Median Nerve Gliding

A happy nerve loves to glide and slide along its pathway with ease. Optimally, a healthy nerve can be tugged and mobilized by putting tension at one end of the nerve path while relaxing it on the other. Like muscles, the connective tissue around nerves can harden, get stuck, and become compressed. These areas of disorganized fascia may irritate nerves and present as tingles (especially in the hands or feet), numbness, rushes of cold or heat, pain, and even loss of strength and mobility. If you're experiencing any of these symptoms, nerve gliding could be the antidote for you.

Nerve gliding (a.k.a., nerve or neural flossing) does not necessarily stretch the nerve but rather encourages the nerve to slide easily through the many overlapping and cohabiting structures of muscles, bones, fascia, and joints. Nerve gliding positions the body to isolate nerve branches and then specific movements are repeated, similar to the motion made while flossing your teeth.

As bodyworkers, we constantly use our hands to connect, discover, and free the body. And as a result, many therapists experience compression on the median nerve that may lead to carpal tunnel syndrome symptoms like hand numbness, weakness, and tingling. Good news: Research has found that nerve glides can be very effective in reducing pain, specifically related to carpal tunnel syndrome symptoms.

Nerve Gliding Guidelines

Avoid forcing or pushing through a movement. You may feel tingling as you move a nerve, but you should not feel any pain or numbness. On a scale of 1-10, where 10 is the greatest intensity, begin with a level 3 intensity. Progress slowly and gently so you can feel and integrate your experience and repeat the nerve glide 3-5 times.

Median Nerve Glide

1. Stand or sit with a tall neutral spine, extending the crown of your head toward the ceiling and feel your neck lengthen (chin up, chest up, chin back). Rest your arm down by your side, dorsiflex your hand by spreading your fingers wide, and extend your wrist (you may feel tingling in your thumb, index finger, and middle finger as you gently stretch the median nerve). This may be enough, and you might linger at this level before moving on.
2. If you feel safe to proceed, externally rotate the arm from the shoulder so your dorsiflexed fingers point behind you and gently lift or abduct the arm about 15-20 degrees away from your body. Breathe and notice. Now that the median nerve is isolated, you may already be feeling some sensations or even relief. For more intensity include flossing motions in steps 3 and 4.
3. Maintain the positions in steps 1 and 2 and begin to lift and depress your scapula up and down 3-5 times.
4. Alternatively, maintain the positions in steps 1 and 2, then laterally flex your neck by leaning your head away from the outstretched arm and hand. You can then lift your head back to neutral and repeat by dropping and lifting your ear to your shoulder 3-5 times. If you feel ready for more coordinated integration, consider combining and alternating the shoulder shrugs and neck range of motion.

Authors' note: Heath and Nicole want to share a deep bow of gratitude to their teachers at Z-Health Education who share this and many other potent nerve glide exercises.

Resource

Ballestero-Perez, R. et al. "Effectiveness of Nerve Gliding Exercises on Carpal Tunnel Syndrome: A Systematic Review." Journal of Manipulative & Physiological Therapeutics 40, no. 1 (January 2017): 50-9, https://doi.org/10.1016/j.jmpt.2016.10.004.