Hello Brian C,

Your description of the symptoms and the relief when lifting the head during the slump test does tie in with a diagnosis of ANT (adverse neural tension) as suggested by marj. The adhesion causing the tension can be anywhere along the nerves pathway but common places are the superior tibiofibular joint, the piriformis muscle (may explain why your previous physio was concentrating on this area) or where the nerve leaves the spinal canal.

Localised manual therapy at these points can help to relieve the tension on the nerve by increasing nerve mobility.

A usefull approach is also to use a neural stretch - you've already identified this yourself ("When I do a slump test I get a tight feeling and can't fully straighten the knee at first, but once I've done 3 or 4 of these slump test stretches I can straighten it, but still tender and tight"). What you were doing there was a type of neural stretch that helps mobilise the nerve. There are a few ways of doing these stretches but the key is to have an on-off cyclic movement rather than a sustained stretch like you would with a muscle stretch. I would typically have a patient perform 3x30 three times a day but this varies depending on severity of symptoms and you may need to build up more gradually to that amount so as not to irritate the nerve and increase the soreness initially. You would need to have the correct technique doing these exercises so its better that you talk to your physio about them rather than have me try describe them over the net.

Hope thats someway helpfull,

ATT Ireland