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Webinar with Dr. Cobb

Episode 242: Leg and Ankle Pain Relief – Nerve Flow Part 1

Video Highlights

- Sensory input reminder
- 3 powerful nerve glides
- Sensory variations example

Today we’re going to be doing a lower body and nerve flow, in combination with some of the sensory work from last week’s blog.

In last week’s blog we talked about this concept of sensory before motor, how the brain is organized, and that sometimes we can help people improve brain promotion, improve strength and get out of pain by just looking at sensory input from a local area to the brain. We talked about using vibration, light touch, sharp/dull, because there’s a couple different pathways. If you need to know more, go back and watch the blog.

Now, today what we want to look at is, if I have issues in my lower body, my knee, my ankle, my foot, if I have pain. Let’s say I have restricted dorsal flexion, my squat, my lunge pattern, whatever, one thing that we want to consider is, can I use sensory to improve that.

You should already have some information about testing that.

In our program, what we look at first, is receptor level input, basically how is the sensory input from the area.

We then want to look at peripheral nerves.

In previous blogs, we’ve been looking at some, what we call, neuro-mechanic drills, nerve flossing exercises for the upper body.

I want to take you through a quick flow for a certain set of nerves today, for the lower body. It’s very simple to do.

What we’re going to start off with is, we’re going to be in a seated position, one leg out in front of us.  What you see here is what else I have, this massager.

What we’re going to begin to think about is, let’s say I have some issues with my knee.

Then I test it, based on the previous blog, maybe 30, 45 seconds of vibration actually improved my knee pain. Cool.

What we’re going to do is, we’re going to actually do a nerve floss for some of the nerves that supply the knee and the posterior aspects of the leg. Then we’re going to combine it with the massager, all right?

So, I’ll start off with our basic nerve flow.

Very simple. I’m going to sit up nice and tall. I’m going to put the working leg out in front of me, and I’m going to lock the knee.

Our first exercise, called the tibial nerve glide.

For the tibial, what we’re going to do is, pull our toes up to the ceiling. We’re going to point them to the wall out to the side. This is called eversion. Then we’re going to actually pull our toes into extension, so I’m pulling my toes back toward my knee.

When you do this, you’re going to get a fairly strong sensation all the way down your sciatic nerve and then through your gastroc. Basically into the bottom of your foot, is really where we’re trying to target this.

Now, with this position, I’m going to slowly bring my body forward, then begin a little slumping motion. When I feel, again, a level three out of 10 tension, which is what we always teach in the initial stages of these neuro-mechanic drills, I’m going to freeze there, then I’ll begin a little bit of a flossing motion.

The easiest way to do that in this position is to just flex and extend the knee.

So, again, I’m holding my dorsal flexion, eversion, toe extension, nice little slump, three out of 10 tension, and again, 5 to 10 little flexions, extensions of the knee to floss the nerve.

Young female athlete in a deep lunge and grabbing her left foot to stretch her leg.

Next, I’m going to continue with that, and I’m just going to take my foot out of that initial position and then back into it. So I’m now flossing the nerve with my ankle.

I can also do the same thing with my toes.

Remember we’re keeping this really, really light.

If you have had sciatic nerve issues, disc issues, you have to go very carefully with these. Clear them with your healthcare provider. That’s always the most important thing, ’cause I don’t know what your body’s capable of, but again, I’m going to keep them very, very light.

Now, once you’ve done that, our second nerve glide is called the sural nerve glide.

What we’re going to do is, we’re going to again start in our extended leg position, lock the knee. We’re going to pull the toes up. Now, what we’re going to do at this point is, we’re just going to invert the ankle, all right?

This is actually for a sensory nerve, for the sural nerve. It doesn’t have a motor component. It’s just for the outside of your foot and your Achilles tendon.

If you have kind of chronic Achilles problems, this is a great one to work on.

So again, pull the toes up toward the ceiling, turn the foot in. Now try to relax the toes. Again, slump forward, you’ll feel this one more laterally in the leg, so it’s going to feel more around the outside ankle bone, and maybe the outside of the knee.

Again, small pumping motion, five to 10 repetitions here. Once you’ve done that, relax for a second, reset. Now, hold the knee still and just simply rotate the foot in and out, all right?

So you can put tension on, take the tension off, all right? So that’s number two.

Exercise number three is for the peroneal nerve.

This one’s going to go across the top of the foot, lateral side of the leg. I’m going to now, start off here. This one’s a little bit different.

In this position, I’m going to point my toes now. I’m going to plantar flex, turn the toes in, and then I’m going to actually grip, I’m going to flex my toes down. The hardest thing to remember is to keep the toes flexed in this position, and your foot may cramp. If your foot cramps, you can take the toe flexion out of it, to begin with.

So, once again, nice and tall, point the toes, turn the foot in, now flex the toes, come forward. You’ll probably have a little bit more range of motion available to you here. Once again, five or 10 little pumps of the knee and five to 10 little pumps of the ankle. Pretty simple.

Once you’ve done that, again, if you responded well to one of the previous sensory drills … Again, I’m just using the massager for example, could’ve been light touch or sharp/dull.

You may have to have someone help you, depending on your flexibility, but what we want to do now is called stacking, where we’re going to actually have the sensory stimulus going at the same time I’m doing my drills.

Once again, let’s say I responded well to vibration on my knee, I’m now going to hold that on here while I’m working through my different nerve glides.

Often, what you’ll find if you do this, is that the addition of the sensory input actually makes the neuro-mechanic drill a little less sensitive, meaning it’ll actually feel a little bit easier to do.  It’ll improve your range of motion and often the overall results of combining the sensory work with the peripheral nerve work, very, very powerful.

Give this a shot.

If you have any questions, let us know.  Otherwise, go very carefully with it.

Remember, three out of 10 tension, and listen to your body.

Good luck.

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