Axillary Nerve Injury

What is Axillary Nerve Injury

Axillary Nerve Injury is common among athletes who participate in contact sports or activities that put a lot of stress on the shoulder.

The axillary nerve supplies a muscle behind the shoulder and the muscle that covers the top of the shoulder (deltoid). The nerve is located in the neck, shoulder, and upper arm.

Stretching of the axillary nerve or pressure on the nerve can cause shoulder weakness, nerve damage (neuropathy), and difficulty lifting the affected arm.

Axillary nerve injuries usually get better in 4–6 months, but surgery may be needed in some cases.

What are the causes?

This condition may be caused by repeated small injuries over time or by a sudden (acute) injury. Acute injuries may result from:

  • A hard, direct hit (blow) to the shoulder.
  • A broken upper arm or shoulder.
  • Dislocation of the shoulder.

This condition may also be caused by surgery on the shoulder or long-term use of a crutch.

What increases the risk?

This condition is most likely to develop in young male athletes who participate in contact sports or activities that put stress on the shoulder. These activities include:

  • Skiing.
  • Football.
  • Rugby.
  • Baseball.
  • Hockey.
  • Wrestling.
  • Weight lifting.

What are the signs or symptoms?

The most common symptom of this condition is shoulder weakness. Symptoms may also include:

  • Difficulty lifting the arm and turning it outward.
  • Numbness on the outside of the shoulder.
  • Shrinking of the deltoid muscle.
  • Shoulder pain.
  • Quick loss of strength (muscle fatigue) when using the shoulder.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your symptoms.
  • Your medical history, especially any recent injuries you have had.
  • A physical exam. Your health care provider may test your muscle strength and check for shoulder numbness.
  • Tests, including:
    • Electromyogram (EMG).
    • MRI.
    • Ultrasound.
    • Injection of a numbing medicine near your nerve to see if that relieves pain.

How is this treated?

Treatment for this condition may include:

  • Avoiding activities that cause pain.
  • Taking medicines that help to relieve pain.
  • Physical therapy.
  • Injections of medicines to numb the area and to help reduce swelling (steroids). These medicines can also help to relieve pain.
  • Surgery. This may be needed if your condition does not get better after 6 months of non-surgical treatment.

Follow these instructions at home:

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Avoid activities that make your symptoms worse.
  • Do exercises as told by your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do notdrive or operate heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe for you to drive.
  • If directed, put ice on the injured area.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Do notuse any tobacco products, such as cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

  • Warm up and stretch before being active.
  • Cool down and stretch after being active.
  • Give your body time to rest between periods of activity.
  • Make sure to use equipment that fits you.
  • Be safe and responsible while being active to avoid falls.
  • Do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking or water aerobics.
  • Maintain physical fitness, including:
    • Strength.
    • Flexibility.
    • Cardiovascular fitness.
    • Endurance.

Contact a health care provider if:

  • You still have symptoms after 4–6 months of treatment.
  • Your symptoms are getting worse.

Axillary Nerve Injury Rehab

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse.  Do notbegin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your arm and shoulder. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Side-lying shoulder internal rotation

  1. Lie down on your left / right side.
  2. Position your left / right upper arm so it is stretched straight out from your side.
  3. Bend your elbow to an “L” shape (90 degrees) so your fist is aimed at the ceiling.
  4. Keeping your elbow bent, use your other hand to press down on the top of your left / right wrist. This will move your left / right forearm down toward the surface that you are lying on. You should feel a stretch in the back of your shoulder.
  5. Hold for __________ seconds.
  6. Return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Shoulder cross-body (

adduction stretch)

  1. Stand or sit comfortably.
  2. Move your left / right arm across your chest.
  3. Use your other hand to gently push your left / right arm into your chest.
  4. Hold for __________ seconds.
  5. Return to the starting position.

Repeat__________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength, control, and endurance around your shoulder. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise C: Shoulder blade squeezes

  1. Sit with good posture in a stable chair. Do notlet your back touch the back of the chair.
  2. Your arms should be at your sides with your elbows bent. You may rest your forearms on a pillow if that is more comfortable.
  3. Squeeze your shoulder blades together. Bring them down and back.
    • Keep your shoulders level.
    • Do notlift your shoulders up toward your ears.
  4. Hold for __________ seconds.
  5. Return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: Side-lying shoulder external rotation

  1. Lie down on your uninjured side. Place a soft object, such as a small folded towel, between your left / right arm (your top arm) and your body.
  2. Bend your left / right elbow to an “L” shape (90 degrees), place your left / right hand on your abdomen, and squeeze your shoulder blade back.
  3. Keeping your elbow bent to 90 degrees, move your left / right forearm away from your abdomen.
    • Your upper arm should not move.
    • Keep your shoulder blade back.
  4. Hold for __________ seconds.
  5. Return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Shoulder abduction, isometric

  1. Stand or sit about 4–6 inches (10–15 cm) away from a wall with your left / right side facing the wall.
  2. Bend your left / right elbow and gently press your elbow against the wall. Gradually increase the pressure until you are pressing as hard as you can without pain and without shrugging your shoulder.
  3. Hold for __________ seconds.
  4. Slowly release the tension and relax your muscles completely before you repeat the exercise.

Repeat __________ times. Complete this exercise __________ times a day.

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