Wheres the strenghth in my arm questions

[admin]

I have barely any muscle in my arm.Been in PT for over 3 years with no sucess.I had a BPI injury,which I was told at the Mayo clinic will heal as much as they will on their own.Is there a possibility that MAYBE,the muscle isnt working because I will have a permanent nerve problem that runs that muscle? If yes,is there anything that will help get some strenghth back?
Tnanks

[EllenB]

Which Mayo Clinic did you go to, & what doctors did you see? The primary bpi clinic is in Rochester - is that the location you went to? I'm the first to admit that my entire frame of reference is regarding situations where the nerve is avulsed from the spinal cord - as opposed to stretched or torn. But nerve grafting can repair bad sections of good nerve. Give us some more info about your situation.

Thanks,

Ellen

[admin]

Yes I went to the Mayo in Rochester,great doctors.They said the nerves are intact/no surgery needed.This was back in 2002 the last I was there.They said back then I needed alot of aggressive PT,which I had till a week ago.Because this is a work comp issue.The minute my Orth doctor said the healing was over,to comp EVERYTHING is over for me as far as any more coverage.Like a say I can raise the arm to 150degrees,which is great to see.But no muscle.My Orth doctor says I probebly wont get anymore back.BUT WHY? thats all I would like to know.No one can give me that answer.Thats why Im asking for all your opionions on this subject.Thanks

[EllenB]

So... you have movement but no strength? Have you contacted the Mayo doctors to get advice at this stage?

One thing you could do until things get straightened out, is water therapy. Removing the gravity allows a LOT of movement, which is good for range of motion - but also can allow some resistance for strengthening (either against the water itself or also with some weights attached). You can do something like this on your own, & it might be worth it to not lose any ground for the time being.

What kind of therapy had you been doing until now?

Ellen

[admin]

Hi,

Yes,thats correct.I have pretty good movement and no strenghth.When in therapy, I was stretched Very aggresively,then the tigger point massage and after I worked on my own with alot of different streghning exersises.From using small weights to the lat row machine,you name it..........my therapist had me try it.I did have pool PT also.That helped alot with the range,but again , any weight added and nothing.Any idea at all why i get no strenghth.Im even up to hearing anyones guess. Thanks!

[EllenB]

Have you had much muscle atrophy? I agree, it seems wierd that you have all this movement - which indicates nerve activity - but yet no appreciable strength.

I'll see if John's PT has any ideas. Maybe somebody else will post, too.

Ellen

[Lorrie]

This is a tough one - could be several things going on. I would really try to get back to Mayo - they may revise their diagnoses. I was originally told by non-experts that I just had to wait and it would all come back. I've had two surgeries and it still won't all come back but I am pretty darn close to normal use now in most of my muscles but wouldn't have been without scar tissue removal. For me with range of motion in each muscle I saw gradual increase in strength. I'm wondering if perhaps certain muscles/nerves have regenerated and others haven't. Have you had a recent nerve test done to see if each muscle responds normally - for instance on mine the biceps and triceps now "read" as normal for electrical nerve activity - still lots of improvements to go on strength but the deltoid as of 3 months ago just barely registered any electrical nerve activity but I had some range of motion - partly due to compensation by my trapezius. For instance you may have great return to your deltoid, infraspinatus and supraspinatus which would allow you to lift your arm over your head but put a weight in your hand and a lot of other supporting muscles have to kick in and if they are not working then what was easy without a weight may be impossible with a weight. I also wonder if perhaps there is some scar tissue that is partially blocking the nerve(s) so the return has been diminished. I was seeing some minor return to some muscles but once some scar tissue was removed the return was much greater. Good luck

Lorrie

[Karl w/ a K]

Hi G,
One other possibility is you stretched the nerves badly, but did not brake them. In that case the doctors don't do a repair (nerve graph or nerve transfer). They hope that the nerve within the myelin sheath will repair it's self. Will it? That depends on a lot of ifs. And once it's stretched you don't get 100% of the motor units to the muscle. Let's say you start with 20% 6 months after tbpi. And now you're up to 50%. And hopefully you get back much more. But scar tissue could interfere with the repair. So ,what to do next, that is the question. This is just one possibility of course. I could be way off base. A good tbpi doc should be able to give you some answers. I would pursue it till you feel like you have your answers. Good luck...Karl...

[admin]

Hi and thanks for the responses.I thought it may be scar tissue also.Another thought I had was maybe nerve entrapment.The Mayo clinic(back in 2002 when I had my accident)said it was probebly badly bruised.But why the cold fingers?Today was 63 degrees and Im outside at work with a glove on because the fingers on that hand are cold.Im so confused and it dont pay to go back to Mayo cause they havent done an EMG the last two times I went there.They always said I needed aggressive PT.I feel everyones missing something.I beleve an another EMG is in order.

[stx431]

Carrie's hand and fingers have been cool/cold for years and have finally found out that she has a colapsed artery in her shoulder (presumably from the seat belt shoulder harness). She 's scheduled to have surgery on April 4th to repair it. Hopefully getting the correct bloodfolw to her hand and fingers will help in her recovery. I would suggest having your dr check out the bloodflow to your cold hand/fingers.