Test: Slump Test

Video Link

Background/Purpose

The Slump Test is a neural tension test designed to assess the mobility and sensitivity of the neural structures within the spinal canal and lower extremities, particularly the sciatic nerve, spinal cord, and dura mater. Developed by Maitland in the 1980s, this test is used to identify adverse neural tension or neurodynamic dysfunction that may be contributing to a patient's symptoms. The Slump Test is particularly valuable in evaluating patients with suspected nerve root compression, sciatica, lumbar radiculopathy, disc herniation, or other conditions causing neural irritation. It combines spinal flexion with lower extremity movements to progressively tension the nervous system, helping clinicians differentiate between neural and musculoskeletal sources of pain. The test is commonly used in orthopedic, sports medicine, and physical therapy settings.

Procedure

Patient Position:
The patient sits upright on the edge of an examination table with knees flexed to 90 degrees
Feet should be off the ground, unsupported
Hands are clasped behind the back
The patient maintains an initial neutral, erect spine position

Procedure:
Initial Position: Begin with the patient sitting upright with good posture
Thoracolumbar Slump: Instruct the patient to "slump" forward, flexing the thoracic and lumbar spine while keeping hands behind the back. The examiner may apply gentle overpressure to the shoulders to increase spinal flexion. Assess for symptom reproduction.
Cervical Flexion: Ask the patient to flex the neck, bringing the chin toward the chest. The examiner may provide gentle pressure to the head to increase cervical flexion. Note any symptoms that develop or increase.
Knee Extension: While maintaining the slumped position and cervical flexion, instruct the patient to actively extend one knee as far as possible. The examiner may provide overpressure to increase knee extension. Document any symptom reproduction.
Ankle Dorsiflexion: With the knee extended, ask the patient to dorsiflex the ankle (pull toes toward the shin). This further increases neural tension. Record symptoms.
Cervical Extension (Sensitizing Movement): While maintaining all other positions, have the patient extend the neck (look up). If symptoms decrease or resolve with neck extension, this supports a neural origin of symptoms.
Repeat: Perform the test on the opposite leg for comparison
Important Notes:
At each stage, ask the patient about symptom location, quality, and intensity
The test is sequential and progressive—each component adds tension to the neural structures
Stop the test if severe symptoms are reproduced
Document the exact sequence at which symptoms appear
Performed: Unilaterally

Dialog

The patient sits and sequentially slumps the spine, flexes the neck, extends the knee, and dorsiflexes the ankle while the examiner monitors for symptom reproduction that changes with neck position.

Criteria

• No reproduction of concordant symptoms:
• No symptom differentiation with cervical movement
• Full knee ROM without neural involvement
• Symmetrical response

Measurement

LOINC Code

Scale/Grading

selection range; grade - LOINC ID
Option - Value option selection range; grade - LOINC IDPass ; Pass - Fail ; Fail -