Long Thoracic Nerve Palsy in a 21-year-old, Collegiate Softball Player: A Case Study
Dr. Kirk Brumels and Professor Margaret Frens
Long Thoracic Nerve Palsy is a unique condition amongst athletes that negatively affects normal shoulder motion and function. The long thoracic nerve innervates the serratus anterior muscle, which functions to keep the scapula positioned against the thorax during scapular movement. If the function of the long thoracic nerve is compromised, such as in long thoracic nerve palsy, scapular winging and decreased range of motion will be present. In general, nerve palsy tends to recover on its own three to six months after the injury with a treatment and rehabilitation program. This case is unique because the typical signs were masked by symptoms of other possible injuries which confounded the assessment process. During the assessment period, the athlete performed a rehabilitation program that mimicked that of a long thoracic nerve palsy program, but she did not increase in function due to the injured nerve. Also, the nerve did not recover until eight months after the injury. Once the nerve recovers and neural impulses to the serratus anterior resume, a continued strengthening program should be maintained to facilitate full function of the serratus anterior allowing normal resumptions of activities during daily living and athletics. Patience is imperative when nerves are injured. It takes time for the injury to present itself, for it to heal, and for the athlete to regain strength.
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