What action can a patient perform to assess a lesion or injury at L4-5?

Walking on the heels is an effective method to assess a lesion or injury at the L4-5 level. This particular action primarily tests the function of the L5 nerve root, which is closely associated with the anterior tibialis muscle responsible for dorsiflexion of the foot. When a patient walks on their heels, they rely on the strength and integrity of this muscle; therefore, any impairment in the ability to perform this action may indicate an issue at the L4-5 segment.

The biomechanics of walking on heels engage the muscles innervated by L5 while also indirectly involving L4. If weakness or inability to maintain this position is observed, it can suggest a potential neurological impairment at that level. This action provides valuable clinical insights into the function of the lumbar spine and its corresponding nerve roots, making it a practical choice for assessing the integrity of the L4-5 region.

Other actions like raising both heels or performing toe raises emphasize the S1 nerve root, which focuses more on plantar flexion, while sitting and standing from a chair might not specifically target the L4-5 region's neurological integrity. Thus, walking on the heels stands out as the most relevant and focused assessment for identifying potential issues at the L4-