United Brachial Plexus Network, Inc.

Has anyone's child had to have a pec release done a second time? (My daughter had her pec released minimally (20%) during the mod quad, but it is really tight again.) Was it done in conjunction with another surgery? Did it help with movement? Did it cause any losses?

Matthew's pec was tight again right after mod quad. His pt would to myo-fascial release on the anterior shoulder and it immediately would loosen. After the capsule release surgery his pecs were no longer tight and I really question them being cut in the first place. Matthew now faces some difficulty to internally rotate and this may be a direct result of the pecs being cut.

Cindy

How old is your child now? How long ago were the pecs released? Are you certain it is the pecs that are tight? Could it be something else?

My child had the anterior capsule release and the pecs have never been touched. Everybody, including many doctors and all of his therapists, were convinced that my child's pecs were tight due to the severe internal rotation and the tight band you could easily feel. However, after surgery, no tightness....hmmmmm. It appears that the pec tightness was only secondary to the capsule tightness.

I have heard of 2 children who had releases done a second time, but I am not sure if it was just the pecs, or the pecs and subscapularis.

I have heard wonders from parents about myofascial release. Maybe a very skilled/trained therapist could help address this issue before trying to release the pecs a second time.

I do believe there are costs to every procedure and trade offs. The pecs are a major internal rotator and I think they may be involved in movements such as hand on belly, hand on chest, buttoning top buttons, zipping pants, behind back movements, etc. Do these movements on yourself and hold it there a little bit and most likely you will feel it in your own pecs. I think we use these muscles for all of these movements BUT I would check with your doctor and therapists, since I am not an expert.

Would Botox be an option for your child?
here in the Uk we never release pecs - we do muscle transfers and rotational osteotomy's and subscapularis releases but never heard of a pecs release ?
sorry to be a bit dim, but what action does releasing the pecs do?
thanks
Karen

I am also interested in this, do we know how or why the pec can tighten again as the child grow if it has already been released? I don't really understand.

This is what one of the surgeons was talking about in regards to Becka reverting back prior to the mod quad. I was hoping for the botox injections but we are facing more surgery again...I will let you all know in a week if we will be doing the pec release again (she had it done in mod) or the osteology.
Her doctor did say she would lose some of her behind the back movement...but gain in other areas...

bump up for new parents

My daughter had her pecs released and she can zipper her coat and can cross midline easily (can scratch the other shoulder actually). We were told she would never get behind the back but she can do that, too. (years later but still, it came at its own time)

I think tight pecs can be secondary to posterior subluxation. Our son had capsule release with joint reduction ('put back in') and pecs were no longer tight.

An MRI for joint subluxation might be a good idea before you pursue releasing the pecs again.

Kate

this is great info! Thanks to guest for bumping up. I love it when great posts get bumped up! I have been having problems with Aarons pecs and was so puzzled cause he had them released already and it seems as though i'm always struggling to keep them in good shape. Now i know why.....