|
JLS_PT_OCS -> Re: Long thoracic palsy (May 25, 2005 7:13:00 AM)
|
If reinnervation is a concern, then specific serratus training may be counterproductive.
Maintain ROM and strength, esp cuff and periscapulars.
Try this reference for a summary:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15150060&query_hl=2
Here's a quote from this article, numbers after sentences are citations from the reference list, which is valuable as well:
NATURAL HISTORY.
The natural history of atraumatic long thoracic nerve palsy is resolution within 1 year.63 However, cases due to Parsonage-Turner syndrome (brachial plexitis) may take as long as 2 to 3 years to resolve.35 It has been reported that nonoperative treatment will not be successful in approximately one quarter of patients affected by long thoracic nerve injury.(3,4)
TREATMENT.
Because of the relatively good prognosis for spontaneous recovery, the mainstay of initial management is a nonoperative program. Nonoperative treatment for this problem includes relative rest, symptomatic management, reassurance, maintaining shoulder range of motion, strengthening of compensatory muscles, and possibly bracing. With regard to relative rest, the athlete should avoid lifting heavy objects or participating in activities that exacerbate symptoms and place the nerve at risk. Pain should be managed symptomatically by use of non-steroidal anti-inflammatory drugs or other medications for neurogenic pain. Athletes should be reassured and informed of the fact that most cases of atraumatic long thoracic nerve injury subside within 6 to 9 months,35 and almost all cases resolve satisfactorily within 12 months.34,39,52,83,110 It should be stressed to the patient to maintain full glenohumeral range of motion, actively, passively, and actively assisted. Furthermore, strengthening of the scapular stabilizers, particularly the trapezius, rhomboids, and levator scapulae, should be instituted because these are stressed more in the face of a nonfunctioning or dysfunctional serratus anterior.
I wonder what the recovery expectation is of a post-viral injuries vs traumatic injuries? Unsure of that...
J
|
|
|
|