United Brachial Plexus Network, Inc.

Hello,

I had a total shoulder replacement in July '07 and was left with a BPI, specifically the axillary nerve. At first, I had no movement, but now I have use of my biceps and some triceps. However, my shoulder muscles are not fully functioning yet, I still have numbness on the skin covering my shoulder, down into the bend of my arm and into my thumb. The major problem this is causing is that b/c my shoulder muscles are not working properly, my shoulder continuously slips in and out of the joint. Most days it feels like it's just hanging there and some days, the numbness gets worse b/c of it. My shoulder is horribly atrophied. My physical therapist is concerned b/c he said if both sensory and motor deficits are present 4 months post-op (I'm almost 5 months out) chances are that what I've got is all I'm going to get.

I see my surgeon and the nerve doctor on Dec. 18th. I'm afraid of what they may offer as a solution, i.e. another surgery. I'm fairly young (46), active and the fact that I have a new shoulder that I may never be able to fully use is depressing.

Any advice or opinions would be greatly appreciated!

MB

MB,
Welcome to the club no one wants to join. Sorry to hear of your problems.
First of all I think that 4-5 months is a short time from what we have seen for a BPI to be healed. Keep in mind that the nerves heal at 1 inch per month. So, depending on the injury it may take a long time. Dustin is over 2 years out from his accident and we are still seeing improvements. Dustin's shoulder was sublexed 2 fingers in the beginning and all he could do for exercise was shoulder shrugs, forward, up and back. We also had him lay on the floor and put a piece of cardboard under his affected side then had him try to do "angel wings". Raise the arm to the side. At first it was very small movements. But we would encourage him to try to get higher. It took a long time but eventually he could move it all the way up. His sublexation is now gone. Water would be another great way to exercise the shoulder/arm as this takes out gravity and you may be able to do more movements there. I don't know what they are having you do or if you are seeing anyone with experience in BPI but if I can help let me know.
Sue

Sue,

Thanks for your reply. Your son's story certainly gives me hope! Did (does) he also have the sensory deficit (skin numbness)?

Thanks for your help!

MB

Yes Dustin does have sensory deficits. When he was first tested for this I was surprised at how much there was throughout the arm. It has also improved but there are still areas where he doesn't have much feeling. He does use the biofeedback and this is helping strengthen the proper muscles. The biggest problem now is the bicep. Although he can move the arm almost like normal when laying on his side or in water he can't get the flex of the elbow in gravity. Tricep and shoulder have returned. He still works on strengthening shoulder as he can't raise it much in gravity either. He now can put it up to shoulder height and then the shoulder can hold it there. It is a long and slow process but every little improvement gives us hope. When we first brought him home he couldn't move anything except the hand.
Sue