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MYOFASCIAL TECHNIQUES SCIATIC NERVE GLIDE TEST are thought to be responsible for many cases of neuropathic pain (pain related to dysfunction of the nerve tissues themselves).2 Most importantly for manual therapists, remember that you can't rub nerve inflammation away. This is the key point for effective work with sciatica (and other nerve pain). Since sciatic nerve inflammation is caused by pressure, applying more pressure won't help. With this in mind, it is usually best to avoid direct manual pressure on the sciatic nerve; instead, our goal is to increase "nerve glide": decompress the nerve's passageways, and release the nerve sheath from adjoining structures to restore normal neural movement, freedom, and elastic sliding. SCIATIC NERVE GLIDE TEST Appendicular sciatica can be related to sciatic nerve entrapment at any of these sites: • Under, over, through, or around the piriformis or other rotators. • Between quadratus femoris/ gluteus maximus. • In the intermuscular septum between biceps femoris/adductor magnus in the posterior thigh. These entrapment sites can be Because the sciatic nerve stretches as much as 5 inches with lower limb movements, the Sciatic Nerve Glide Test can help locate sciatic nerve entrapment sites. If knee extension and ankle dorsiflexion increase sciatic symptoms, nerve tethering in the hip or leg is likely, usually at the site of pain, or at a place proximal to it along the nerve's pathway. Images courtesy Advanced-Trainings.com. assessed with the Sciatic Nerve Glide Test. To perform the test, have your client lie supine with the hip and knee flexed on the affected side (Image 4). Direct your client to actively straighten the bent knee of the raised leg (Image 5). Extending just the knee from 90 degrees to fully straight stretches the sciatic nerve about 1½–2½ inches; adding ankle dorsiflexion (as pictured) typically adds another half inch of stretch.3 Thus, if straightening the affected leg increases sciatic symptoms, nerve tethering in the hip or leg is a likely contributor to the sciatic pain. You can get even more specific about where to begin your work by asking your client to compare tune in to your practice at ABMPtv 113