/ankle testing. A comprehensive lumbar spine examination demonstrated impairments in range of motion and joint mobility that were hypothesized to be contributing. Positive lower quarter neurodynamic tests were also found. <jats:italic><jats:bold>Management and Outcomes<\/jats:bold>:<\/jats:italic> All patients were treated with nonthrust lumbar spine mobilization and lower quarter neural tissue mobilization. Changes in the Patient-Specific Functional Scale, Numerical Pain Rating Scale, Lower Extremity Functional Scale, and Global Rating of Change occurred after intervention targeting the lumbar spine and lower-extremity neurodynamics in all patients. <jats:italic><jats:bold>Conclusions<\/jats:bold>:<\/jats:italic> This case series demonstrates the importance of including a thorough lumbar spine examination and neurodynamic testing to identify appropriate interventions while managing patients with foot\/ankle pain, even when patients have signs indicative of local ankle\/foot pathology. These examination procedures should be performed particularly when a patient is not <jats:underline\/>responding to management targeting local foot\/ankle structures.<\/jats:p>","DOI":"10.1123\/jsr.2024-0035","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T03:37:18Z","timestamp":1724297838000},"page":"549-555","source":"Crossref","is-referenced-by-count":0,"title":["Lumbar Spine and Neural Tissue Mobilizations Improve Outcomes in Runners Presenting With Foot\/Ankle Pathology: A Case Series"],"prefix":"10.1123","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0356-6360","authenticated-orcid":true,"given":"Christopher R.","family":"Hagan","sequence":"first","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9759-775X","authenticated-orcid":true,"given":"Alexandra R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA"},{"name":"The Physical Therapy Academy, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4488-1332","authenticated-orcid":true,"given":"Craig P.","family":"Hensley","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"100","reference":[{"issue":"3","key":"r1","series-title":"Sports","doi-asserted-by":"publisher","DOI":"10.3390\/sports8030035","article-title":"Factors affecting training and physical performance in recreational endurance runners","volume":"8","author":"Boullosa D","year":"2020","unstructured":"Boullosa D, Esteve-Lanao J, Casado A, Peyre-Tartaruga LA, Gomes da Rosa R, Del Coso J. Factors affecting training and physical performance in recreational endurance runners. Sports. 2020;8(3):35. doi:10.3390\/sports8030035"},{"issue":"9","key":"r2","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"2211","DOI":"10.1177\/0363546518773755","article-title":"A 2-year prospective cohort study of overuse running injuries: the Runners and Injury Longitudinal Study (TRAILS)","volume":"46","author":"Messier SP","year":"2018","unstructured":"Messier SP, Martin DF, Mihalko SL, et\u00a0al. A 2-year prospective cohort study of overuse running injuries: the Runners and Injury Longitudinal Study (TRAILS). Am J Sports Med. 2018;46(9):2211\u20132221. doi:10.1177\/0363546518773755"},{"issue":"6","key":"r3","series-title":"PLoS One","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099877","article-title":"A prospective study on time to recovery in 254 injured novice runners","volume":"9","author":"Nielsen RO","year":"2014","unstructured":"Nielsen RO, Ronnow L, Rasmussen S, Lind M. A prospective study on time to recovery in 254 injured novice runners. PLoS One. 2014;9(6):e99877. doi:10.1371\/journal.pone.0099877"},{"issue":"8","key":"r4","series-title":"Br J Sports Med","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1136\/bjsm.2006.033548","article-title":"Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review","volume":"41","author":"van Gent RN","year":"2007","unstructured":"van Gent RN, Siem D, van Middelkoop M, van Os AG, Bierma-Zeinstra SM, Koes BW. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007;41(8):469\u2013480. doi:10.1136\/bjsm.2006.033548"},{"issue":"7","key":"r5","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"518","DOI":"10.2519\/jospt.2019.8473","article-title":"Running themselves into the ground? Incidence, prevalence, and impact of injury and illness in runners preparing for a half or full marathon","volume":"49","author":"Franke TPC","year":"2019","unstructured":"Franke TPC, Backx FJG, Huisstede BMA. Running themselves into the ground? Incidence, prevalence, and impact of injury and illness in runners preparing for a half or full marathon. J Orthop Sports Phys Ther. 2019;49(7):518\u2013528. doi:10.2519\/jospt.2019.8473"},{"issue":"12","key":"r6","series-title":"Foot Ankle Int","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1177\/107110079801901203","article-title":"Outcome study of subjects with insertional plantar fasciitis","volume":"19","author":"Martin RL","year":"1998","unstructured":"Martin RL, Irrgang JJ, Conti SF. Outcome study of subjects with insertional plantar fasciitis. Foot Ankle Int. 1998;19(12):803\u2013811. doi:10.1177\/107110079801901203"},{"issue":"1","key":"r7","series-title":"Sports Med","doi-asserted-by":"publisher","first-page":"73","DOI":"10.2165\/00007256-200737010-00006","article-title":"A systematic review on ankle injury and ankle sprain in sports","volume":"37","author":"Fong DT","year":"2007","unstructured":"Fong DT, Hong Y, Chan LK, Yung PS, Chan KM. A systematic review on ankle injury and ankle sprain in sports. Sports Med. 2007;37(1):73\u201394. doi:10.2165\/00007256-200737010-00006"},{"issue":"1","key":"r8","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03357-4","article-title":"Prevalence and incidence of low back pain among runners: a systematic review","volume":"21","author":"Maselli F","year":"2020","unstructured":"Maselli F, Storari L, Barbari V, et\u00a0al. Prevalence and incidence of low back pain among runners: a systematic review. BMC Musculoskelet Disord. 2020;21(1):343. doi:10.1186\/s12891-020-03357-4"},{"issue":"20","key":"r9","series-title":"Spine","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1097\/brs.0000000000002646","article-title":"Musculoskeletal multisite pain and patterns of association after adjusting for sleep, physical activity, and screen time in adolescents","volume":"43","author":"Silva AG","year":"2018","unstructured":"Silva AG, Couto PS, Queir\u00f3s A, Neto M, Rocha NP. Musculoskeletal multisite pain and patterns of association after adjusting for sleep, physical activity, and screen time in adolescents. Spine. 2018;43(20):1432\u20131437. doi:10.1097\/brs.0000000000002646"},{"key":"r10","series-title":"Foot","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.foot.2017.09.003","article-title":"Low back pain and disability in individuals with plantar heel pain","volume":"34","author":"McClinton S","year":"2018","unstructured":"McClinton S, Weber CF, Heiderscheit B. Low back pain and disability in individuals with plantar heel pain. Foot. 2018;34:18\u201322. doi:10.1016\/j.foot.2017.09.003"},{"year":"2023","series-title":"APTA Guide to Physical Therapist Practice 4.0","key":"r11","unstructured":"American Physical Therapy Association, ed. APTA Guide to Physical Therapist Practice 4.0. American Physical Therapy Association; 2023. Accessed December 27, 2023. https:\/\/guide.apta.org\/"},{"year":"2013","series-title":"Maitland\u2019s Vertebral Manipulation: Management of Neuromuscular Disorders","key":"r12","unstructured":"Hengeveld E, Banks K, eds. Maitland\u2019s Vertebral Manipulation: Management of Neuromuscular Disorders. 8th ed. Churchill Livingstone; 2013."},{"issue":"1","key":"r13","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04310-9","article-title":"Effectiveness of local exercise therapy versus spinal manual therapy in patients with patellofemoral pain syndrome: medium term follow-up results of a randomized controlled trial","volume":"22","author":"Scafoglieri A","year":"2021","unstructured":"Scafoglieri A, Van den Broeck J, Willems S, et\u00a0al. Effectiveness of local exercise therapy versus spinal manual therapy in patients with patellofemoral pain syndrome: medium term follow-up results of a randomized controlled trial. BMC Musculoskelet Disord. 2021;22(1):446. doi:10.1186\/s12891-021-04310-9"},{"key":"r14","series-title":"J Bodyw Mov Ther","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.jbmt.2020.08.014","article-title":"The effect of lumbar spine manipulation on pain and disability in achilles tendinopathy. A case report","volume":"26","author":"Savva C","year":"2021","unstructured":"Savva C, Kleitou M, Efstathiou M, Korakakis V, Stasinopoulos D, Karayiannis C. The effect of lumbar spine manipulation on pain and disability in achilles tendinopathy. A case report. J Bodyw Mov Ther. 2021;26:214\u2013219. doi:10.1016\/j.jbmt.2020.08.014"},{"key":"r15","series-title":"Clinical Neurodynamics: A New System of Neuromusculoskeletal Treatment","author":"Shacklock M","year":"2005","unstructured":"Shacklock M. Clinical Neurodynamics: A New System of Neuromusculoskeletal Treatment. Butterworth-Heinemann; 2005."},{"issue":"4","key":"r16","series-title":"Man Ther","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1054\/math.2001.0411","article-title":"Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia","volume":"6","author":"Vicenzino B","year":"2001","unstructured":"Vicenzino B, Paungmali A, Buratowski S, Wright A. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Man Ther. 2001;6(4):205\u2013212. doi:10.1054\/math.2001.0411"},{"issue":"4","key":"r17","series-title":"Man Ther","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1054\/math.1996.0268","article-title":"An investigation of neural tissue involvement in ankle inversion sprains","volume":"1","author":"Pahor S","year":"1996","unstructured":"Pahor S, Toppenberg R. An investigation of neural tissue involvement in ankle inversion sprains. Man Ther. 1996;1(4):192\u2013197. doi:10.1054\/math.1996.0268"},{"issue":"10","key":"r18","series-title":"Am J Phys Med Rehabil","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1097\/PHM.0b013e3181ec98e6","article-title":"Reliability, construct validity, and responsiveness of the neck disability index, patient-specific functional scale, and numeric pain rating scale in patients with cervical radiculopathy","volume":"89","author":"Young IA","year":"2010","unstructured":"Young IA, Cleland JA, Michener LA, Brown C. Reliability, construct validity, and responsiveness of the neck disability index, patient-specific functional scale, and numeric pain rating scale in patients with cervical radiculopathy. Am J Phys Med Rehabil. 2010;89(10):831\u2013839. doi:10.1097\/PHM.0b013e3181ec98e6"},{"key":"r19","series-title":"Musculoskelet Sci Pract","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1016\/j.msksp.2019.06.005","article-title":"Neurodynamic test of the peroneal nerve: study of the normal response in asymptomatic subjects","volume":"43","author":"Bueno-Gracia E","year":"2019","unstructured":"Bueno-Gracia E, Malo-Urri\u00e9s M, Borrella-Andr\u00e9s S, et\u00a0al. Neurodynamic test of the peroneal nerve: study of the normal response in asymptomatic subjects. Musculoskelet Sci Pract. 2019;43:117\u2013121. doi:10.1016\/j.msksp.2019.06.005"},{"issue":"5","key":"r20","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"331","DOI":"10.2519\/jospt.1998.27.5.331","article-title":"The patient-specific functional scale: validation of its use in persons with neck dysfunction","volume":"27","author":"Westaway MD","year":"1998","unstructured":"Westaway MD, Stratford PW, Binkley JM. The patient-specific functional scale: validation of its use in persons with neck dysfunction. J Orthop Sports Phys Ther. 1998;27(5):331\u2013338. doi:10.2519\/jospt.1998.27.5.331"},{"issue":"4","key":"r21","series-title":"Phys Ther","first-page":"371","article-title":"The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American orthopaedic rehabilitation research network","volume":"79","author":"Binkley JM","year":"1999","unstructured":"Binkley JM, Stratford PW, Lott SA, Riddle DL. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American orthopaedic rehabilitation research network. Phys Ther. 1999;79(4):371\u2013383."},{"issue":"3","key":"r22","series-title":"J Man Manip Ther","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1179\/jmt.2009.17.3.163","article-title":"Global rating of change scales: a review of strengths and weaknesses and considerations for design","volume":"17","author":"Kamper SJ","year":"2009","unstructured":"Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther. 2009;17(3):163\u2013170. doi:10.1179\/jmt.2009.17.3.163"},{"issue":"11","key":"r23","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"780","DOI":"10.2519\/jospt.2009.3002","article-title":"Mechanosensitivity of the lower extremity nervous system during straight-leg raise neurodynamic testing in healthy individuals","volume":"39","author":"Boyd BS","year":"2009","unstructured":"Boyd BS, Wanek L, Gray AT, Topp KS. Mechanosensitivity of the lower extremity nervous system during straight-leg raise neurodynamic testing in healthy individuals. J Orthop Sports Phys Ther. 2009;39(11):780\u2013790. doi:10.2519\/jospt.2009.3002"},{"issue":"suppl 3","key":"r24","series-title":"Pain","doi-asserted-by":"publisher","first-page":"S2","DOI":"10.1016\/j.pain.2010.09.030","article-title":"Central sensitization: implications for the diagnosis and treatment of pain","volume":"152","author":"Woolf CJ","year":"2011","unstructured":"Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152(suppl 3):S2\u2013S15. doi:10.1016\/j.pain.2010.09.030"},{"issue":"1","key":"r25","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"8","DOI":"10.2519\/jospt.2018.7476","article-title":"Unraveling the mechanisms of manual therapy: modeling an approach","volume":"48","author":"Bialosky JE","year":"2018","unstructured":"Bialosky JE, Beneciuk JM, Bishop MD, et\u00a0al. Unraveling the mechanisms of manual therapy: modeling an approach. J Orthop Sports Phys Ther. 2018;48(1):8\u201318. doi:10.2519\/jospt.2018.7476"},{"issue":"1\u20132","key":"r26","series-title":"Pain","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/s0304-3959(03)00320-8","article-title":"Joint manipulation reduces hyperalgesia by activation of monoamine receptors but not opioid or GABA receptors in the spinal cord","volume":"106","author":"Skyba DA","year":"2003","unstructured":"Skyba DA, Radhakrishnan R, Rohlwing JJ, Wright A, Sluka KA. Joint manipulation reduces hyperalgesia by activation of monoamine receptors but not opioid or GABA receptors in the spinal cord. Pain. 2003;106(1\u20132):159\u2013168. doi:10.1016\/s0304-3959(03)00320-8"},{"issue":"11","key":"r27","series-title":"J Orthop Sports Phys Ther","doi-asserted-by":"publisher","first-page":"685","DOI":"10.2519\/jospt.2010.3271","article-title":"The effects of thoracic manipulation on posteroanterior spinal stiffness","volume":"40","author":"Campbell BD","year":"2010","unstructured":"Campbell BD, Snodgrass SJ. The effects of thoracic manipulation on posteroanterior spinal stiffness. J Orthop Sports Phys Ther. 2010;40(11):685\u2013693. doi:10.2519\/jospt.2010.3271"},{"issue":"2","key":"r28","series-title":"J Man Manip Ther","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1179\/106698110X12640740712572","article-title":"Application of a classification system and description of a combined manual therapy intervention: a case with low back related leg pain","volume":"18","author":"Petersen SM","year":"2010","unstructured":"Petersen SM, Scott DR. Application of a classification system and description of a combined manual therapy intervention: a case with low back related leg pain. J Man Manip Ther. 2010;18(2):89\u201396. doi:10.1179\/106698110X12640740712572"},{"issue":"1-2","key":"r29","series-title":"Pain","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/s0304-3959(00)00482-6","article-title":"The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs","volume":"92","author":"Bennett M","year":"2001","unstructured":"Bennett M. The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 2001;92(1-2):147\u2013157. doi:10.1016\/s0304-3959(00)00482-6"},{"issue":"9","key":"r30","series-title":"Pain","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1016\/j.pain.2013.05.047","article-title":"Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus","volume":"154","author":"Backonja MM","year":"2013","unstructured":"Backonja MM, Attal N, Baron R, et\u00a0al. Value of quantitative sensory testing in neurological and pain disorders: NeuPSIG consensus. Pain. 2013;154(9):1807\u20131819. doi:10.1016\/j.pain.2013.05.047"}],"container-title":["Journal of Sport Rehabilitation"],"original-title":[],"link":[{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jsr\/33\/7\/article-p549.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jsr\/33\/7\/article-p549.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/jsr\/33\/7\/article-p549.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:07:39Z","timestamp":1724371659000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/jsr\/33\/7\/article-p549.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":30,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.1123\/jsr.2024-0035","relation":{},"ISSN":["1056-6716","1543-3072"],"issn-type":[{"type":"print","value":"1056-6716"},{"type":"electronic","value":"1543-3072"}],"subject":[],"published":{"date-parts":[[2024,9,1]]}}}