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  • Writer's pictureMary Brooking

Nerve flossing: why? what? how?

We often don’t think of this but our nerves can affect our movement, range of motion and cause feelings of tightness. Just like muscles, nerves can get sore or inflamed and lose their mobility. Injuries, poor biomechanics and imbalances can cause problems including when a nerve gets “stuck” to surrounding structures as a result of inflammation. 


Why?

The main nerves in the arms include the median nerve, ulnar nerve and radial nerve. In the legs they include the sciatic nerve and femoral nerve. These nerves all play essential roles in sensation, coordination and movement of our limbs. The two nerves most affected by the repetitive movements of running are the sciatic and femoral nerves in our legs. Hand numbness can be an issue for cyclists, especially if they tend to ride with their hands in the same position for extended periods of time resulting from excessive compression, irritation, or stress on the nerves. Poor seated or standing posture can also cause nerve issues, frequently in sciatic or upper limb nerves as the prolonged incorrect position of bones and muscles can put unnecessary pressure on nerves.


What?

While we don’t stretch a nerve in the same way as a muscle it is possible to mobilise them. Benefits can include increased range of motion, reduced irritation to nerves, improved strength and relief of pain, numbness and tingling symptoms. Mobilisations place the nerve in tension and then move it in and out of that tension position, “flossing” the nerve, but importantly the nerve should never be held in tension for a period of time. 


There are two sorts of nerve flossing. Nerve gliding exercises encourage the nerves to glide normally as you move your joints by pulling the nerve from one end and shortening it from the other end. Nerve tensioning entails stretching the nerve from both ends and is much more intense. Start cautiously with some of these nerve glide ideas remembering the following:  


How?

  • Start slowly with five or so repetitions a day, gradually increasing up to 20-30, maybe in 2-3 sets of 10.

  • Don't tense up. Keep your body relaxed even as certain muscles are stretched or flexed.

  • Be conscious of inhaling and exhaling as you go through the movements.

  • Stop immediately if you feel any new pain.

  • Daily consistency with these glides can start to have an impact on symptoms in a few weeks, be patient!

  • Nerve flossing may cause slight tingling or aching, but this should subside within a few minutes. If the pain or tingling is extreme or persists, you may be doing the movements too aggressively. Give it a rest for several days, and speak with a physiotherapist, doctor, osteopath or sports massage therapist for advice.



Median nerve:  

Symptoms of medial nerve issues include numbness and tingling in the palm of the hand and the thumb, index or middle finger and carpal tunnel syndrome


To floss the median nerve (which helps you bend the wrist and fingers):

  • Starting position: Stand up straight. Place your right arm by your side with your palm facing outwards..

  • Slowly bend your wrist back, stretching the front of your wrist and palm.

  • Then, slowly bend your head away from your arm.

  • Return slowly to the starting position.



Ulnar nerve

Symptoms of ulnar nerve issues include numbness, tingling or pain in little and ring finger and the iinside of elbow

To floss the ulnar nerve (which also helps bend your wrist and move your fingers from side to side):

  • Starting position: Stand with your arm stretched out to the side, palm facing outwards.

  • Slowly bend your elbow and wrist up so that the palm moves towards the side of your face.

  • Tilt your head away from your hand and then slowly return to starting position.



Radial nerve

Symptoms of ulnar nerve issues include forearm & wrist tightness, pain in the back of arm, back of the hand, thumb and the first two fingers.

To floss radial nerve (which helps you straighten the elbow, wrist, thumb, and fingers):

  • Starting position: Stand with your arm down at your side near your hip, palm facing back.

  • Flex your wrist and then slowly pull your shoulder back into extension.

  • While holding this position, bend your neck away from your arm.

  • Slowly relax the hand to reduce the stretch and return to starting position.



Sciatic nerve:

Symptoms of limited sciatic nerve mobility are discomfort in various places through the lower back, buttocks and legs. Here are three mobilisations that focus on addressing issues in different areas:

Sitting Sciatic Nerve Glide (the slump): helpful for hamstring and glutes/buttock pain or tension

  • Starting position: Sit on a chair (or table if possible) and bend the head and trunk so you are effectively slumped. 

  • Flex the foot and straighten the knee then slowly swing the leg up and down again to return to starting position


Long sitting sciatic nerve glide : helpful for tension behind the knee

  • Starting position: Sit on floor with legs straight out in front. Bend the head and trunk forwards and pull the toes of one foot towards you.

  • Relax the leg and move the knee up and slowly down again to return to starting position.


Supine Sciatic Nerve Glide: (helpful for calf and achilles tightness)

  • Starting position: Lie on your back with your legs out straight.. Bend one knee and grab behind it with both hands, flex ankle and then straighten your knee.

  • Point your foot and then flex your ankle to return to starting position.



Femoral nerve: 

The femoral nerve supplies nerves to the thigh and hip muscles that flex the hip and extend the knee. Symptoms of femoral nerve issues include tightness at the front of the hip or in quadriceps, poor hip range of motion and unexplained knee pain.

  • Starting position: Begin in a half kneeling position with one leg in front and other ankle on a pillow/step/stool/box. Keep spine neutral and gaze down, you should feel a stretch in the hip flexor and the front of the thigh.

  • Shift your weight forward to extend the hip a it more and achieve the nerve glide, you should feel a deeper pull in front of the hip and thigh. Return to starting position.



References:

Science of Stretch Dr Leada Malek

Running well Sam Murphy & Sarah Connors

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