Are you experiencing pain in a muscle that doesn’t go away after stretching? Have you tried other forms of therapy that still left you in pain? More so, left you wondering if anything will make it stop? Muscle pain should get better with stretching, right? So what if it doesn’t improve? What kind of problem is this? Our movement can be restricted in many different ways– from our bones, muscles, organs, or even our nerves. When we think of bone restrictions we are familiar with fractures, breaks, and even arthritis. Common restrictions from our muscles include strains, ligament sprains, and tendonitis. Organs, which can be a less obvious problem due to their internal location, are also capable of restricting our movement. Think of appendicitis or kidney stones. In all of the above, we can experience pain that can keep us from moving confidently without fear of pain.
When our nerves are restricted, we experience what is called neural tension. Neural tension can occur when our nerves’ ability to slide and glide through our body is interrupted. Common symptoms of neural tension are tingling, pins and needles, burning sensations, reduced sensations, as well as referred pain. For example, neural tension in our peripheral nerves, the nerves that supply the sensation and movements to our arms and legs, can cause referred pain into our fingers, hands, toes, feet, or calves. It can be confusing to distinguish where exactly the root of our pain is coming from, especially when it can begin anywhere from our bones, to our muscles, organs, or our nerves. Though Dr. Google is convenient and seems to have all the answers, it is best to consult with your Physical Therapist to determine the exact cause of your pain. My experience at Ke Ola Kino Physical Therapy has shown me how helpful, and gratifying, it can be to know what is causing your pain and how you can best resolve it.
To help understand and distinguish neural tension, imagine your nerves. Imagine they are a system of ropes running throughout your body. They go from your brain to your feet and everywhere in between. These are special ropes that are like wet and sticky, overcooked spaghetti noodles. It is very important that they stay separate to allow for movement and blood flow. To properly achieve this, nerves need space. Think of them as social-distancing-lovers! Neural tension occurs when your nerve’s ability to move has been disrupted. They have lost their ability to slide and glide throughout the body as they typically would, which causes pain. Essentially, they no longer have the necessary space, movement, and blood flow.
Physical therapy is traditionally thought to relieve movement restrictions using exercises, stretching, manual joint mobilizations, and/or soft tissue mobilizations. To address neural tension, your Physical Therapist will likely include nerve flossing. Nerve flossing is a dynamic mobilization applied to the nerve. It works by tensioning one end of the nerve and slacking the other, just like how we floss our teeth! Nerve flossing helps to restore space, movement and blood flow to the nerves, alleviating the pain.
I am glad to have been able to learn and observe Dr. Malia Tallett, PT, DPT, TPS treat patients experiencing neural tension. Ke Ola Kino Physical Therapy offers services for you to address and improve your neural tension problems, too! If you feel like this is you and may be experiencing neural tension, do not hesitate to contact Ke Ola Kino Physical Therapy, LLC!
- Duong, A. Are Your Nerves Limiting Your Mobility?. Ladner Village Physiotherapy. https://ladnervillagephysio.com/blog/are-your-nerves-limiting-your-mobility. Published August 23, 2021. Accessed February 22, 2023.
- Louw, A., Tatta, J. Pain Neuroscience Education Plus. Integrative Pain Science Institute. 2021. Available at: https://integrativepainscienceinstitute.com/latest_podcast/pain-neuroscience-education-plus-with-adriaan-louw-pt-phd/
- Sissons, B. Nerve Flossing Exercises. Medical News Today. https://www.medicalnewstoday.com/articles/nerve-flossing#what-is-it. Published February 26, 2020. Accessed February 23, 2023.
Authored by Mikaela Chong
Student at University of Hawaii at Hilo
Edited by Dr. Malia Tallett P.T., D.P.T., T.P.S.