Hi this is Dr. Silvester and I’m going to show patients how to do a thing that we call nerve gliding here at the clinic. It’s an exercise we use for all kinds of neuropathology. A lot of people have Neuropathy and we use it for patients with Neuropathy, and we also use it after surgery if you have Tarsal Tunnel Syndrome. If you have Tarsal Tunnel Syndrome, we use it before surgery to try and get it to go away. \n\n \n\n Basically, it’s stretching the nerve and getting it to glide. So I’m going to have my assistant here move her foot and we’re going to show you where this Tarsal Tunnel is. \n\n \n\n The nerve comes down here like this and then it branches out into three big branches and then a couple depending on the individual variability of these other branches as well. And then this branch is quite small. But anyway, there’s a tunnel that this nerve gets trapped in... there’s a little thing up here called the Flexor Retinaculum, this is called the Tarsal Tunnel, and then there are some other tunnels down here over the nerve. The nerve kind of gets pinched there. So, one of the things that we do is try to get this nerve to move in this tunnel. So, I’ve drawn it so you can see it move all the way in and the nerve is fairly short. And then you move it all the way out and the nerve gets very long. You can see a “gliding” going on alongside that foot. And so, what happens is that we’re trying to get the nerve to loosen up and glide, and thereby decrease the adhesions and things. \n\n \n\n How we tell our patients to do it is to take the foot up and out this way (hold it for 30 seconds), and then bring it down and in and hold for 30 seconds. And then repeat that about 5 or 6 times, and then do that maybe 10 times a day: up and out, down and in, do that 5 times, and then do that 10 times a day. Okay? \n\n \n\n There’s another nerve on this leg and it comes down here on the leg and goes down. You can do that nerve as well, which is typically the same exercise but you’re just stretching the nerves on the front of the leg. And so it’s down and in, you stretch it for 30 seconds, and then up and out. The symptoms that can go along with this nerve pain on the top of the leg you have are numbness, burning, electrical sensation, on the top of your foot in this area. On the bottom of your foot when you have that, it can come as pain, it can come as arch pain, it can come as just nighttime burning, tingling - all the symptoms that people associate with Neuropathy. \n\n \n\n So anyway, this is a nerve exercise you can do, and if you do it frequently a lot of times it can alleviate the pain that you have in your leg. We use it all the time right after surgery to keep the nerves moving so the scar doesn’t heal down on the nerve. Thanks for listening. \n
