Nerve flossing is a specialized way of easing neural tension in different parts of the body. The process, also known as nerve mobilization. Flossing is sometimes required to mobilize entangled or hypersensitive peripheral nerve. Peripheral nerves become hypersensitive due to overuse of muscles, poor posture and severe nerve injuries. In such condition, nerves in the affected areas recoil or gets entrapped leading to neural tension. Symptoms of neural tension include pain, tingling, numbness, and weakness of muscles in the affected region. The body responds automatically to protect the nerve by contracting the muscles, which lies close to the affected areas. Such physiological response protects affected nerves from further damages. The Muscles become short, tight and stiff because of continuous prolong contraction while protecting the hypersensitive nerves. Persistent and unattained neural tension can create several other physical problems that can affect myofascial system. Abnormal function of myofascial system causes problems in normal limb movements and joint activities. In this condition, medical experts often advise for nerve flossing to get rid of such painful and abnormal conditions.

What is Nerve Flossing?

Nerve Entrapments

Average individual in present days aware of function of nerves. Nerve relays information from certain body point to brain or spinal cord and vice versa. Nerves are densely present everywhere. Nerves actually form a continuous system which are interconnected with each other and then with the brain and spinal cord. Nerves in human body are surrounded by soft tissues to protect them from external injuries. Every bit of movement of a person keeps the nervous system in constant tension of transmitting normal and abnormal impulses. In some extraordinary condition following surgery, injuries or repetitive movements during work, one or more nerves may get trapped within the surrounding tissues. This condition is called 'Nerve Entrapment'. Such condition can cause continuous pain, tingling, lack of sensation (numbness) and muscle weakness.

What is Nerve Flossing?

Nerve Flossing refers to special exercising techniques that try to restore normal movement of nerves or mobilizes the nerves from surrounding soft tissues to alleviate neural tension. Nerve flossing exercises are advised not separately, but as a part of integrated treatment to restore the patient normal condition. Nerve Flossing is used to release the nerve irritation or nerve entrapment resulting in decrease of pain and discomfort experienced by individual.

How is Nerve Flossing Done?

Let us see how nerve flossing is used for different parts of the body and what are recommended exercises for releasing the neural tension of the part.

Nerve Flossing for Arms and Legs

The nerves of the arms and legs normally move and stretch quite freely and in different directions. Trapped nerves in arms and legs lead to chronic inflammation of nerve and pain. Sometimes the pain is felt continuously and sometimes it may surface while moving the hands and legs. To ease the nerves, neural flossing can be applied successfully.

Nerve flossing for upper arm:

Nerve flossing for the arm are recommended for three major nerves of the arm known as ulnar, median and radial nerve. Nerve flossing often causes severe pain during and after exercise for initial few days. Most individuals tolerate moderate increase of pain. Flossing is to be performed very carefully and gently, so that the patient doesn't feel any further increase of pain.

  • Ulnar Nerve Flossing for chronic pain in upper Arm: Hold middle, index and little finger of painful arm with the opposite hand. Extend the 3 fingers assisted by the hand while palm facing away from body. Then stretch the painful upper arm in extension at elbow and hyperextension at wrist. Maintain the hyperextension of 3 fingers at wrist for 10 seconds by using hold of 3 finger with normal hand. While doing this maneuver flex the neck to bring chin close to the chest. Repeat the exercise 8 to 10 times 3 times a day. The angle of extension of 3 fingers depends on pain. The degree of extension can be increases depending on pain tolerance and decrease in pain intensity.
  • Median Nerve Flossing for Arm pain: The affected hand is to be stretched out to the side at an angle of 90 degrees to the head. The palm should face upward towards the ceiling. Keeping the fingers straight, the palm is to be bent up and down at the wrist keeping it parallel to the head. Once the pain tolerance improves then median nerve further stretch by bending the head to the opposite direction as far as possible.
  • Radial Nerve Flossing for Arm pain: The radial nerve flossing technique is similar to median nerve flossing. The difference is palm is facing to floor while arm is completely stretch on lateral side of the body. The hand hyper flex and hyper extend at the wrist multiple times. Once pain tolerance improves then while doing hand movement head is tilted opposite side during the entire period of exercise. The exercise repeated 2 to 3 times a day.

Nerve Flossing for Legs:

For performing nerve flossing for the legs, the patient needs to sit on a low height chair with his affected leg stretched forward making a right angle with the body. The foot should be pointed upward. At this posture, the entire foot from the ankle needs to be pulled towards the body and push it back to the previous position again. This can be practiced 10 to 12 times at one sitting and the exercise can be practiced 3-5 times every day.

Nerve Flossing for Shoulder

Millions of people all over the world suffer from shoulder nerve entrapment. This leads to shoulder stiffness and pain. Nerve flossing can be effectively used to mobilize shoulder nerves or axillary nerves.

Nerve Flossing Exercise for Shoulder:

The hands are to be kept straight downward touching the thigh with the palms facing outward. Now the head is to be bended on the opposite side of the affected shoulder as much as possible. At first for a few days, it may be painful but later it would be eased. Then the target would be to touch the opposite shoulder with the ear. After bending it to the opposite side of the affected shoulder, the head is to be taken to the normal position for a few seconds and again to be bended to the affected side to touch the shoulder.

Nerve Flossing for Sciatica

Sciatic nerve is the largest nerve in human body. It passes through the back of both thighs, calf and ends at the foot. It is bifurcated in to 2 nerves below the knees, which are known as Tibial and Fibular nerve. Sciatica is a typical type of leg pain which occurs when any part of the nerve gets entangled in its path. Sciatic nerve floss can be applied to treat sciatica pain.

Nerve Flossing Exercise for Sciatica:

The patient needs to sit on a low height chair or stool with a straight posture and both the legs resting on the floor. The affected leg is to be pulled up as much as possible but not more than ninety degree to the rest of the body in sitting position. At this position, the toes should be point upward. Then, the foot is to be moved over ankle joint forward (towards the body) and backward (away from the body) 5-6 times while upper body from the waist (the seated part) stretched backward at an angle of 45 degrees. This is to be performed as a 5 to 10 sets depending on tolerance of pain and repeated several times a day. Sciatic nerve flossing can be performed simultaneously with leg nerve flossing at least three times a day.

Nerve Flossing Exercise for Peroneal Nerve:

Peroneal nerve or fibular nerve is the one of the two parts of sciatica nerve that is found below the knee joint. The patient needs to sit down on a low height chair like the previous posture. The patient then needs to stretch the leg vertical to the body and move the foot on left and right side with the head slightly postured backwards. The exercise should be practiced at least three times a day.

Nerve Flossing for Piriformis Syndrome

Piriformis is the muscle attached to lower spine and top of the femur bone. The piriformis muscles contraction assists in the hip joint movement. Piriformis syndrome happens when this muscle experiences spasm and causes pelvic as well as hip pain.

Nerve Flossing for Piriformis Syndrome:

Sit in a chair keeping your foot flat on the floor. Now raise your leg at a 90-degree angle to the body while tucking your chin to the chest. Hold on for 2-3 seconds without hurting any further. Slowly lower your leg while moving your head up and looking towards the ceiling. Repeat for 5 to 10 times in 3 to 5 sets depending pain tolerance. Repeat the exercise three times day.

Nerve Flossing for Femoral Nerve

Femoral Nerve is the largest nerve that arises from the 2nd, 3rd and 4th Lumbar vertebrae in the spine and descends to the thigh through the psoas muscle and inguinal ligament. Femoral nerve entrapment can cause severe pain and weakness in the quadriceps or the thighs limiting movements.

Femoral Nerve Flossing Exercise:

Lie down on your chest in a half cobra posture (lift upper body away from flat surface) to get a mild stretch around your waist muscle. After taking 3 deep breaths slowly start moving your head up towards the ceiling and simultaneously also flex your lower leg at knee joint. Maintained the position and count up to 10. Now extend the leg at knee and let the leg lay flat on ground at the same time maintained flex upper body position to neutral position. You need to co-ordinate the upper body movement with your leg. Make sure as you take your leg down, roll your head down simultaneously and tuck your chin in your chest. Repeat the exercise for 15-20 times. The exercise can be done 3 times a day.

Nerve Flossing for Spinal Accessory Nerve

Cranial nerve XI (eleventh), also called Spinal accessory nerve, present in the upper part of the neck, is responsible for delivering signals to and from the trapezius and sternocleidomastoid muscle. Irritation or entrapment of this nerve can result in pain spread over outer (lateral) part of the neck over sternocleidomastoid muscles as well as top portion of the shoulder and upper portion of back near spine.

Nerve Flossing for Spinal Accessory Nerve:

The spinal accessary nerve flossing is done in sitting position and straight posture. The exercises involve sternocleidomastoid and trapezius musclecontraction and relaxation. The trapezius muscle exercise is performed by stretching the hand of the affected side forward with the palm in the posture of a fist. The entire hand up to the shoulder point is to be considered like a stick attached with the shoulder blade. The entire hand is to be pushed back and forward without bending from the elbow keeping it straight like a stick and assuming it is attached with the shoulder blade only. It is to be kept in that position while hand is moved forward and backward. The extreme forward and backward position of hand is maintained for 10 seconds. The exercise repeated 15 times during each session. Sternocleidomastoid muscle exercise involves the neck to be pushed forward and simultaneously tilt on opposite side maintained the position for 5 seconds then bring the neck back to neural position. The exercise is repeated 15 times. In most cases, the results of flossing of spinal accessary nerve is favorable when both exercises are performed simultaneously. This cycle is to be practiced 15 times at one go and at least 5 times a day.

Conclusion

Nerves may entangle at any moment. These problems are quite common in sports persons. Daily commuters who regularly need to travel for a long time in crowded public transportations and workers who need to carry loads also face different types of nerve entrapments frequently. These people should visit orthopedics immediately who can advise them for nerve flossing exercises along with other treatments for early recovery. Individuals who aren't affected with nerve entrapments can also practice these exercises to keep the nerve passages in perfect condition and also to mitigate minor problems immediately.

Undergoing necessary nerve flossing exercises along with some other physiotherapy and treatment process can help the affected person to resolve unrelieved painful conditions that have not been improved through other conventional therapy.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: October 10, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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