Median nerve slider, glider and flossing exercises for neural mechanosensitivity | The MSK Physio

Neural symptoms such as burning, tingling, pins and needles or lightning like pain are common indications that a nerve may have a mechanical interface issue with adjacent tissues (1). This is called nerve excursion i.e. can’t floss, slide or glide without irritation. An example of this is with a cervical radiculopathy.

The median nerve’s excursion, or ability to floss and glide is reduced when a cervical radiculopathy is present (2). When excursion improves, clinical signs and symptoms will also improve!
So how do we best improve excursion? Using sliders has been shown to increase nerve excursion the most, when compared to tensioning techniques (3).

So in essence, to improve a mechanical sensitivity a nerve might have (e.g. sensitivity to compression, friction etc), sliders are a useful treatment method. We discuss the various applications of sliders in the video. That is, how to best position yourself and also how to promote specific excursion at the certain regions e.g. shoulder, elbow or wrist!

   • Median nerve slider, glider and floss...  

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References:
1. Smart KM, Blake C, Staines A, Thacker M, Doody C. Mechanismsbased classifications of musculoskeletal pain: Part 2 of 3: Symptoms and signs of peripheral neuropathic pain in patients with low back (±leg) pain. Manual Therapy. 2012 Aug;17(4):345–51.
2. Thoomes E, Ellis R, Dilley A, Falla D, Thoomesde Graaf M. Excursion of the median nerve during a contralateral cervical lateral glide movement in people with and without cervical radiculopathy. Musculoskeletal Science and Practice. 2021 Apr 1;52:102349.
3. Coppieters MW, Hough AD, Dilley A. Different NerveGliding Exercises Induce Different Magnitudes of Median Nerve Longitudinal Excursion: An In Vivo Study Using Dynamic Ultrasound Imaging. J Orthop Sports Phys Ther. 2009 Mar;39(3):164–71.




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