I am looking for anyone who has had experience dealing with Long Thoracic Nerve Injury. I fell off my Mountain bike 14 months ago broke my collar bone and did a pretty decent job of damaging my shoulder in general. Most of the issues have now healed but I still have considerable winging in my shoulder blade and a loss of strength and reduced range of motion in the shoulder in general. I have had MRI’s, ultra-sounds and now a nerve conduction test. The last of these has confirmed there is injury to the Long Thoracic Nerve. I am wondering if anyone else has had this issue and what treatment may have been used? I am hoping to have an informed discussion with my doctor when I go back to discuss options.
I am looking for anyone who has had experience dealing with Long Thoracic Nerve Injury. I fell off my Mountain bike 14 months ago broke my collar bone and did a pretty decent job of damaging my shoulder in general. Most of the issues have now healed but I still have considerable winging in my shoulder blade and a loss of strength and reduced range of motion in the shoulder in general. I have had MRI’s, ultra-sounds and now a nerve conduction test. The last of these has confirmed there is injury to the Long Thoracic Nerve. I am wondering if anyone else has had this issue and what treatment may have been used? I am hoping to have an informed discussion with my doctor when I go back to discuss options.
What is the professional opinion about your degree of scapular winging? Have you made any gains in physical therapy?
Ask your doc how much deficit in velocity the nerve test showed. You’ll need about 75% of normal nerve velocity to regain useful function of the serratus anterior, which has likely atrophied and become very weak.
14 months is long enough for neuroregeneration of the LTN no matter where the injury site. Chances are the regenerating nerve sprouts had difficulty finding and entering the appropriate endoneurial tubes at the injury site.
I made some gains in physical therapy initially but it levelled off. There is still considerable winging - I will ask for a more precise answer from the doctor on the degre. I will also ask about the deficit in velocity. Thanks for the reply.
Injury to TN affects serratus anterior muscle hence winged scapula. Doesn’t matter what nerve velocity is because clinically this is what you have. Can take several years of recovery and if not there are muscle transfer procedures that can be done with variable results…
Robert
It does matter if LTN conduction is permanently impaired. Then a nerve transfer probably from the latissimus dorsi would be needed.
Injury to TN affects serratus anterior muscle hence winged scapula. Doesn’t matter what nerve velocity is because clinically this is what you have. Can take several years of recovery and if not there are muscle transfer procedures that can be done with variable results…
Robert
Do you mean a nerve graph?
This reply is why ST needs a “like” button!
Do you mean a nerve graph?
Similar. A branch of the thoracolumbar nerve is transferred (and graphed) to the healthy part of the damaged LTN.
I have no idea if this would be needed or an option in your case. In that you are an athlete, it might be considered.