Good afternoon, enjoying your website and finding lots of good information. Do you by chance have any information on rehab for a brachial plexus injury on your site? I could not find anything but just wanting to get some extra ideas for one that is coming to me. Thanks so much!
JR
Brachial Plexus
Re: Brachial Plexus
Hi J.,
So the info I have on that topic specifically is in bits and bites:
Brachial Plexus Lesions - (type that into the search and it shows up with the following)
Blogs
Lower Motor Neuro forelimb...
NMES / E-stim Settings
A brachial plexus lesion case - what to do at this point?
Supporting the 'good' leg after a brachial plexus
Nerve Palsy
Video Training
Video Training 54: Dad's Nerve Palsy
And really, I’d look at it as 1) you don’t know if you have an neuropaxia, an axonotmesis, or a neurotmesis.
Also look up Modalites Update in the Articles Section. I can’t remember which one was about E-stim / NMES. I touch on the differences there.
Articles
Modalities Update 2011: Part 3
Modalities Update 2011: Part 2
Modalities Update 2011: Part 1
A nerve grows back at 1mm / day or 1 inch a month. So for a month (two at the most), you can direct your therapy towards healing nerve damage. (Neuropraxia or axonotmesis). A neuronotmesis is basically a severed / fully torn nerve (and/or the nerve root has been pulled from the Spinal Cord). Because of the slow regrowth of a nerve, you are just hoping it’s not fully torn - the other two types of nerve damage can heal… but since we’re not going in to ‘look’… it’s a guess. So you focus on nerve regrowth strategies (laser is your best modality) for the first 2 months - aimed along the radial nerve / nerve roots. You would also want to protect the paw and try to prevent contractures (stretching, ROM, and splinting/bracing). You could try to do functional activities that would encourage use if the nerve were to come back (i.e. supported weight shifting onto the leg.) But there isn’t really any need for E-stim (other than to test), or massage, etc. etc. Owners also need to by hyper-vigilent about watching for any signs of the dog licking, chewing, or starting to mutilate the leg. I believe that any of those things means that the nerve is regrowing and that there are abnormal sensations in the leg. So a cone would be mandatory and maybe even a covering over the leg. If that were to occur, I’d do more laser, and desensitizing techniques (i.e. rub the leg with different fabrics and types of touch), plus massage, ROM, stretching to the non-affected limb (sort of like treating phantom limb pain… trying to target the spinal cord segments that would supply both legs.
Check on the forum as well. (I’m going to post this question there as well, because it’s a good one.) I know I’ve answered this question before. It does need a video, doesn’t it!
Best of luck!
Laurie
So the info I have on that topic specifically is in bits and bites:
Brachial Plexus Lesions - (type that into the search and it shows up with the following)
Blogs
Lower Motor Neuro forelimb...
NMES / E-stim Settings
A brachial plexus lesion case - what to do at this point?
Supporting the 'good' leg after a brachial plexus
Nerve Palsy
Video Training
Video Training 54: Dad's Nerve Palsy
And really, I’d look at it as 1) you don’t know if you have an neuropaxia, an axonotmesis, or a neurotmesis.
Also look up Modalites Update in the Articles Section. I can’t remember which one was about E-stim / NMES. I touch on the differences there.
Articles
Modalities Update 2011: Part 3
Modalities Update 2011: Part 2
Modalities Update 2011: Part 1
A nerve grows back at 1mm / day or 1 inch a month. So for a month (two at the most), you can direct your therapy towards healing nerve damage. (Neuropraxia or axonotmesis). A neuronotmesis is basically a severed / fully torn nerve (and/or the nerve root has been pulled from the Spinal Cord). Because of the slow regrowth of a nerve, you are just hoping it’s not fully torn - the other two types of nerve damage can heal… but since we’re not going in to ‘look’… it’s a guess. So you focus on nerve regrowth strategies (laser is your best modality) for the first 2 months - aimed along the radial nerve / nerve roots. You would also want to protect the paw and try to prevent contractures (stretching, ROM, and splinting/bracing). You could try to do functional activities that would encourage use if the nerve were to come back (i.e. supported weight shifting onto the leg.) But there isn’t really any need for E-stim (other than to test), or massage, etc. etc. Owners also need to by hyper-vigilent about watching for any signs of the dog licking, chewing, or starting to mutilate the leg. I believe that any of those things means that the nerve is regrowing and that there are abnormal sensations in the leg. So a cone would be mandatory and maybe even a covering over the leg. If that were to occur, I’d do more laser, and desensitizing techniques (i.e. rub the leg with different fabrics and types of touch), plus massage, ROM, stretching to the non-affected limb (sort of like treating phantom limb pain… trying to target the spinal cord segments that would supply both legs.
Check on the forum as well. (I’m going to post this question there as well, because it’s a good one.) I know I’ve answered this question before. It does need a video, doesn’t it!
Best of luck!
Laurie
LAURIE EDGE-HUGHES
Re: Brachial Plexus
Thank you so much for the quick reply! I will definitely take a look at these videos.
This is a 2 year old FS boxer through the rescue. Unfortunately she was referred to me only 4 weeks ago, diagnosis before I saw her was HBC 9/26, sustaining a R distal RU fx which was stabilized on 10/1. She really had not walked since so upon arrival I talked with the foster about the brachial plexus injury which he seemed to not know about. She has moved to 3 different fosters but the one she is in now is doing great with her so we have consistency. We have gotten full ROM in all joints now on both front legs and improved her strength greatly on the RF(Fx side). She is finally up and walking, playing with the other dogs in the house. We have been doing lots of swimming, weight shifts while helping with stabilization, obstacle work for awareness.
She does have motor and strangely will correct slowly when she knuckles. We tried a brace that I had in house last time but it would not fit around the carpus correctly so I flared it out last night and will try it again next time.
I will send some pics and video, her name is Hope, I will label them with her name as I will need to send from work email.
Thank you again!
J.
Video Link: https://youtu.be/MeVATRuIWfs
This is a 2 year old FS boxer through the rescue. Unfortunately she was referred to me only 4 weeks ago, diagnosis before I saw her was HBC 9/26, sustaining a R distal RU fx which was stabilized on 10/1. She really had not walked since so upon arrival I talked with the foster about the brachial plexus injury which he seemed to not know about. She has moved to 3 different fosters but the one she is in now is doing great with her so we have consistency. We have gotten full ROM in all joints now on both front legs and improved her strength greatly on the RF(Fx side). She is finally up and walking, playing with the other dogs in the house. We have been doing lots of swimming, weight shifts while helping with stabilization, obstacle work for awareness.
She does have motor and strangely will correct slowly when she knuckles. We tried a brace that I had in house last time but it would not fit around the carpus correctly so I flared it out last night and will try it again next time.
I will send some pics and video, her name is Hope, I will label them with her name as I will need to send from work email.
Thank you again!
J.
Video Link: https://youtu.be/MeVATRuIWfs
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Re: Brachial Plexus
Hey J.,
These videos look very promising for sure!
Continue with the weight shifting and therapeutic exercises like you’ve been doing.
Does she have any contractures in the LF leg? Those may require some kind of serial splinting / thermoplastics at the carpus to help her to maintain proper placement?
Maybe some shoulder extension stretches would help as well. I’d think of way to get her to stretch out (i.e. extend her body as well… she’s been crumpled up and leaning backwards for a while now - and it shows in her pictures / videos.)
I’d do weaves as well, again to get her stretching her body (laterally).
Honestly, keep it up! I’d be very encouraged by all of this!
You’re doing great work so far!
Cheers,
Laurie
These videos look very promising for sure!
Continue with the weight shifting and therapeutic exercises like you’ve been doing.
Does she have any contractures in the LF leg? Those may require some kind of serial splinting / thermoplastics at the carpus to help her to maintain proper placement?
Maybe some shoulder extension stretches would help as well. I’d think of way to get her to stretch out (i.e. extend her body as well… she’s been crumpled up and leaning backwards for a while now - and it shows in her pictures / videos.)
I’d do weaves as well, again to get her stretching her body (laterally).
Honestly, keep it up! I’d be very encouraged by all of this!
You’re doing great work so far!
Cheers,
Laurie
LAURIE EDGE-HUGHES