South Plains College PTA

Good for PTA’s to know too!

Blood Cells You Must Know for NCLEX & nursing:

WBCs (5 Types) = Fight Infection

-Monocytes = Street Cleaners (clean up during illness)
-Neutrophils = Rapid Response Team (1st to bacteria)
-Eosinophils = Parasite Hunters & Allergy Role
-Basophils = Allergy & Inflammation Team
-Lymphocytes = Viral Fighters & Antibody Producers

Red blood cells (RBCs) = Oxygen Transport

Platelets = Keep You From Bleeding Out

Nerve Gliding (Neural Mobilization / Neural Flossing)

Nerve gliding is a specialized physiotherapy technique used to restore the normal mobility and mechanics of peripheral nerves. It involves gentle, controlled movements that allow nerves to move smoothly through surrounding muscles, fascia, and joints without excessive tension.

This technique is widely used in rehabilitation for nerve compression syndromes, radiculopathy, and movement-related neural pain.

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Basic Principle

Peripheral nerves constantly move during body motion.
When a nerve becomes compressed, inflamed, irritated, or restricted by surrounding tissues, its normal movement decreases, producing symptoms such as pain, tingling, numbness, or burning sensation.

Nerve gliding exercises aim to restore normal neural mobility and reduce mechanical irritation.

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Main Goals of Nerve Gliding

◆ Improve neural mobility and excursion
◆ Reduce nerve irritation and sensitivity
◆ Enhance blood circulation around the nerve
◆ Decrease tingling, numbness, and radiating pain
◆ Improve functional movement patterns
◆ Restore normal neurodynamics

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Types of Neural Mobilization

1. Nerve Sliders / Gliders

◉ One end of the nerve is tensioned while the opposite end is relaxed
◉ Produces a sliding movement of the nerve
◉ Gentle and less symptom-provoking
◉ Commonly used during the early rehabilitation stage

Clinical Purpose

➤ Reduce neural sensitivity
➤ Improve nerve excursion
➤ Minimize irritation

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2. Nerve Tensioners

◉ Both ends of the nerve are tensioned simultaneously
◉ Produces greater mechanical loading
◉ Used in advanced rehabilitation stages

Clinical Purpose

➤ Improve nerve tolerance to stretch
➤ Enhance neural adaptability
➤ Restore functional mobility

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Conditions Commonly Treated

Cervical Region

➤ Cervical radiculopathy
➤ Thoracic outlet syndrome

Upper Limb

➤ Carpal tunnel syndrome
➤ Cubital tunnel syndrome
➤ Radial nerve entrapment

Lower Limb

➤ Sciatica
➤ Piriformis syndrome
➤ Lumbar disc-related neural irritation
➤ Femoral nerve irritation

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Physiological Effects

Research suggests nerve gliding may:

◆ Improve axoplasmic flow
◆ Reduce intraneural edema
◆ Improve neural blood supply
◆ Reduce adhesions and fibrosis
◆ Decrease mechanosensitivity
◆ Improve neural excursion

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Common Neural Symptoms

Patients may experience:

◉ Tingling sensation
◉ Numbness
◉ Burning pain
◉ Electric shock-like sensation
◉ Radiating pain
◉ Pulling sensation along the nerve pathway
◉ Symptoms aggravated by movement

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Important Clinical Principles

Movements Should Be

➤ Slow
➤ Controlled
➤ Rhythmic
➤ Within tolerable range

Symptoms Should NOT

✖ Produce sharp severe pain
✖ Persist long after exercise
✖ Increase progressively
✖ Cause strong neurological aggravation

A mild stretching sensation is generally acceptable.

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Median Nerve Glide

Commonly Used For

◆ Carpal tunnel syndrome
◆ Median nerve irritation
◆ Cervical radiculopathy

Technique

➤ Shoulder depression
➤ Shoulder abduction
➤ Elbow extension
➤ Forearm supination
➤ Wrist and finger extension
➤ Neck side-bending away from affected side

Expected Sensation

◉ Mild pulling in the forearm, thumb, or index finger

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Sciatic Nerve Glide

Commonly Used For

◆ Sciatica
◆ Neural hamstring tightness
◆ Lumbar nerve irritation

Technique

➤ Sit upright on a chair
➤ Slowly extend the knee
➤ Pull ankle upward (dorsiflexion)
➤ Simultaneously extend the neck
➤ Return slowly to starting position

Goal

◉ Promote smooth sciatic nerve excursion without excessive tension

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Ulnar Nerve Glide

Commonly Used For

◆ Cubital tunnel syndrome
◆ Ulnar nerve irritation

Technique

➤ Shoulder abduction
➤ Elbow flexion
➤ Wrist extension
➤ Hand positioned near face (“glasses position”)
➤ Slow repetitive movement in and out of position

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Contraindications & Precautions

Use carefully or avoid in:

✖ Acute severe nerve inflammation
✖ Progressive neurological deficit
✖ Recent nerve repair surgery
✖ Severe radicular pain
✖ Malignancy involving neural tissue
✖ Highly irritable nerve conditions

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Exercise Dosage

◆ 5–10 repetitions
◆ 1–3 sets
◆ Slow controlled movement
◆ Once or twice daily depending on tolerance

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Benefits of Nerve Gliding

✅ Reduces pain and neural irritation
✅ Improves mobility and flexibility
✅ Decreases tingling and numbness
✅ Enhances functional movement
✅ Improves nerve mechanics
✅ Helps recovery from nerve entrapment syndromes
✅ Supports rehabilitation progression

✅‌Scapular Movements — The Foundation of Healthy Shoulder Function

▪️The scapula (shoulder blade) is not a fixed bone. It moves continuously with arm and shoulder motion, providing a stable base for the rotator cuff and upper limb.

▪️Proper scapular movement is essential for strength, mobility, posture, and injury prevention.

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🟣 Major Scapular Movements

🔹 Depression
➟ The shoulder blade moves downward.

🔹 Primary muscles:
➟ Latissimus dorsi
➟ Pectoralis minor
➟ Lower fibers of pectoralis major

🔹 Function:
➟ Helps during pushing down on armrests, climbing, and lifting the body upward.

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🔹 Elevation
➟ The shoulder blade moves upward toward the ears.

🔹 Primary muscles:
➟ Upper trapezius
➟ Levator scapulae

🔹 Function:
➟ Occurs during shrugging and carrying heavy objects.

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🔹 Retraction
➟ The shoulder blades move toward the spine.

🔹 Primary muscles:
➟ Middle trapezius
➟ Rhomboids

🔹 Function:
➟ Improves posture and stabilizes the shoulder during pulling activities.

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🔹 Protraction
➟ The shoulder blades move forward around the rib cage.

🔹 Primary muscles:
➟ Serratus anterior
➟ Pectoralis minor

🔹 Function:
➟ Important for pushing, punching, and reaching forward.

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🔹 External Rotation
➟ The humerus rotates outward away from the body.

🔹 Primary muscles:
➟ Infraspinatus
➟ Teres minor
➟ Posterior deltoid

🔹 Function:
➟ Essential for throwing, reaching backward, and overhead sports.

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🔹 Internal Rotation
➟ The humerus rotates inward toward the body.

🔹 Primary muscles:
➟ Pectoralis major
➟ Latissimus dorsi
➟ Teres major

🔹 Function:
➟ Used during pulling, hugging, and reaching across the body.

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🟣 Why Scapular Mechanics Matter

🔹 Provides a stable base for arm movement.

➟ Allows efficient force transfer from the trunk to the upper limb.

🔹 Maintains shoulder joint alignment.

➟ Reduces stress on the rotator cuff and surrounding tissues.

🔹 Supports overhead activities.

➟ Essential for athletes, workers, and daily activities.

🔹 Enhances posture.

➟ Proper scapular control helps prevent rounded shoulders and forward head posture.

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🟣 Signs of Scapular Dysfunction

🔹 Shoulder pain during movement.

🔹 Reduced range of motion.

🔹 Shoulder weakness.

🔹 Clicking or snapping sensations.

🔹 Scapular winging.

🔹 Neck and upper back tightness.

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🟣 Common Causes

🔹 Poor posture.

🔹 Muscle imbalance.

🔹 Rotator cuff injuries.

🔹 Repetitive overhead activities.

🔹 Weak serratus anterior or lower trapezius muscles.

🔹 Previous shoulder trauma.

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🟣 Management & Prevention

🔹 Postural correction.

➟ Maintain proper sitting and standing alignment.

🔹 Strengthening exercises.

➟ Focus on serratus anterior, trapezius, and rotator cuff muscles.

🔹 Mobility training.

➟ Improve thoracic spine and shoulder flexibility.

🔹 Activity modification.

➟ Reduce repetitive aggravating movements when symptoms occur.

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🟣 Clinical Pearl

🔹 Healthy shoulder function depends on coordinated movement between the scapula and humerus.

➟ Even small abnormalities in scapular mechanics can contribute to shoulder impingement, rotator cuff disorders, neck pain, and reduced athletic performance.

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⭐ Medical Disclaimer

This post is for educational purposes only and should not replace professional medical advice, diagnosis, or treatment. If you experience persistent shoulder pain, weakness, instability, or restricted movement, consult a qualified healthcare professional for assessment and management.

When you block out visual cues, your body has to rely entirely on proprioception—your internal sense of body awareness and joint positioning.
🧠 👣 C’16s

𝗡𝗲𝗰𝗸 𝗣𝗮𝗶𝗻 𝗮𝗻𝗱 𝗠𝗮𝗻𝘂𝗮𝗹 𝗧𝗵𝗲𝗿𝗮𝗽𝘆 + 𝗘𝘅𝗲𝗿𝗰𝗶𝘀𝗲: 𝗪𝗵𝗮𝘁 𝗗𝗼𝗲𝘀 𝘁𝗵𝗲 𝗘𝘃𝗶𝗱𝗲𝗻𝗰𝗲 𝗦𝗮𝘆?

◼️ Neck pain is a widespread and disabling condition that can significantly impact daily life and lead to substantial economic and healthcare costs.

◼️ A 2025 Cochrane Database systematic review evaluated whether combining manual therapy with exercise is an effective and safe treatment for adults suffering from acute to chronic neck pain.

𝗪𝗵𝗮𝘁 𝗗𝗼𝗲𝘀 𝘁𝗵𝗲 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁 𝗜𝗻𝘃𝗼𝗹𝘃𝗲?

◼️ Manual therapy includes hands-on techniques, such as joint manipulation and tissue mobilization, performed by healthcare providers.

◼️ The exercise component involves purposeful physical activities prescribed to improve symptoms, such as stretching, strengthening, motor control, cardiovascular training, or mind-body exercises like yoga.

📚 𝗧𝗵𝗲 𝗥𝗲𝘃𝗶𝗲𝘄'𝘀 𝗦𝗰𝗼𝗽𝗲

◼️ Researchers analyzed data from nine randomized controlled trials involving a total of 694 adults across North America, Europe, Central Asia, East Asia, and the Pacific.

◼️ The average participant was 46 years old, and 76% of the participants were female.

◼️ The vast majority of the included studies focused specifically on individuals with chronic neck pain, which is pain lasting longer than 12 weeks.

🔍 𝗞𝗲𝘆 𝗙𝗶𝗻𝗱𝗶𝗻𝗴 #𝟭: 𝗠𝗮𝗻𝘂𝗮𝗹 𝗧𝗵𝗲𝗿𝗮𝗽𝘆 𝗮𝗻𝗱 𝗘𝘅𝗲𝗿𝗰𝗶𝘀𝗲 𝘃𝘀. 𝗣𝗹𝗮𝗰𝗲𝗯𝗼

◼️ When compared to a placebo (sham) treatment at short-term follow-up (closest to four weeks), the combined therapy showed mixed results.

🔹 Pain

◼️ The treatment resulted in little or no difference in pain reduction compared to a placebo, improving by less than a single point on a 0 to 10 scale.

🔹 Function

◼️ There was a moderate increase in physical function, with participants improving by an average of 10.20 points on a 100-point scale.

🔹 Quality of Life

◼️ The therapy yielded little or no improvement in health-related quality of life.

📈 𝗞𝗲𝘆 𝗙𝗶𝗻𝗱𝗶𝗻𝗴 #𝟮: 𝗠𝗮𝗻𝘂𝗮𝗹 𝗧𝗵𝗲𝗿𝗮𝗽𝘆 𝗮𝗻𝗱 𝗘𝘅𝗲𝗿𝗰𝗶𝘀𝗲 𝘃𝘀. 𝗡𝗼 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁

◼️ The benefits were much clearer when the intervention was compared to receiving a wait list or no treatment at all.

🔹 Pain

◼️ Participants experienced a large reduction in pain, improving by an average of 2.44 points on a 10-point scale.

🔹 Function

◼️ The treatment led to a moderate improvement in physical function, translating to a 14% absolute benefit over doing nothing.

🔹 Quality of Life

◼️ There was a moderate improvement in health-related quality of life, equating to an absolute improvement of 25% on a 100-point scale.

𝗦𝗮𝗳𝗲𝘁𝘆 𝗮𝗻𝗱 𝗔𝗱𝘃𝗲𝗿𝘀𝗲 𝗘𝘃𝗲𝗻𝘁𝘀

◼️ The treatment appears to be relatively safe, as there was little to no difference in non-serious adverse events when compared to the control groups.

◼️ There was only a 2% absolute risk increase for mild, transient issues such as treatment-related soreness, dizziness, or headaches.

◼️ Additionally, no serious adverse events were reported in any of the studies, though detecting such rare events would likely require a much larger sample size.

⚠️ 𝗟𝗶𝗺𝗶𝘁𝗮𝘁𝗶𝗼𝗻𝘀 𝗼𝗳 𝘁𝗵𝗲 𝗘𝘃𝗶𝗱𝗲𝗻𝗰𝗲

◼️ The review authors rated the certainty of the evidence as low to very low.

◼️ This was primarily due to non-modifiable challenges in rehabilitation research, such as the impossibility of "blinding" therapists and patients to whether they were administering or receiving physical therapy.

◼️ Other issues that lowered the evidence quality included small study sample sizes, reliance on self-reported outcomes, and a complete lack of trial data for patients with acute neck pain.

🎯 𝗧𝗵𝗲 𝗙𝗶𝗻𝗮𝗹 𝗧𝗮𝗸𝗲𝗮𝘄𝗮𝘆

◼️ If you are struggling with chronic neck pain, combining manual therapy with exercise is significantly better than doing nothing at all, offering large reductions in pain and noticeable improvements in daily function.

◼️ However, when compared to a convincing placebo, the benefits are mostly limited to a moderate increase in physical function rather than actual pain relief.

◼️ Ultimately, patients who are willing to adhere to an exercise routine, can tolerate manual manipulation, and have the resources to attend multiple sessions a week may find this combined approach to be a valuable option for managing their symptoms.