An Obstetrical Brachial Plexus Injury (BPI) is a serious condition in which damage has been done to the nerve bundle that supplies motor and sensory nerves to the shoulder and arm. BPI often happen during birth if the baby gets stuck in the birth canal causing the Brachial Plexus to be over stretched. A newborn baby with BPI has one arm that may be flaccid (no movement) or one arm that has significantly less movement than the other arm. The severity of damage to the Brachial Plexus varies from over-stretching of the nerve bundle to disruption of one or more nerves or nerve roots because the nerves are torn or because the nerve root is torn from the spinal canal. A doctor who specializes in BPI should always evaluate a baby with BPI. Many babies with less serious injuries recover without intervention. As a rule if the baby has residual weakness in the arm at 3 months of age permanent damage may have occurred and it is extremely important for the baby to be further evaluated, as surgery may be needed to repair the damaged nerves. If serious damage has been done to one or more nerves the baby will not recover strength and function without surgical intervention and there is a window of opportunity during which the success rate for complete or partial recovery is good.
Physical Therapy is an integrate part of recovery from BPI. A PT who has specialized training in BPI should follow the baby regularly. Physical Therapy for BPI may include exercises to maintain joint range of motion and to promote strengthening of weak muscles pre- and post surgery, use of Threshold Electrical Muscle Stimulation (night time TES), Neuro -Muscular Electrical Muscle Stimulation (daytime NMES), bracing of the shoulder, family teaching on strategies to enhance development – and much more!
More information can be found at: ubpn.org (United Brachial Plexus Network) or brachialplexuspalsyfoundation.org (Brachial Plexus Palsy Foundation)