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Acute brachial neuropathy in athletes

Department of Orthopaedic Surgery, Section of Sports Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

Asa J. Wilbourn, MD

Department of Orthopaedic Surgery, Section of Sports Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

John A. Bergfeld, MD

Department of Orthopaedic Surgery, Section of Sports Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

Acute brachial neuropathy is an uncommon etiology of shoulder pain and disability. It can, however, present in association with athletic activity and therefore must be included in the differential diagnosis of athletes with such symptomatology. Findings that should alert the examiner to the possible presence of acute brachial neuropathy include 1) onset with noncontact as well as contact sports, 2) rather acute onset of pain without specific inciting trauma, 3) persistent, often severe pain that continues despite rest, 4) patchy brachial plexus and/or peripheral nerve involvement, and, 5) dominant arm predominance of symptoms and signs.

Electromyography and nerve conduction studies often can confirm the diagnosis. Treatment begins with rest and continues through a rehabilitation phase. Fol lowup of athletes with acute brachial neuropathy dis closes that weakness may persist in the affected mus cles. Absolute strength parity may be difficult to achieve, so permission to participate in athletics must be given on a case by case basis.

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				S. M. Aval, P. Durand Jr, and J. A. Shankwiler Neurovascular Injuries to the Athlete's Shoulder: Part I J. Am. Acad. Ortho. Surg., April 1, 2007; 15(4): 249 - 256. [Abstract] [Full Text] [PDF]