Scrape, Tape, Cup & Glide: Restoring Space, Motion, & Slack for Restricted Neural Dynamics of the Lower Quarter

The concept of restricted neural dynamics is not new, however, its impact on our patients’ daily activities and movement tolerance is often overlooked during the examination and treatment of our patients. This course integrates the basic concept of “test-treat-retest” as a foundation to manage these challenging patients. Motion-based interventions consisting of neural flossing, nerve bed/nerve differential gliding, instrument assisted soft tissue mobilization (IASTM), and negative pressure soft tissue mobilization (cupping); as well as corrective exercises and taping are covered in this lower extremity focused course. The basic principle that neural tissue needs space, motion, and slack for optimal healing potential underpins all concepts covered.

The course is appropriate for physical therapists, as both assessment and treatment concepts will be covered to aide in the care of their patients. This course includes laboratory sessions in which participants will practice neural mobilization and examination techniques. Interventions including instrument assisted soft tissue mobilization, negative pressure soft tissue mobilization (cupping), exercises, and taping to facilitate movement and proprioception will be covered.

Please dress to allow access to your entire lower quarter to enhance the learning process.

During the hands-on lab sessions, the course instructor will evaluate each application for neural mobilization, IASTM, Cupping and Taping to determine 100% proficiency of all basic treatment techniques. This will be determined by direct observation and correction of any issues with techniques. A post-test at the end of the course is used to review new knowledge.

This course content is not intended for use by any participants outside the scope of their license or regulation.

Course Objectives:

At the completion of this course you will be able to:

  • Recognize the 3 conditions neural tissue requires for optimal health and healing potential
  • Given a patient with suspected lumbar radiculopathy vs. peripheral nerve entrapment, the participant will accurately bias the sciatic, tibial, fibular, sural, femoral, saphenous, and obturator nerves for differential assessment
  • Justify based on evidence how basic treatment to restore space, motion, and slack can be integrated into the overall treatment plan for patients with chronic plantar foot and heel pain
  • Given a case scenario, choose 3 appropriate IASTM treatments to enhance movement and space for movement dysfunctions resulting from restricted neural mobility for a patient with chronic hamstring or adductor strain
  • Choose from among 3 basic negative pressure soft tissue techniques (cupping) over the nerve bed to enhance space and movement for addressing restricted neural dynamics for a patient with chronic hamstring tightness
  • Following the course and given a case scenario the participant will integrate cupping, IASTM strokes and taping techniques in a patient with Meralgia Paresthetica

CE Credits

14 contact hours

BOC Level: Advanced

This course is accepted by many professional credentialing organizations and state professional regulatory boards. Rules and regulations change frequently without notification, and apply differently to live and online courses. Please check with your state board to confirm accuracy of this list and acceptance of contact hours. Certificate of Attendance will be issued to all participants upon completion of the course and may be used for CEU verification of credits. CE credits vary by state. Please check with your state board/certifying agency to confirm conversion of contact hours to CE. See links below.

Physical Therapy Board of California: The Physical Therapy Board of California recognizes Rehab Education, LLC as an approval agency to approve providers offering continuing competency courses for CA licensed PTs and PTAs. This course is approved for 14 contact hours.

New Jersey State Board of Physical Therapy Examiners: This course has been approved by the New Jersey State Board of Physical Therapy Examiners for 14 continuing education credits, Approval #2001-37. (Course must be taken between 01-31-2020 and 01-31-2022)

NJ Board of Chiropractic Examiners: The New Jersey State Board of Chiropractic Examiners has approved Rehab Education as a pre-approved provider/sponsor of chiropractic continuing education courses. This course has been approved for 14 contact hours. (Course must be taken between 09-1-2019 and 08-31-2023)

NY State Physical Therapy Board: Rehab Education, LLC is recognized as an approved provider of PT and PTA continuing education by the NY State Education Department Board of Physical Therapy. (Course must be taken prior to 05-10-2022)


Day 1

7:30 – 8:00 Continental Breakfast and sign in
8:00 – 9:00 Introduction and background of basic concepts: Neural Physiology for Optimal Healing – Space, Motion, Slack
  Assessing the Sensitized Neural Tissue: The following Labs are focused on collecting baseline data for test-treat-retest guided clinical decision-making
9:00 – 9:45 Palpation Lab
9:45- 10:00 Break
10:00 – 12:00 LE Mobility Assessment Lab
12:00- 1:00 Lunch Break
1:00 – 1:30 Quiz for concept retention & treatment conditions
Review/ Quiz
1:30 – 2:00 Basic Concepts
  Instrument Assisted Soft Tissue Mobilization
2:00 – 2:15 Instrument Anatomy
2:15 – 2:45 Basic nerve bed strokes
2:45 – 3:00 Indications/contraindications
3:00 – 3:15 Break
  Case Scenario Teaching Labs – Application of Concepts, Introduction of Interventions & Techniques
Posterior Hip & Thigh, Foot
3:15 – 4:45

Concepts covered: structural differentiation. Treatment principles: nerve bed IASTM & manual therapy (pin & glide) – clinical cases Lab

  • Chronic hamstring tightness
  • Lumbar radiculopathy with anterolateral thigh symptoms
  • Chronic plantar foot and heel pain
  • The painful foot (AMPS vs. CRPS)

Day 2

7:30 – 8:00 Continental Breakfast and sign in
8:00 – 8:15 Basic Principles and Techniques
9:15 – 9:15 Integrating IASTM and Cupping simultaneously over the nerve bed to promote space and motion in the above clinical scenarios
  Sliders and Tensioners
9:15 – 9:45 Exercises to facilitate carry-over of manual interventions
9:45 – 10:00 Break
  The Pelvis, Inguinal Region, and Medial & Lateral Thigh
10:00 – 11:00

Chronic Adductor Strain

  • Structural Differentiation
  • IASTM, NPSTM, Pin & Glide
11:00 – 12:00

Pelvic Pain

  • Neural Anatomy and entrapment sites
  • Releasing the Psoas
12:00 – 1:00 Lunch
1:00 – 1:30 Anterolateral Thigh – the Meralgia Paresthetica
  Elastic Therapeutic Tape
1:30 – 2:00

Basic Principles and types

  • Enhance motion
  • Carry-over from manual interventions
2:00 – 3:00 Taping Application Lab – Use of taping over nerve beds
3:00 – 3:15 Break
  Integration of Skills – Course Conclusion
3:15 – 4:15

Small Group Activity – Use of selected patient case scenarios above

  • Perform pre-assessment to establish neural mobility baseline
  • Combine IASTM, NPSTM, Pin & Glide, and Taping interventions
  • Perform post-assessment to identify treatment effect
  • Provide exercise program to enhance treatment carry-over


Mark W. Butler, PT, DPT, OCS, Cert. MDT

is a board certified Orthopaedic clinical specialist and Mckenzie certified specialist for mechanical diagnosis and treatment of the spine. He started his own practice eighteen months after graduating from the Philadelphia College of Pharmacy and Science (now the University of Science in Philadelphia), which he sold to NovaCare in 1997.

He is an Adjunct Assistant Professor at UMDNJ, guest lecturer at Stockton College in New Jersey, and Medical College of Virginia where he lectures on Advanced Orthopedics, Neural Mobilization, Radiology, and Evaluation and Treatment of TMJ Disorders. Mark is also a continuing education speaker on Evaluation and Treatment of Brachial Plexopathies, Neural Mobilization, the lumbar spine, and the shoulder. He was honored in 2006 with the James Tucker Excellence in Clinical Practice and Teaching Award by the APTAnj. He presented at the national conference in Hollywood of the American Society of Hand Therapists on Evaluation and Treatment of the Brachial Plexopathy Patient. His lecture series was selected as the featured topic on CD ROM to be available to the ASHT membership.

Mark is a frequent presenter at conferences, including the APTAnj annual conference, the InNovations and Sports Medicine conferences at the Philadelphia Eagles Complex, and the Cincinnati Fracture conference. He authored the shoulder chapter in the textbook Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity, which was published in 2014. Mark continues to manage the NovaCare Medford outpatient clinic, where the majority of his caseload is brachial plexopathy, shoulder, and spine patients.

Classes taught by Mark W. Butler: