Long Thoracic Nerve injury...will it heal?

[Scottyb825]

This is a bit of a long read. My story starts in early September 2010. I was at the tail end of some training I was doing in the Army. On the last day of our training we did a 70 lb ruck sack (a large backpack) march which lasted for about 1 hour. During this march I noticed my right arm going numb as if circulation was being cut off. So I would occasionally loosen the strap and this seemed to help.

After the march everything seemed fine. Later that day I also did some pullups which seemed to go as normal. It wasn't until the next day that I woke up with pain in my right arm. This went away after a couple days. However I had lost most strength and mobility in my right arm/shoulder. I couldn't do a single push up or pull up and if I tried to raise both arms straight above my head, the right arm can not go as high. I also have scapular winging.

I went the the on base doctor and was told it was a long thoracic nerve injury and that with rest I would be good to go in 4 months. Luckly training was done so I got to go home and didn't have to do anything that would really strain my arm anymore. However all the symptoms continued minus any pain well past the 4 month mark. I starting seeing my own doctor who referred me to an orthopedic doctor. He seemed to agree that it was a long thoracic nerve injury as well and had an EMG done on me. The EMG also supported that this is a long thoracic nerve injury. The neurologist who did the EMG and doctors told me the injury is somewhere between the moderate to less than sever side.

I was told that this could take anywhere from 18 months to over 2 years to heal. My biggest problem is that my career and life goals require me to be in physical shape. I am an officer with the Army National Guard and have to be able to take a PT test once this heals. If it doesn't I could possibly be med boarded out of the Army. Which I don't want cause I love it. As for my civilian career aspirations I wanted to start working on becoming a cop, since my major in college was criminal justice. Now I can't go about that since physical test are required to join any force.

I'm currently doing physical therapy but until my arm is 100% I'm more or less SOL with pretty much everything else I do in life. I also know surgery is an option but my doctors don't seem to think that would be the best choice. They tell me that might cause more harm than good to surrounding nerves and muscles. My question is what are my chances of this thing healing on its own? Also has anybody had experience with surgery?

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[Emanuele]

The longissimus thoracis nerve palsy can give indeed a "wing scapula". This nerve supplies a muscle called serratus anterior which main task is to hold in place the shoulder blade and allows gliding of it over the posterior aspect of the thoracic cage during movement of the shoulder.

Could you tell us more about your weakness in your right arm? does it affect your hands and forearm too? have you experienced funny sensation as pins and needles or numbness? if yes where about exactly?

Nerve palsy does need lots of time to fully recover, time of recovery change accordingly to the severity of the injury.

All the best

Emanuele