A brachial plexus injury (BPI) is a serious condition in which damage has been done
to the nerve bundle in the neck (brachial plexus) that supplies motor and sensory
nerves to the shoulder and arm. BPI often occurs during the birth process if the
baby gets stuck in the birth canal, causing the brachial plexus to be over stretched.
A newborn baby with a BPI may have one arm that is either flaccid (no movement) or
has significantly less movement than the other arm. The severity of damage to the
brachial plexus varies, from an over-stretching of the nerve bundle to a disruption
due to torn nerves or torn nerve roots from the spinal canal. Babies with BPI should
always be evaluated by a doctor of specializes in this type of injury.
Many babies with less serious BPI 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. 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. There is a window of opportunity during which the success
rate for complete or partial recovery is good.
Physical therapy is an integral part of recovery from BPI. A physical therapist
who has been specially trained 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, both before and after surgery. Therapy may also involve
the use of threshold electrical muscle stimulation (nighttime use TES), neuromuscular
electrical muscle stimulation (daytime use NMES), bracing of the shoulder, family
teaching on strategies to enhance development – and much more!
More information for parents of children with brachial plexus injuries: