See Also
1. Peripheral Nerve Injury
Causes
1. Direct blow to Shoulder
2. Chronic repetitive overhead Shoulder traction (e.g. tennis, swimming, baseball)
Symptoms
1. Diffuse Shoulder or Neck Pain with overhead activity
Signs
1. Forward flexion weakness at Shoulder
2. Scapular winging
Management
1. Shoulder Range of Motion Exercises
  1. Prevents Frozen Shoulder and contractures
2. Strengthen remaining Shoulder stabilizing muscles
  1. Trapezius Muscles
  2. Rhomboid Muscles
  3. Levator Scapula Muscle
3. Surgery is rarely indicated
Diagnostics
1. Nerve Conduction Studies and EMG
2. Shoulder MRI
  1. Not typically indicated but may show supraspinatus and infraspinatus denervation changes
Course
1. Therapy leads to recovery times typically of 9-12 months (may require up to 2 years)
References
1. Neal (2010) Am Fam Physician 81(2): 147-55
2. Safran (2004) Am Sports Med 32(4): 1063-76

Family Practice Notebook

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This page was written by Scott Moses, MD, last revised on 12/23/2011 and last published on 5/17/2012.

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