By: Nichole Chakur, Student Physical Therapist
Traditionally when people think of physical therapy, they think of treatments for joint and muscle injuries, but people can also have nerve injuries as well. Common nerve injuries include nerve entrapment in the arms and legs, such as carpal tunnel syndrome or sciatica; or nerve root impingement potentially from a herniated disc in the spine. A rapid stretch to the nerve can also happen with a sports injury or motor vehicle accident. Symptoms of a nerve injury or tension in the limbs can include pain, numbness, or tingling. Nerve flossing, also known as neural tissue management (NTM), is an intervention that physical therapists can use if nerve tension is a cause of the symptoms.
Nerve flossing uses a combination of different movements that aim to reduce nerve mechanosensitivity and restore symptom free function.1 Nerve mechanosensitivity is how easily the nerve and neural tissues produce impulses or signals when force is applied. 2,3 When there is inflammation or swelling of the neural tissues, which may be caused by compression, then the nerve becomes more sensitive.2,3 When the tissue is more sensitive, less force is needed to produce an impulse or signal which can cause symptoms of pain, numbness, or tingling.2, Evidence shows that physical therapists who use neural flossing procedures help to reduce pain and disability in patients with neck and arm pain.4
Beside neck and arm pain, nerve flossing or NTM can be used for other nerve injuries as mentioned above. Your physical therapist is trained to perform special tests and recognize signs of nerve tension. If you have a nerve injury your physical therapist may perform nerve flossing or provide you with exercises that incorporate nerve flossing for a home program to help improve your function and reduce your pain.
1. Nee, R. J., Vicenzino, B., Jull, G. A., Cleland, J. A., & Coppieters, M. W. (2013). Baseline characteristics of patients with nerve-related neck and arm pain predict the likely response to neural tissue management. The Journal of Orthopaedic and Sports Physical Therapy, 43(6), 379.
2. Geoffrey M. Bove, Bernard J. Ransil, Hsi-Chiang Lin, & Jeong-Gill Leem. (2003). Inflammation induces ectopic mechanical sensitivity in axons of nociceptors innervating deep tissues. Journal of Neurophysiology, 90(3), 1949-1955. doi:10.1152/jn.00175.2003
3. Dilley, A., Lynn, B., & Pang, S. J. (2005). Pressure and stretch mechanosensitivity of peripheral nerve fibers following local inflammation of the nerve trunk. Pain, 117(3), 462-472. doi:10.1016/j.pain.2005.08.018
4. Childs, J. D., Cleland, J. A., Elliott, J. M., Teyhen, D. S., Wainner, R. S., Whitman, J. M., American Physical Therapy Association. (2008). Neck pain: Clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopedic section of the american physical therapy association. The Journal of Orthopaedic and Sports Physical Therapy, 38(9), A1.
5. Allison, G. T., Nagy, B. M., & Hall, T. (2002). A randomized clinical trial of manual therapy for cervico-brachial pain syndrome — a pilot study. Manual Therapy, 7(2), 95-102. doi:10.1054/math.2002.0453
By: Nichole Chakur, Student Physical Therapist Traditionally when people think of physical therapy, they think of treatments for joint and muscle injuries, but people can also have nerve injuries as well. Common nerve injuries include nerve entrapment in the arms and legs, such as carpal tunnel syndrome or sciatica; or nerve root impingement potentially from a herniated disc in the spine. A rapid stretch to the nerve can also happen with a sports injury or motor vehicle accident. Symptoms of a nerve injury...read more
By Dan Phelps, PT, DPT Working on your balance probably isn’t at the top of your work out “to do” list. Balance training often gets overlooked until we get older and by that time progress is often slower. The benefits for improved balance range from a reduced risk of injury, improving athletic performance, reducing fall risk, and even potentially increasing one’s life span. Here are just a few reasons to work on improving your balance, and some suggestions on how to get started Balance for Injury Prevention Improving your balance has shown...read more
By Annalee Appledorn, PT, DPT, OCS One type of exercise that I commonly suggest as a possible home program for my patients is Pilates. The most common type of classes are mat classes, which are done on thick yoga-type mats with minimal to no equipment. Although I believe anyone could benefit from its focus on core and gluteal strengthening, posture and breathing, the clients that I feel it could be most beneficial for are those with low back pain, anterior hip pain or gluteal weakness. That being said, there are a lot of classes out there...read more
By Annalee Appledorn, PT, DPT, OCS So, you have been having this [insert body part here] pain. It comes, it goes… maybe you don’t even know what started the problem. And you’re wondering–is this something that physical therapy could address? As physical therapists, we have all heard patient stories similar to this, often from family members or friends that need a little guidance on what to do next. In order to answer that question, there a few key areas we look at in the course of a physical therapy evaluation: 1....read more
By Dan Pasiak, PT, MSPT, OMPT, CIMT What is Parkour? Parkour is an obstacle course method of training that was first promoted by French naval officer Georges Herbert prior to World War I. It was influenced by native peoples that he observed while on duty in Africa. He thought that a more effective way to train would be to perform functional activities as occurred in a person’s environment. The training included climbing, running, jumping, balancing, throwing, swimming, self-defense, and quadruped movements. The training developed...read more
On Monday, April 22nd, Probility will be holding a runner’s clinic at their Saline location. The clinic will take place from 6:30pm- 8:00pm and therapists will address proper dynamic and static stretching techniques as we as offer injury, shoe and treadmill assessments. This clinic is completely FREE and open to all. Please note that if you are under the age of 18, you MUST have a parent or legal guardian sign a waiver before an assessment can be given. The waiver can be downloaded here. Questions or comments? Call 734-316-2903, or...read more
By Adam Naab, PT, DPT Physical Therapist Summer in Michigan is a great place to be! There are countless lakes, forests, and parks that practically require us to explore and enjoy them. Now that all the leaves have fallen off the trees, it can be hard to move indoor and get in all of the exercise you need to be able to stay in shape. Add to that all the football games and holiday food, finding some good winter activities is paramount to maintain health. For these reasons, I have made a list of relatively inexpensive exercise activities. ...read more
Check out the following article featuring two of Probility’s patients– Olympic Wrestler Jake Herbert and Grand Blanc Middle School Physical Education Teacher Kara Chiano! After meeting at Probility, Chiano invited Herbert to the middle school to inspire more than 100 students on the importance of goals and dedication. How awesome! http://www.mlive.com/sports/flint/index.ssf/2012/11/olympic_wrestler_jake_herbert.html Check out some photos from the speech below: Jake speaking with student Aric Besso, a visually impaired wrestler at Grand Blanc...read more
This coming Friday, October 5, 2012, is Saline High School’s Homecoming! To celebrate with the community, the Saline Clinic has continued the tradition of hosting our own Spirit Week leading to up the big game. The Saline clinic has the privilege of treating a lot of Saline’s athletes, coaches and students, so it is especially exciting for us to partake in this annual event! This year, the Saline Clinic chose to celebrate Homecoming with the following themes: Monday – Pajama Day Tuesday – Mismatch Day Wednesday – High School Alma Mater Day...read more
Team Probility Physical Therapy was at the Dances with Dirt Race this past Sunday, September 21st in Hell, Michigan. The race consisted of a 5 person relay, each member running 3 of 15 legs. (Each leg being about 4 miles). The course was tough, with river crossings, swamps, steep hills and other insane challenges. Stated on their website as a “serious achievement” of a race, Team Probility placed 17th overall…. with more than 400 teams participating! Congrats, Team Probility!...read more