Is Nerve Tension Limiting Your Shoulder Range of Motion?
Is Nerve Tension Limiting Your Shoulder Range of Motion?
Boy oh boy - another post to nerd out over the neurodynamics of stretching!
In the past I’ve talked about how sometimes when we feel “tightness” in a stretch, it’s not actually a tight muscle we’re feeling, but rather nerve tension from a nerve that’s trapped and unable to slide and glide appropriately. The super-speedy recap is:
nerves - unlike muscles - do not respond well to be put under tension (they are not meant to stretch)
instead, nerves are designed to glide back and forth through our soft tissue (like a slack piece of yarn inside a straw)
if there’s something that prevents the nerve from gliding back and forth, that can put the nerve on too much tension, causing it to send signals to the muscles to contract to protect your body (leading to sensations of pain, muscle tightness, or even tingling in your extremities)
Henry Vandyke Carter, Public domain, via Wikimedia Commons
When it comes to being able to reach your arms overhead (shoulder flexion), there are a couple of nerves that - when under tension - can cause tightness in this range of motion. The two most common troublemakers are the ulnar nerve and the median nerve - because they impact very similar ranges of motion, I’m lumping them together in the same blog post.
Your ulnar nerve runs from your skull, out your spine in your upper back, through the shoulder, through your elbow, all the way down to your pinky and ring finger. This is the nerve responsible for the tingling sensation you get in the pinky side of your hand when you jam your “funny bone.”
Your median nerve also starts in your skull, runs down your neck, out your upper back, through your shoulder, through your elbow, down to the thumb, index, and middle finger.
It’s important to understand where these nerves run in our body, because if you have nerve tension, that may manifest as symptoms (pain, tightness, tingling) anywhere along the path of your nerve. For these two nerves, the most common symptoms of tension are tension/discomfort in our chest, upper arm, forearm, or wrist, tingling in the fingers, and/or neck pain when reaching the arms out to the side (shoulder abduction) or overhead (shoulder flexion).
For me, I have some mild nerve tension in both my ulnar and median nerves, and I notice it most when reaching my arms out to the side for chest stretches, and it manifests as tingling in my fingers.
How to Tell If You Have Nerve Tension (in Your Ulnar or Median Nerve)
Usually “tingling” sensations in your fingers when doing overhead or out-to-the-side arm movements is a pretty dead giveaway that something’s up with one of your nerves. But sometimes nerve tension can just feel like a stretch - so it can be tricky to identify! To sleuth out if the sensations you are feeling in a particular stretch/position are from a muscle stretch (good!) or nerve tension (not good!), we need to:
Start in a position where you’re feeling the sensation
Move a joint where the muscles don’t cross the area you’re feeling the sensation in that the nerve runs through to put the nerve on/off tension
If you feel a difference when adjusting the farther-away joint, you know it’s not muscle related (because we picked a joint where the movement doesn’t affect the muscles where you’re feeling the stretch/discomfort/tingling/pain), and likely due to your nerves!
Ulnar Nerve Tension Self Test
Ulnar nerve tension can feel like a stretch, tightness, tingling or pain anywhere from the neck, shoulders and chest, down the arm, all the way to your fingertips. This test is designed to isolate the sensations you might be feeling in a stretch, and identify if they are due to muscle length (aka just a regular ol’ stretch) or due to your ulnar nerve getting tugged too tight. Because there are multiple muscles/joints that the ulnar nerve runs through, we have to do try a couple of different motions where the ulnar nerve is put on more tension, but the muscle group in question is not changed (stretched/contracted).
Position 1: Start with one arm extended out to the side, arm straight at shoulder height, wrist flexed, making an “OK” sign with your last three fingers extended up towards the ceiling
Position 2a: Keep the same position of your “OK” hand and wrist as you bend your elbow, bringing your “OK” sign towards the side of your head. Do not let the elbow drop below shoulder height.
Positive-for-nerve-tension result: If any of the sensations in your fingers or chest change as you reach your hand in toward your face (which doesn’t change the length of the muscles in your hand or chest), then you likely have some ulnar nerve tension. This can often feel like “tingling” in your fingers
Position 2b: Start in position 2a (see above). Keeping your elbow in the same spot, make a fist with your hand (instead of your “OK sign”).
Positive-for-nerve-tension result: If any of the sensations in your upper arm, chest, or shoulder change (where the muscles aren’t affected by making a fist), you likely have some nerve tension
Position 2c: Go back to your “OK” sign hand and elbow out to the side (Position 2a). Keeping your hand and wrist in the same position, bring your elbow forwards so it comes in front of your shoulder
Positive-for-nerve-tension result: If any sensations in your forearm, wrist, hand or fingers change (lessen in intensity) when you bring your elbow forwards (which does nothing to change the length of the muscles in our forearm or hand), this is likely due to nerve tension (you give the nerve some slack when you bring that elbow forwards)
Median Nerve Tension Self Test
Like ulnar nerve tension, median nerve tension can also manifest as tightness/stretching/pain/tingling anywhere from your neck/shoulders/chest down to your fingers. Just like the ulnar nerve test above, this test is meant to help identify whether the sensations you are feeling are due to a muscle stretch, or nerve tension.
Position 1: Start facing a wall, with your palm flat on the wall at shoulder height, fingers pointing down, arm straight. This may feel like a bit of a forearm/wrist stretch, it may not (depending on your wrist flexibility)
Position 2a: Keeping your palm on the wall, open your chest out to the side. Note: is this a more intense stretch? Where do you feel the stretch?
Positive-for-nerve-tension result: If the sensations in the forearm, wrist, palm, or fingers change when you rotate your chest towards and away from the wall while our palm is staying flat on the wall, then you likely have some median nerve tension (opening the arm out to the side increases the tension on the nerve)
Position 2b: If you did NOT feel any different sensation below your elbow in the variation above, but you DID feel a change in sensation in your upper arm, shoulder or chest, because we did just change what the muscles were doing there we need one more test. Keeping your arm reaching out to the side and chest open, come up onto the fingertips of the palm that was flat on the wall, tenting your fingers and flattening your wrist.
Positive-for-nerve-tension result: If any of the sensations in the chest, shoulders, or upper arm change when you tent your fingers and flatten the wrist while your arm stays in the same position, then you likely have some median nerve tension (tenting the fingers to flatten the wrist decreases median nerve tension, while keeping the wrist flexed and palm on the wall increases the tension)
How to Train to “Fix” Nerve Tension
How to best “fix” your nerve tension depends on the cause of the tension to begin with - which is something you could get evaluated by a knowledgeable physical therapist or flexibility coach who has a solid understanding of neurodynamics (but do ask them in advance if this is something they have experience with - not all do!).
That said, there are some general “best practices” that we can use to reduce nerve tension:
Short-Term Fix: Nerve Mobilizations
Nerve mobilizations like nerve glides (also called slides) and nerve tensioners can help our nerves slide back and forth like they’re supposed to without being put under loads of intense tension. These are best done as part of your warm up, or right after your warm up. Nerve glides are great because for folks with nerve tension, they often provide some immediate relief and allow for an increased range of motion right away. Just be aware that this effect is temporary, and only lasts for an hour or two.
Important reminders about nerve glides: these should be gentle and you shouldn’t push through to any intense sensations of stretching, pain, tingling, or discomfort (on the intensity scale, think of keeping it at a 3/10 intensity). You also only need to do like 10-20 per nerve, per day, max. Doing too high a volume can aggravate your nerves and make your nerve tension worse, not better!
The Long-Term Fix: Work Your Active Flexibility
To improve our nerve mobility long-term, this usually involves working on our active flexibility for both the smaller stabilizer muscles in the shoulder (hello rotator cuff!) and deep neck flexors, as well as strengthening the larger muscle groups that support end range positions when we typically feel nerve tension (specifically the scapular muscles helping with protraction and retraction, but also our wrist extensors!).
Recommended Drills
Drills like these that work your internal and external shoulder rotation are great to help strengthen your rotator cuff - but the best ones to really challenge the stabilizers are “open chain” drills where you aren’t using a block or the floor to brace against for the movement and you’re forced to control the whole movement yourself (like open sesames or the banded "wax on wax off" stretch)
