United Brachial Plexus Network, Inc.

I am sure this topic has been brought up before, but lately I am concentrating on the differences in length between Ella's injured and uninjured arms. Her injured arm is about an inch (or maybe more) shorter. I also notice a fairly big difference when I am holding her hands b/c her injured sides hand is so much smaller by the feel of it. Her hand feels more skinny or just smaller in general. Her wrist is smaller too.
Can you guys tell me what your experience is with the lengths of your children's arms? And those of you who are adults, do you notice a big difference? I am afraid that it will only get worse or more noticable. Now, you cannot tell, but me being her mommy, of course I know about it and can see it.
Thanks for any info.
~Krista~

Hi Krista,
From birth, until the arm nerves "kick in", the child has lost growth that can not be regained. Once the arm is "working", we have to get the child to use her muscles that she never knew she had. Train the brain! These are underdeveloped as compared to her uninjured side. The bones are not as osified as the other side, and , in our daughter's case, her arm bones are literally smaller in diameter.

MUSCLE LENGTHEN BONES. The more muscle mass and ROM the child has, the longer the arm...that's it in a nutshell.

we do tons of weight bearing, actually all kinds of therapy daily. She wears infrared shirts (keeps her arm circulating), and sleeps on magnets.

Our daughter is having an amazing "recovery". She is nearing 20mo. old, and so far seaming so good on length. Just keep thinking up ways for her to use her muscles in her shoulder, back, and arm. I would be happy to share some of the , what we call over here, 'baby workout' activities, that we do with our daughter... in fact, I just made 25, 3 lb. beanbags that she works out with. I just got her to touch her hands together over her head, yesterday! Of course her left side seems 'stiffer', but she can move it now.
Her BPI doctor says we need to keep up everything we are doing, and if all goes well...when she's 6, we'll have a clear picture of the extent of her injury.

We just discovered that she suffered a cranial nerve injury as well... she was delivered with the Woods maneuver, and the OB accidentally had too much pressure pressing behind her ear. So now we are hitting the speach therapy, and I'm learning all that I can do for her there.

I'm with you on that arm length. I really want her arms pretty even. She's coming in at under a half inch different in length. How old is your daughter? I wonder at what age is it noticeably shorter? Is there an average age? Where is the window? Can it just stop growing in length, along the way? Like a few years down the road? Her hands kind of look the same tho....but when she was 6mo old...WOW was her arm smaller, hand too, and it was limp like a piece of paper! Just hanging. That's when I started noticing the difference huge. We started her in therapy at 8 mo. old (we didn't know about the njury until then)
email me any time,
Love,
SusanLynn

Krista
Gavin is now 13 years old and has a difference of about 1.5 inches in the length of his arms.
He fgeels quite self conscious about the difference in the size of his hand - his right hand is much smaller and "pudgier" ( do you have that word in the US?? - sort of chubbier) than his left (unaffected) hand. His left hand is now growing into the hand of a young man whilst the right hand still looks kind of babylike.
We are concentrating on trying to do some exercises to build up the muscle strength in his right hand to see if we can give it more definition.
Another long road ahead I guess LOl
Karen

Brittney just turned 13. When she completely straightens her arm and fingers - there is probably about a 1-1/2 - 2" difference. When she doesn't care about straightening her arm as far as she can and keeps it 'comfortable' there is about a 3" difference. Her hands are the same though - her injured arm is skinnier now - but will get stronger during swim team season, and more muscular and she'll be able to straighten her arm out farther because of the swimming laps daily at practices. Things seem to get better and then worse and then better again. The arm length difference is not as bad as it sounds and most people do not notice unless she is being "comfortable" and doesn't try to straighten out that arm. She has learned her own tricks over the years. As she has grown her arm length differences have seemed to matter less and less. When she was younger the kids didn't notice and now that she's older she knows tricks to use if she wants to - and friends and family don't care at all - just love her and so she is comfortable then.
Christy

As part of an annual OT exam, Nicole's therapist measures the circumference and length of her arms. The difference in size this past year is a greater difference in size than the prior year.

Circumference (cm):
Jan 2005 Dec 2003
L Biceps 17.5cm 17.00cm
R Biceps 18.5cm 17.25cm
Difference 1.0cm 0.25cm

L Upperforearm 16.0cm 16.00cm *no growth
R Upperforearm 18.0cm 17.25cm
Difference 2.0cm 1.25cm

Length:
L Shldr-Mid Fngrtp 47cm 41.9cm
R Shldr-Mid Fngrtp 53cm 46.4cm
Difference 6cm 4.5cm
(2.4") (1.8")

As you can see, Nicole's L arm is growing in biceps circumference (but there was no forearm growth) and in length, but at a slower rate than the R arm, so the size difference is increasing. Also, this has nothing to do with posturing, so when Nicole postures her L arm (bent), the difference appears even greater. Her left hands look much different (w/the left having more of a baby look as someone else mentioned), esp. her left thumb and pinky.

~Tina

Hi, This my 2 cents. I am 66yrs,LOBPI. The short amd small of my left arm/hand and 1/4 " limp was more often then not unnoticed most of my life because I always carried something in my hand or on my left arm. As for the limp,some people commented when they learned about the shortness on my left side,"Oh, I always thought it was just a sexy walk". Sometimes I just had fun with it! I do have to share with you that a dark sense of humor is a great way to get thru
embarrassing questions and moments. I believe that children will find their own way to be comfortable with their bodies.
Carolyn J

Krista:
My ROBPI is about 1 1/2 inches shorter when measured from the elbow and, like Brittney, my hands are about the same size (I have good hand and wrist function but limited arm and shoulder function). As Christy says, other than needing some tailoring of jackets for fit, etc. the arm length difference has not been a serious problem for me. However, I know others with significantly shorter injured arms where it has been an issue and I expect some will comment in this thread.

It's neat to read about Brittney learning the "tricks" because that is part of the adaptation process we all go through. The most important part, however, is that her friends and family just don't care about the differences in her arm and don't call attention to her injury. I was fortunate to experience that same respect.

John P.

Hey John - You and Brittney sound alot alike. The ones that really count in your life - they don't care what so ever - they do not even notice - and who really cares about the unimportant ones anyhow.........
Christy

Krista,
I have notices a difference in my arm length and hand size. My right hand is about 1cm shorter on every finger than my left and looks more child like than my left. I have never measured my arm length but I would guess about a 2 inch differnce.
Nobody ever notices unless I tell them my story.
Amy