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34 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 3 What many massage therapists don't always consider is the importance of mobility to the health of our nervous systems. Nerve fascicles, like muscle fascicles, are wrapped in layers of connective tissue that can stiffen, adhere, and become ischemic if we don't move and stretch them regularly through active movement. And like tight muscles, restricted nerves can cause various problems leading to pain and dysfunction. So when a client comes to us with a complaint, we have to be able to mobilize nerves as effectively as we mobilize muscle. Neurodynamics is a term coined by physical therapists David Butler and Michael Shacklock to describe manual methods for mobilizing peripheral nerves. 1 Nerve mobilization includes nerve gliding and nerve tensioning. Nerve gliding, or flossing, is a manual technique where a therapist uses specific body positions and movements to pull a nerve back and forth along its path, similar to the action of dental f loss. Nerve tensioning elongates a nerve by placing it under gentle, tensile force at both ends. When therapists use these techniques during a massage session, they passively move some areas of the client's body while the client actively moves others to elicit the proper glide or tension on a nerve. In addition, many therapists teach clients to move their bodies in ways that mobilize the nerves as part of home-retraining exercises to maintain the positive results achieved during sessions. We can incorporate nerve mobilization methods with massage and other manual therapy techniques to help resolve common soft-tissue conditions like carpal tunnel, thoracic outlet syndrome, hip pain, piriformis syndrome, and more. Unfortunately, while physical therapists, occupational therapists, and athletic trainers use these procedures to increase the efficacy of treatment outcomes, many MTs have never learned these techniques. In this article, I'll introduce neurodynamics and nerve mobilization methods. Then, we'll look at an integrated routine to address cervical and brachial nerves using multiple manual methods, including nerve mobilization. The goal is to provide a routine you can immediately use to support clients exhibiting symptoms of neurogenic thoracic outlet, radial nerve entrapment , cubital tunnel, and carpal tunnel syndromes. If these techniques are a good fit for your bodywork career, I encourage you to seek training in nerve mobilization, which is advanced work requiring proficiency in anatomy, palpation, and client communication. Exploring Neurodynamics in Your Massage Practice By Erik Dalton, PhD As massage therapists, we know physically active people are less prone to chronic musculoskeletal pain problems. As I like to say, "Motion is lotion." We must pull and stretch muscle and fascia through movement if we want these tissues to remain elastic, hydrated, and healthy.

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