Can an EMG tell me why I have no strenghth?

[admin]

Im having an EMG soon.Im just wondering if the doctor can tell me after this is done,the location the nerve isnt working or why I cant lift anything? Ive had no improvements in 2 years.I can only lift one pound alittle higher than chest level.Thanks

[Nan in On]

Sorry, I have been absent from the forum for a while and missed your post about weakness...I have a question or two...
Can you raise your arm over your head without lifting anything?
Have you noticed if when you try to raise your arm or put your arm straight out in front of you and press on a wall your scapula (shoulder blade) wings out at all?
If this is the case, I would think that you have an injury to either the long thoracic nerve or the spinal accessory nerve. These nerves send impulses to the serratus muscle which attaches the scapula to the chest wall and rotates it so you can raise your arm.
If the muscle is not getting the nerve impulses for whatever reason (don't know your history), there's no way you can raise your arm. An EMG/NCV test done be a qualified neurologist should indicate if this is the problem, as long as the neuro tests the right area and knows what he/she is looking for. The LTN is not an easy nerve to isolate, so the person doing it must be very skilled in this area.
Please check for the winging in a mirror...I didn't know I had scapular winging until my doctor pointed it out during a physical...not often we check out our backs in a mirror.
I also couldn't raise my arm above shoulder level and please be aware that if this is the case, no amount of AGGRESSIVE PT will help...in fact, strengthening exercises done improperly will only make things worse.
I am surprised you would have this going on for 2 years and nothing has been tested until now!
Good grief!

[admin]

I can raise my arm to around 140 degrees (with pain).To the side about 90.I can live with the function,but having no strength,thats the real issue.Ive already had 6 Emgs,the first right after my crush accident 3.5 years ago.It should all nerves are intact.So by the time I seen the Mayo guys,the nerves were already healing.Last year was the last Emg I had and it showed chronic axon loss.Any idea what that is and could that be why the muscles are not coming back all in all this time?

[admin]

These are questions you really should be asking your doctors to clarify. After 6 EMGs I would think they could at very least be frank with you about the results and what they mean.
Sorry to be no help here.

[EllenB]

I'll be meeting with John's physical therapist later this week & will ask him why there isn't more strength in reinnervated bpi muscles. Obviously a lot of PT comes into play to develop strength, but at some point there isn't any further progress. John (who had all 5 avulsed) was told he'd be able to lift something that weighed 5 lbs. - better than nothing, but still...

Ellen

[admin]

Ellen,

Thanks in advance for asking the therapist for me.No one can seem to figure this mystery out for me.I look forward to the therapist response.

[lizzyb]

Ellen and Guest...My theory on this, for what it's worth, is this: you might find that the answer is closely linked the thickness of the nerve bundles that reinnervate the muscles. It's a bit like wiring...you need a thicker wire to run all your household wiring than you would to run a small desk lamp.

If the only nerve bundles available to use as a graft are from the 'desk lamp' to fire up a powerful muscle like the bicep, then you can see the problem. The new nerve probably won't be able to conduct as much'current' that the reinnervated muscle is used to.

I know that it's really only the nerve sheath that they use in nerve transfers, and the nerve grows down inside this tube to the target nerve, but it seems reasonable to assume the same thing.

In the case of cronic axonal loss, this seems to me to be the same ting in a way...the 'wiring' has become weaker and is probably now not conducting enough power to the muscles.

I would love to know what John's surgeons at the Mayo think about this. They could probably can come up with a much better theory! Please let me know if you hear anything...it would answer a lot of questions.

Lizzy B

[EllenB]

Hey Ya'll (I'm from the South so I have to write this way.)

I actually did ask Mayo not that long ago, and my layman's interpretation of the explanation was basically same as your thoughts, Lizzy. Something about 'not enough nerves going to the muscle' - and at the time it didn't really compute to me since I was thinking the transferred nerve replaced the avulsed one, kind of by a one to one ratio. You lose the C7, you get a phrenic - something like that.

Will ask PT Larry tomorrow & get more explanation...

BPI-ers are famous for being patient because they have to be. So be a bit more patient & I'll respond back asap.

Cheers,

Ellen

[EllenB]

Hey -

I spoke w/the PT this afternoon. He said that between the (inevitably) partially atrophied muscle & the fact that only one nerve was going to it, there would be limited strength. He said normally nerves branch out & in effect share functions with other nerves. When the transfers are done there is less nerve to work with.

Hope that helps! If I've misstated anything, jump right in...

Ellen

[cbe411]

Ellen... I have to wonder about this though..

"BPI-ers are famous for being patient because they have to be."

I have NO PATIENCE with anything! I never have been great with it but since my crash I really dont have any! hahaha I know that some would totally agree. I guess when it comes to certain things I do have a bit but thats aobut it. I think that is why I got this BPI thingy! GOD wanted me to learn patience, i think its not working for the first 4 years anyway! hahahaahhahaah

COurt xx