Quote:
Originally Posted by Red Arrow
8 months ago I fell while skiing. It was a pretty dumb fall, I just wasn't paying attention and my skis crossed and I fell forward stretched out in a superman position. It didn't hurt that bad when I fell, but a few days later I was in serious pain. I went to a dr and based on xrays he determined that I fractured my scapula. I was in a sling for a while and at about 6 weeks the pain went away for the most part but I had very limited range of motion and hardly any strength.
I scheduled an appointment with a physical therapist who was surprised at my lack of strength and range of motion due to a fractured scapula. He had me take off my shirt and noticed that my scapula was winging and thought I may have long thoracic nerve palsy. He referred me to a neurologist to do an EMG. The first neurologist ran me through a bunch of tests but said he couldn't test for long thoracic nerve palsy and there was only 1 guy in Utah that would do that kind of EMG. So I went to that guy and he said he couldn't find anything, although he said because I have muscular lats he may not have got the needle in the right place and he was hesitant to try anymore because he didn't want to go through the lung.
So I have a few of questions.
Has anyone had this type of injury?
Is there a doctor that you would recommend? I would fly about anywhere.
I understand that the course of action is generally to wait and it usually gets better. My injury has not improved at all and it's been 8 months. Has anyone had surgery? How were your outcomes and is there a doctor you would recommend?
It seems like there are very few doctors who have experience with this type of injury and I don't know what to do next. Any help would be greatly appreciated
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hi Red Arrow,
I developed long thoracic nerve palsy (about 18 years ago) from vaulting a fence using my left arm to a escape a charging pit bull trying to attack me whilst camping with friends. Unknown to me I had pre-existing bilateral TOS which set up a compression /traction injury. Initially was told I had a brachial plexus syndrome but they couldn't find the injury on the nerve conduction tests because they didn't test far enough down nerve trunk. 11 years later neurosurgeon had tests redone prior to implanting SCS and included LTN - nerve damage showed up as well as chronic denervation of Anterior Serratus muscle. I had an opinion from a neurosurgeon about whether they could do anything surgically at this late stage. He said no. There are a lot of risks operating on nerves.My impression is unless there is something structural obstructing, placing pressure on the nerve (e.g. neuroma, tumour) or it is severed they won't usually operate. However, I'm in Australia and they don't have the economies of scale here so it's hard to get highly specialised treatment. This neurosurgeon had actually only operated on one LTN and it was a complete sever. My LTN palsy started with the winged scapula but over the years have done lots of PT -in particular clinical Pilates and a technique called Bobath. The neurosurgeon said you would never pick mine by looking at me whereas my neurophysiological results are very poor so I hope this gives you some encouragement for getting more function than you should have. I went ahead with the SCS because I continue to get severe nerve pain which became centralised CRPS. I think this would be a risk of operating on a long thoracic nerve and because it connects in with your arm/neck/back, there's a lot to be said for the conservative approach if you're not in too much pain. Just make sure you get a really good physiotherapist to work with you if you decide to give clinical Pilates or Bobath a go. I have a second hand pilates reformer at home and it's part of my fitness routine along with regular walking.
good luck!
Booklover