Sciatic Nerve Entrapment due to Fibrous Adhesion in the Deep Gluteal Space: Proposed Clinical Diagnostic Criteria and Therapy Using Manual Adhesion Release®

Study: Sciatic Nerve Entrapment from Fibrous Adhesions (2020)

Journal of Musculoskeletal Disorders & Treatment
Summary:
This study found that nearly 10% of chronic low back pain patients had sciatic nerve entrapment caused by fibrous adhesions. After targeted adhesion-release treatment, patients saw strong improvements in flexibility and pain.
Key Findings:

~21° increase in SLR

64% pain reduction

67% overall improvement
Why It Matters:
Some chronic LBP cases aren’t muscular — they’re caused by nerve entrapment. Treating the root mechanical restriction can lead to real change.
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Hypoxia-generated superoxide induces the development of the adhesion phenotype

This study shows that when tissue doesn’t receive enough oxygen — such as during chronic tightness, compression, or reduced blood flow — fibroblasts can shift into a “scar-forming” mode. Under these low-oxygen conditions, they produce more collagen and fibronectin, and fewer of the enzymes that normally keep tissue healthy and mobile. This creates an environment where fibrous adhesions form and accumulate over time.

In other words, adhesions aren’t random — they’re a cellular response to stress. When soft tissue becomes hypoxic, it starts to thicken, stiffen, and lose its ability to glide, which may help explain why chronic pain and restricted movement persist even without an acute injury. This research supports the idea that targeted adhesion-release work may be needed to restore normal tissue mobility when these structural changes have taken hold.
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Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space

Deep Gluteal Syndrome: Sciatic Nerve Entrapment (2015)

Journal of Hip Preservation Surgery
Summary:
This review explains how sciatic nerve pain can be caused by deep structural entrapment — not disc issues — due to fibrous bands, anatomical variations, or scar tissue in the deep gluteal space.
Key Findings:

Entrapment can occur from fibrous tissue, vascular structures, trauma, or muscle variations

MR neurography improves diagnosis of deep nerve restrictions

Surface-level treatments often fail because the true restriction lies deeper
Why It Matters:
This study reinforces that chronic buttock, hip, or leg pain may be caused by restricted nerve glide, and requires targeted treatment — not generic stretching or strengthening.
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