Adding Nerve and Joint Gliding Routines
Addressing Lunate-Triquetrum-Scaphoid Mobility
Restoring CTS Nerve Glide
In this order, each joint-positioning component is added until mild pain is provoked. Therapeutic nerve flossing occurs as the therapist slowly releases the client’s elbow extension (slackening the nerve) while the client sidebends her head to the opposite side (tractioning the nerve). As the routine is repeated, the client’s head returns to neutral (slackening the nerve) while the therapist extends the elbow to stretch the nerve back through the tunnel. Play with this maneuver until you determine the best angle for maximum tractioning.
Nerve and carpal mobilizations form a powerful team for treating CTS pain. Improved signal conduction to the muscles, increased sensory perception, and greater hand function are just a few of the therapeutic benefits derived from these stretching modalities. Remember to be very gentle when working in areas of nerve inflammation. If your state laws allow, advise your clients how to perform these simple nerve and carpal gliding techniques at home.
- C. Fernández-de-Las Peñas et al., “Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: A Randomized Parallel-Group Trial,” The Journal of Pain 16, no. 11 (November 2015): 1087–94.
Eren Cansü et al., “Neglected Lunate Dislocation Presenting as Carpal Tunnel Syndrome,” Case Reports in Plastic Surgery and Hand Surgery 2, no. 1 (January 2015): 22–24, doi:10.3109/23320885.2014.993397.
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