Brachial Plexus Injuries

• Brachial plexus injuries occur, primarily, at birth in babies that are larger than normal where the shoulders become compressed while passing through the birth canal. Adults can attain brachial plexus injuries if trauma occurs to the neck, head or shoulders.
  
  It is estimated that two in every 1,000 children attain brachial plexus injuries during childbirth. While complete avulsions and ruptures must be treated with timely surgery for reattachment of the brachial plexus nerves, mild brachial plexus injuries in children may heal by themselves after 3 or 4 months of age.
  
  Some type of physical therapy is almost always required to recover from brachial plexus injuries regardless of whether surgery is used.
  
  

Therapy Activities

• In infants, range of motion exercises are used to restore full utilization of the arms and hands.
  
  For the first exercise---shoulder flexion---lay the infant on their back. Stabilize the left shoulder with your left hand and lift the arm up to shoulder height with the thumb leading and the arm straight at the elbow. Do this ten times, and then repeat this procedure with the other shoulder.
  
  Elbow flexion and extension is the next exercise. Lay the infant on their back and stabilize the child's right elbow with your right hand. Bend the elbow as far as possible and then straight again. Continue this exercise for ten repetitions and then switch to the other elbow.
  
  For shoulder abduction, lay the child on their back and stabilize the left shoulder with your left hand. Lift the arm sideways until the arm is at shoulder level and then move the arm back the child's side. Continue this exercise for ten repetitions and then switch to the other arm.
  
  For wrists adduction and abduction, lay the child on their back and stabilize the child's left forearm with your left hand. Hold the child's wrist with your right hand. Move the wrist gently from side to side for ten repetitions, and then repeat with the other arm.
  
  For finger flexion and extension---with the child on their back---hold the child's left wrist with your left hand. Hold the child's fingers in your right hand. Gently bend each finger toward the wrist, and then straighten them again. Do this 10 times with each finger and switch to the other hand, repeating the process.