The brachial plexus is a network of nerves that provides both sensory and motor function to the shoulder, arm and hand. The brachial plexus originates from the C5, C6, C7, C8 to T1 nerves and controls important functions in the shoulder arm and hand including; muscle contraction, proprioception, maintenance of body control and coordination, reaction to sensations such as heat, cold, pain and pressure.
Injuries to the brachial plexus occur when the nerve is stretched, compressed or in more serious cases ripped or torn.
The main types of brachial plexus injury include;
- Avulsion- This the most severe brachial plexus injury where the nerve root is torn away from the spinal cord.
- Rupture- A forceful pull of the nerve may cause the nerve to tear fully or partially.
- Stretch or Traction- When the nerve is mildly stretched without causing rupture or avulsion.
Most traumatic brachial plexus injuries occur when the arm is forcefully pulled or stretched away from the body and the neck is stretched in the opposite direction.
Events that cause brachial plexus injuries include;
- Sporting collisions
- Motor vehicle accidents
- Knife or gunshot wounds
- Difficult infant births
- Motorbike accidents- this is the most common cause
Brachial plexus injuries can present in a number of ways depending on the mechanism of injury and the severity of the injury.
Common signs and symptoms in the shoulder arm of hand include;
- Loss of sensation
- Muscle weakness
- Burning sensation
- Paralysis of some or all muscles
Treatment of brachial plexus injuries depends on the severity and the nature of the injury.
Conservative treatment involving exercise rehabilitation is beneficial for stretch or traction injures. The aims of exercise rehabilitation include to maintain range of motion in the extremity, strengthen the functional muscles, protected the denervated dermatomes and help to manage pain. In severe cases involving avulsion and rupture or if there is an open wound, surgery is usually required. Exercise rehabilitation is used post-surgery to increase surgical outcomes and restore as much function as possible the affected limb.
If you would like more information on exercise rehabilitation following a traumatic brachial plexus injury, please contact an Accredited Exercise Physiologist at Absolute Balance.
Lisa Wallbutton (BSR, MClinicalExPhysiol(Rehab))
Accredited Exercise Physiologist
Sakellariou, V. I., Badilas, N. K., Stavropoulos, N. A., Mazis, G., Kotoulas, H. K., Kyriakopoulos, S., … Sofianos, I. P. (2014). Treatment Options for Brachial Plexus Injuries. ISRN Orthopedics, 2014, 314137. http://doi.org/10.1155/2014/314137