Axillary Nerve: Understanding, Gliding Techniques, and When to Seek Help

How to Stretch the Axillary Nerve?

The axillary nerve, a crucial component of shoulder function and sensation, is not "stretched" in the traditional muscular sense but rather "mobilized" or "glided" to improve its movement and reduce potential impingement within surrounding tissues.

Understanding the Axillary Nerve

The axillary nerve originates from the posterior cord of the brachial plexus (derived primarily from C5 and C6 nerve roots). It courses through a confined space known as the quadrangular space, alongside the posterior circumflex humeral artery, before innervating key shoulder structures.

Key Functions:

• Motor: Supplies the deltoid muscle (responsible for shoulder abduction and flexion/extension) and the teres minor muscle (a rotator cuff muscle aiding in external rotation).
• Sensory: Provides sensation to the "regimental badge" area, which is the lateral aspect of the shoulder, often described as a patch.

Common Issues Affecting the Axillary Nerve: Due to its anatomical course, the axillary nerve is vulnerable to injury or compression. Common culprits include:

• Shoulder Dislocation: Especially anterior dislocations, which can stretch or compress the nerve.
• Humeral Fractures: Fractures of the surgical neck of the humerus.
• Direct Trauma: Blows to the shoulder.
• Compression Syndromes: Conditions like Quadrangular Space Syndrome, where hypertrophy of surrounding muscles or fibrous bands can impinge the nerve.
• Overuse or Repetitive Strain: Less common but possible with certain athletic activities.

Symptoms of axillary nerve irritation or damage often include weakness in shoulder abduction and external rotation, along with numbness or tingling in the lateral shoulder region.

The Concept of Nerve Gliding vs. Stretching

It is critical to understand that nerves are distinct from muscles. Muscles are elastic and designed to lengthen and shorten. Nerves, while possessing some elasticity, primarily need to slide and glide freely through fascial planes and muscle tissues as the body moves.

• Nerve Stretching: Applying sustained tension to a nerve can be detrimental, especially if the nerve is already compressed or inflamed. This can exacerbate symptoms, cause micro-trauma, or even lead to further irritation.
• Nerve Gliding (Mobilization): This technique involves creating a gentle "push-pull" motion on the nerve. By simultaneously lengthening the nerve at one end while shortening it at another, nerve glides encourage the nerve to slide through its surrounding tissues. This can help break up adhesions, reduce impingement, and improve nerve health and function without placing excessive tension.

The goal of axillary nerve mobilization is to restore its natural mobility, reduce sensitivity, and alleviate symptoms.

When is Axillary Nerve Mobilization Indicated?

Axillary nerve gliding techniques may be beneficial for individuals experiencing symptoms consistent with mild axillary nerve irritation, such as:

• Lateral shoulder pain.
• Numbness or tingling in the lateral shoulder.
• Mild weakness in shoulder abduction or external rotation, confirmed to be nerve-related.
• Symptoms that are exacerbated by specific arm or shoulder movements.
• Post-rehabilitation for shoulder injuries (e.g., after a dislocation has healed and stability is restored), under professional guidance.

Precautions and Contraindications

Nerve mobilization should always be approached with caution. Never push into pain. Stop immediately if symptoms worsen or new symptoms appear.

Absolute Contraindications (Do NOT perform):

• Acute, severe, or worsening neurological symptoms (e.g., progressive weakness, rapid loss of sensation).
• Recent fracture or dislocation of the shoulder or humerus that has not been medically cleared.
• Unexplained, severe pain.
• Signs of active inflammation or infection.
• Suspected nerve laceration or severe nerve damage.

Relative Precautions (Proceed with extreme caution and professional guidance):

• Known nerve entrapment syndromes.
• Post-surgical recovery periods.
• Conditions like diabetes or peripheral neuropathy, which can affect nerve health.

Always consult with a healthcare professional (e.g., physical therapist, physician, kinesiologist) before attempting nerve mobilization techniques, especially if you have pre-existing conditions or severe symptoms.

Axillary Nerve Gliding Techniques

The following techniques are designed to gently mobilize the axillary nerve. Perform them slowly and mindfully, staying within a comfortable, pain-free range. The sensation should be a gentle stretch or pull, not sharp pain, burning, or increased numbness.

1. Arm Abduction & Head Tilt Glide

This glide aims to mobilize the nerve by creating a push-pull effect through the shoulder and neck.

• Starting Position: Sit or stand upright with good posture. Let your affected arm hang relaxed at your side.
• Action:
  1. Gently tilt your head away from the affected shoulder (e.g., if mobilizing the right axillary nerve, tilt your head to the left). This creates tension on the nerve from the cervical spine.
  2. Simultaneously, slowly abduct (lift out to the side) your affected arm, keeping the elbow straight and palm facing forward or up. As you lift the arm, gently bring your head back to neutral or slightly tilt it towards the affected shoulder.
  3. Lower your arm back to the starting position while simultaneously tilting your head away again.
• Focus: The movement should be fluid and coordinated. You are essentially "flossing" the nerve. The range of motion should be limited by any sensation of pull or stretch.
• Repetitions: Perform 10-15 slow, controlled repetitions.

2. Arm Extension & External Rotation Glide

This technique targets the nerve as it passes through the quadrangular space, emphasizing shoulder extension and rotation.

• Starting Position: Stand upright with good posture. Let your affected arm hang relaxed at your side.
• Action:
  1. Gently tilt your head away from the affected shoulder.
  2. Simultaneously, slowly extend your affected arm behind your body (as if reaching for your back pocket) while externally rotating your shoulder (turning your thumb outwards, away from your body). As you extend and rotate the arm, gently bring your head back to neutral or slightly tilt it towards the affected shoulder.
  3. Return your arm to the starting position while simultaneously tilting your head away again.
• Focus: Maintain a gentle, controlled movement. Do not force the arm into a position that causes pain.
• Repetitions: Perform 10-15 slow, controlled repetitions.

Integrating Nerve Glides into Your Routine

• Frequency: You can perform these glides 2-3 times per day, for 1-2 sets of 10-15 repetitions, or as advised by your healthcare professional.
• Duration: Consistency is key. Results may take time to manifest.
• Progression: As your nerve sensitivity decreases, you may gradually increase the range of motion. However, always prioritize comfort over depth.
• Complementary Practices: Combine nerve glides with good posture, gentle shoulder mobility exercises (if appropriate), and strengthening exercises once pain has subsided and stability is restored.

When to Seek Professional Guidance

While nerve glides can be beneficial, they are not a substitute for professional medical advice. Seek immediate attention from a physical therapist, chiropractor, or medical doctor if you experience:

• Sudden onset of severe shoulder pain, weakness, or numbness.
• Symptoms that worsen or spread despite gentle mobilization.
• Persistent symptoms that do not improve after a few weeks of consistent, gentle glides.
• Any suspicion of a fracture, dislocation, or other acute injury.

A healthcare professional can accurately diagnose the cause of your symptoms and provide a comprehensive treatment plan tailored to your specific needs, which may include manual therapy, targeted exercises, or other interventions.

Conclusion

Understanding the unique nature of nerve tissue is paramount when addressing discomfort or limitation related to the axillary nerve. Instead of aggressive "stretching," gentle nerve gliding techniques aim to restore the nerve's natural mobility, reducing irritation and promoting healthier function. Always approach these exercises with caution, listen to your body, and never hesitate to consult a qualified healthcare professional for an accurate diagnosis and personalized guidance.