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  1. #1
    Registered User rmanuelsanchez's Avatar
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    Long Thoracic Nerve injury/Wing Scapula/No ability to raise arm overhead w/o assitans

    Everybody with this condition please feel free to add on bc this is a rare/uncommon condition that needs to be address for those looking for some answers.


    On October 21st, 2011 while asleep I had severe pain starting at my right arm/read deltoid and radiated down my tricept and ended at my forearm. Unbareable pain. When I awoke that morning I had a dead shoulder. I didn't have anymore pain but function of my arm raising it overhead and holding it there without assistance what not happening. More so, I had my right shoulder blade sticking out my back when I raised my arm. My wife looked at it and never seen anything like it before. For the next couple of weeks I delt with it thought it might go away. On certain days that pain I described would show up but go away when I awoke. Maybe sleeping on it wrong, who knows. I visited my ORTHOPEDIC doctor. He by visual observation diagnosed the condition as Long throracic Nerve damage/impingement. He says the LTN damage is causing the winging of the scapula and not the other way around. No reason for it he says it sometimes just happens. He referred me to a NEUROlogist who says basically the same thing but told me there is hope with TIME (I don't have time to sit around). Due to my career I need my shoulder I told him. He didn't put me on any restrictions. He also set me up for an EMG test. EMG can pinpoint what nerves and muscles are not functioning. NEUROlogist prescribed me physical therapy. I've been doing physical therapy for about 3 weeks now (11/23/2011). I don't have any improvement to report. This is horrible. The stabalization of my scapula hasn't changed. Still feel like it rolling around in jelly. I've read information on the internet which is very inconsistant. Some say rest it and some physical therapy. I doing physical therapy and going to the gym and running to stay in shape. I figure as long as I don't have pain I'm not hurting myself. Thats my opinion. If it was painful obviously I would stop. I have the EMG test 11/28/2011 and will post what the NEURO says. For you that have been suffering with this longer than I feel for you. I've been speaking with a member here who did fully recover after a year. THe function came back but the winging took longer to disappear.

    A little background. I'm and Police Officer. I'm a former college baskeball player now a very active person in recreational sports. You name it I participate. Basketball, soccer, flag football, softball. Love the gym with a passion. It gives me a sense of accomplishment everyday to push my body bc you never know when it will be challenged. I also eat healthy. Veggies, fruit, proteins, vitamins, other natural sups. I don't lift heavy. Focus more on definition and functional strenght. I list all this bc this condition has happened to me and I don't know why. I didn't injury myself so if it can occur to me it can happen to anybody.

    I'll keep this thread up to date when I make progress. Maybe my exp will help you and you help me with yours. If you do the same maybe other with this can do the same here.
    Last edited by rmanuelsanchez; 11-23-2011 at 11:02 AM. Reason: just adding
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  2. #2
    Registered User 8michael8's Avatar
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    I had the same thing. Went to bed one night feeling fine, woke up with radiating pain in my left shoulder and down my arm. Felt better later that day. Didn't discover until a few days later that I lost a lot of strength in that shoulder. Was difficult to even raise my left arm straight up. Also noticed the "winging scapula". Still have no idea how I did it or what exercise might have caused it. Like you, I don't really lift heavy.

    3 or 4 months later, same thing happened with the right side. It's been about 1 year since the problem started on the left. Left is a little better. Right is probably a little worse than in the beginning. Still have strength loss and winging scapulas on both sides..

    I just assumed I had torn something in the area of the scapula on both sides. Haven't been to any doctors (bad health insurance) but I've pretty much self-diagnosed using the wonderful internet. Damage to the long thoracic nerve can cause these symptoms, and it seems many doctors will often prescribe physical therapy or immobilization to allow the nerve to repair itself. However, I've not come across many accounts of this working for people. It seems the best route is usually surgery because although the long thoracic nerve can cause these symptoms, there is often accompanying structural tears that can only be addressed surgically...
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  3. #3
    Registered User rmanuelsanchez's Avatar
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    Brachial Plexus/ Neuropathey with scapular Winging

    Mike, I'm back to normal as of about march or april. My condition lasted about 6march months like my doctors had predicted. They told me the nerve would grow or regenerate and that my muscles in the area would start working again. Exactly that happened. Although it took several weeks to build up the muscles which instantly returned my range of motion I have almost 100% strenght back. I experience pops and some weakness at some angles however it does not affect my exercise routine. I figure it proba scar tissue working itself out. My suggestion to you and what I did is first don't waste money on seeking opinions from all types of doctors. If you didnt sustain the condition as fault of an injury or traumatic incident it will heal over time. My doctor told me 6mothe to 1tell yr give or take. My neurologist, ortho, phys therapist, all had little or no exp dealing with this conditiin. All they recommended was to continue light exercise and stretch the shoulder bc most likely it was a pinched LT nerve. Throughout my recovery process I my wife massaged the area and I would focus on angles when i felt the nerve pain. Once i felt the nerve pain i focused on stretching my shoulder from the position. Suggestion...practice pulling your shoulders back as much as possible. I obsessived on posture. Not that i have nad posture but sometimes we relax muscles so much like our shoulders that we dont realize it its Habit. Exercises ....lay on your stomach and do Y' and T's. Y's- arms straight in from with elbows locked and raise really focusing on muscles. T's are same but arms to your side like a plane. At the gym do rows but focus on full range of motion back and forward focusing touching your blades together. Lastly, these exercise will strenghten the muscles in your back to prevent further injury. In the process as you strengthen muscles it will lossen up whatever knots or triggerpoints you might have. Maybe muscle spams. Try everything. Thats what i did but the above worked for me. Be patient there is nothing you can do. Its frustrating its was for me.


    KEEP IN TOUCH WITH progress,
    RONNIE
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    Registered User Sathane's Avatar
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    I have this exact issue right now with my right arm. Unable to raise it above shoulder level and can't even hold that for very long. No strength at all in overhead movements. I can't remember a shoulder injury but mobility was reduced over 5 years ago. It's gotten very slightly better over that last couple of months since I've been hitting the gym hard but nothing very significant at all. I have no pain in the shoulder but only some slight discomfort if I try to force overhead movements.

    If I lean backwards, range of motion is much better and I can reach up. Lying on my back I can stretch the arm straight out (as if reaching over my head, but lying down).

    When shaking anything (like my protein shakes) in my right hand I can feel it jumping around in there and when doing pull ups (assisted as it's very weak) I have to forcefully roll my shoulder at around the halfway point when pulling up in order to overcome the doorstop effect that seems to be causing the reduced range if motion.

    My clavicle sticks up a bit on that side and I can feel it push up further when lifting that arm so I'm convinced that the bone (scapula?) has rolled slightly forward and the clavicle is restricting movement in the joint. The "doorstop" effect I mentioned above.

    I have to admit my posture hasn't been the best for some time. I used to use perfect posture but over the last decade or so I've succumbed to hunching forward as I'm at a computer all day. I've been making conscious efforts to correct this though.

    Does this sound similar?
    Last edited by Sathane; 09-30-2012 at 03:20 AM.
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    Registered User 8michael8's Avatar
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    Finally back with an update. I retract my earlier statement about the best route being surgery. I never consulted any doctor and just worked on it myself. For those interested, it's also sometimes diagnosed as Parsonage-Turner Syndrome, but the effects and symptoms are all the same.

    My left side is much better. Right is also better, but still have weakness and winging scapula during certain movements. That's to be expected since the right happened about 6-8 months after the left. It seems that this is just something that takes a LONG time to heal. Already nearly 2 years in on the left, and it's still not all the way recovered.

    I have also recently started working on the shoulder, scapula, and serratus anterior with a foam roller in order to break up the scar tissue/lesions that are generally considered to be the cause of this syndrome. For anyone else dealing with this, it is just a matter of time and being patient. If you do a Google search on "long thoracic nerve" or "parsonage-turner syndrome" you will probably find more helpful information than you'll ever get from any doctor or surgeon you might visit. As Ronnie pointed out, most doctors have little experience with, and even less knowledge of, this particular syndrome.
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    Registered User bowleyUK's Avatar
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    i also have a issue similar but not as bad as you guys had it fro approx 5 years and i also struggle to hold my arm out in front of me without it getting fatigued! the muscle that causes me the pain is the SERRATUS ANTERIOR muscle which i believe attaches to the scapula and rib cage the finger looking muscles apparently may be worth looking into this muscle for help with the winging scapula exercises such as push up plus but if you google it there are 1 or more exercises! probably not much help with my comment but it may be beneficial. iI'm currently using a TENS machine, the exercise mentioned as well as ice packs really want this problem gone so i can hit the gym!
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    I just faced the exact same problem except it appeared after a series of pull ups a month ago. I couldn't move my arm even though I still had sensation in it. Just like Ronnie I had a series of exams done (Angioscan, Electrogram on 5th rib, clinical exams), which confirmed the diagnosis (Long throracic Nerve damage/impingement). After 4 weeks of the injury I haven't resumed my fitness routine (crossfit), I go running instead. My sports doctor recommended exercices to strenghten the muscles in my back and particularly the one behind the scapula (pulling shoulder back and forth with an elastic). Other symptoms included of course winging scapula and weakness in the Serratus anterior muscle. My doctor said to avoid pull ups, throws, or any movement that engages the shoulder at too wide a range. He also says all will return to normal in 2 to 3 months. He wasn't sure about the scapula though, he said it might always wing... I have a question for Ronnie if he gets this: did your scapula return to normal? Thanks! ma
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    Registered User rmanuelsanchez's Avatar
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    LTN/Scapular Winging

    Yes my scapula returned to normal. No winging. I have full range of motion back. The doctors assumed I would but there would be permanent weakness. I have found that a muscle between my scapula and spine is not as strong. When I do a pushup workout my shouder fatigues much faster than the other. I have also noticed that if I don't consciously pull my scapula back while I'm sitting it tends to want to roll forward. All this is just me sensing a weakness there nothing noticeable. All in all I have 100% function. There's nothing I can't do. Only time I notice anything is the occasional popping in that shoulder when I stretch it and when I lift I'm not as strong. Hope that answers your question.


    Ronnie
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  9. #9
    Banned Flognuts's Avatar
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    Going through this right now, had the run around from retard doctors and physio's for over a year. Finally Im getting in to see a neruologist and get an EMG done.

    My serratus anterior has stopped working completley.
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    Registered User rmanuelsanchez's Avatar
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    LTN/Scapular Winging/Serratus

    My serratus anterior was also not functioning for several months. After a couple month I noticed and felt it atrophy due to the muscle not being worked. If the nerves don't work it doesn't matter how many different exercises you do BC the muscle is not being stimulated to work. My phys therapist prescribed exercise to keep other muscle strong to prevent further injury to shoulder. The other non-functioning muscles is only a waiting game til the nerves regenerate. But mine did.
    Last edited by rmanuelsanchez; 06-05-2013 at 11:31 AM. Reason: misspelling
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    Registered User mralex070's Avatar
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    I recently have got a winged scapula after doing a series of overhead shoulder presses. The pain in my shoulder like 6 hours later was really intense for about a week i thought i damaged my rotator cuff but I soon noticed I have winged scapula... Im going to the doctors tomorrow to see if i can get an EMG to see the extent of the damage. However the pain has stopped just feels uncomfortable sleeping now

    I had limited movement in my shoulder but i can raise my arms above my head but it looks awkward at the shoulder, and my lats have gone completely from that side. Really annoyed but **** happens I guess... Just wish I didnt try to more weight and more reps... Progressive overload can hurt... I had no idea this injury existed.. I start to wish it was just a rotator cuff issue.. |Hopefully the nerve isnt that damaged as I do have quite a bit of movement in my right arm like I said. Or maybe I have a higher tolerance to pain than the other sufferers.
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  12. #12
    Registered User rmanuelsanchez's Avatar
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    Brachial Plexus Neuropathy with Scapular Winging

    February 03, 2015:

    Have received many personal emails of people suffering through this condition. Sorry to hear it.

    I'm back normal as stated above. I have not experience any other set backs since then. All I can complain about is that I have very very minor difference in strength on my right shoulder (the injured side-im right arm dominant) compared to my left. I workout religiously. I go heavy from time to time but mostly do higher rep ranges with form as best I can. The differences I speak about are in regards to strength and stamina. On heavy days when I try to challenge myself I notice my right shoulder struggles some and on days I do light reps it fatigues faster than my left. Now, these are very subtle differences. It stems from permanent damage somewhere in my shoulder. I believe its more neurological than anything. I think although my recovery is close to full (95% if you need a #) there are nerves that are not firing on all cylinders. I feel like my serratus anterior had permanent weakness. Now, all this has no effect on the function of my shoulder. I can throw the ball far, shoot a basketball, press or pull weight as normal. I really make a conscious effort to warm up properly. During the six months my shoulder was disabled it was frustrating but I was optimistic about recovering. I performed therapy exercises such as Y's and T's. I used YouTube where some therapist post different exercises. I exhausted everything I could try. I'd have to say the most helpful was my physical therapist who I visited once. He gave me some exercises to try and i did it every other day. The least helpful was my Orthopedic "specialist" and Neurologist who basically told me they rarely seen my condition and refered me to the neurologist who refered me to the physical therapist. So skip all them, save your money and see a phys therapists. I felt like they pushed me out the door after the took my money. Months later, at that same orthopedic office my wife was treated for another injury; there I ran into that same doctor that treated ( for lack of a better word) and I figured the Doctor would ask me about my recovery to pass on the knowledge but he did not ask. Yes, he did know who I was. Lastly, stay with your program. Keep working out but just do it smartly. Good luck.
    Last edited by rmanuelsanchez; 02-04-2015 at 12:19 AM. Reason: spelling
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    Registered User Moonveelt's Avatar
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    Winged scapulas?

    Hey everyone!
    I think that I also have winged scapula, thing is that I have it on my both shoulder blades. I have kind of getting used to it, cant recall how long i've had them but recently it has bugged me a lot.
    It looks like sh*t when I stand in profile, looks like I have a hunchback, but it is my shoulders that points out from my back.
    I am 18 and have had this winged scapula since I was nine or ten perhaps. My "symptom" does not hurt in any way however. I can move my arms and body in almost any direction/pose.
    So my question is what to do? I want to start hit the gym and swim but is that a bad idea? Should I fix this problem first or will it haunt me later? Since my symptom differs a bit from the others? Help please!
    /Daniel
    Last edited by Moonveelt; 02-14-2015 at 07:57 PM.
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    Registered User sowilson's Avatar
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    Have your doctor recommend a good PT to work with. You need a good treatment plan that will work for you. Often times the Serratus Anterior is worked if other muscles aren't overly tight. A push up plus is good for this or a shrug at the end of an overhead press. My son's PT also recommends an Arnold Press as a rotational shoulder movement that will work the shoulder and activate the Serratus Anterior.
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    Registered User Moonveelt's Avatar
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    Okay thanks for the help, I will try that out!
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    Struggling with depression due to winged scapula

    Though it seems as though people on this thread have experienced varying degrees of success and failure regarding their mobility and winged scapula, I'm thankful to know that there are others out there who can empathize with the frustration and debilitating effects of this condition. I apparently developed winged scapula and muscle imbalances progressively throughout my life due to my complete ignorance and lack of consideration of my personal health and fitness. I always had terrible posture both standing and sitting. To make matters worse, I wear my heavy carrier bag strapped over my left shoulder daily. It wasn't until at age 30 I decided to turn my life around and start exercising and receiving personal training that I realized the damage I did to my body. As it turns out, I had winged scapula on my right side and an MRI revealed that I had bulging discs C-4~C-6. The Orthopedic doc made no connection to my condition with the impingement or compression of the long thoracic nerve connecting to the serratus anterior. With that being said, through continued muscle development and strengthening, I had somewhat unbalanced/limited yet functional range of motion in my right arm and shoulder. Fast forward several years later, after suffering a popped/possibly fractured rib sparring in BJJ, I was out of commission from any form of exercise for 5-6 months. As a result, I became overweight and severely out of shape. Well, after that time, I decided to jump right back into BJJ training. In one of my sessions back my BJJ instructor had me do conditioning after class by doing a total of 100 Hindu push-ups. This was my first actual "exercise" after my injury 6 months earlier. Clearly it was too much too soon since immediately after, I was in excruciating pain in my shoulder, traps, lats to the point where trying to raise my arms above my 90 degrees and above would simply be too painful. This pain lasted for perhaps 2-3 weeks. I didn't think much of it at the time since I thought I would recover as I would normally. As it turns out, this was the beginning of the gradual deterioration of my condition. After "recovering" from the muscle soreness and pain, I could no longer raise my right arm unless I threw my arm up with momentum. There was no pain, but it seemed as though my winged scapula got worse and when I tried to lift my arm, my right trap would elevate and all tension would be localized in that trap. However, I had full range of movement in my left arm with no problem whatsoever. Unfortunately, like an idiot, I thought somehow with time and lifting weights, the problem would resolve itself. Consequently, I signed up at a new gym and they had a special on personal training, so I decided to take advantage. This turned out to be a huge mistake as the trainers had no idea or understanding of my condition, so they just put me through their regular training regimen. Unbeknownst to me until it was too late, I gradually started losing flexibility and mobility in my left arm/shoulder until it became identical to my right side in which my left scapular became winged as well and I couldn't raise my arm! About a year after I started experiencing immobility I finally got another MRI and EMG along with the electro stimulation exam. The doc said he couldn't pinpoint the problem but thought it might be a problem with my anterior horn nerve center. With no known cure if his diagnosis were true, he suggested physical therapy and muscle strengthening of the affected areas. Since then, I've been doing PT for a little over 3 weeks 3x a week, and though I've gotten in better shape and do feel progressively stronger, there has been little to no improvement in my mobility in either side. I tried playing basketball, a sport I love and grew up playing and I can't even shoot the ball. Besides that, there is simply so much I can no longer do in my everyday life. This is definitely one of the lowest points if not lowest point in my life. I see this PT I'm doing currently as my last option before I seriously consider and look for surgical remedies. I apologize for the TLR/FRAT, but wanted to be as detailed as possible in the event someone could offer any advice or assistance.
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    Registered User cartoonandrew's Avatar
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    After a month of having limited mobility on my right side and the inability to activate my serratus anterior, I've finally figured out through the internet that this is what I have. Same symptoms as everyone else, started with a strange pain that last a few days followed by the weakness, limited range of motion, and total inability to activate the serratus anterior causing the winged scapula. I haven't been to a doctor yet but I've got an appointment coming up soon, however it looks like there's not much anyone can do for it huh?

    My question for now is, should I still work out and do what I'm capable of? Or is that going to just irritate the nerve more and make it harder for it to heal? As a 25 year old guy I don't really want to take a year or two off lifting waiting for a nerve that may or may not heal. Do you guys think there are specific exercises I should avoid or things I should do to help it heal?

    Looks like most of the posters in this thread have eventually regained use of the muscle, so at least that's hopeful.
    Last edited by cartoonandrew; 11-30-2015 at 08:38 AM.
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    Registered User LP2500's Avatar
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    I've been dealing with this since February 2015. 90% sure it is a thoracic nerve injury as the first month with the injury was nothing but pure pain. When the pain subsided I was left with winged scapula. I'll finally be seeing a doctor in January due to health insurance finally being active. I hired a trainer online who has fixed many of these winged scapula issues and was thrilled to start working with him. I followed a routine for 3 months and got in good shape for having such an injury but the scapula didn't fall back in to place. Around late July I basically lost hope with this and have realized I have some real nerve damage on this whole right side. Such a ****ty injury to deal with Ive never been more depressed amongst this injury and what it has done to my life this year. I can feel I need I surgery but does that ever lead to a gym routine with weight lifting? I feel ill never have a bicep/tricep muscle contraction again and I have a seperate case of tennis elbow and forearm numbness as well. For just turning 29 it's been a mental battle. I feel for anyone who's gone through this through the cause of nerve injury. And if so what a day to celebrate once this ever gets resolved. I still do some resistant band stuff and surrounding shoulder work, lower traps, but it feels like most stuff just irritates the forearm numbness and the upper thoracic area near the chest/first rib. Would love to hear from anyone dealing with similar injury through thoracic nerve injury.
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    Registered User LP2500's Avatar
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    I would just wait to see what the doctor says. I'm sure youll be doing physical therapy for it but that part confused me also. Some say to not do anything at all on the nerve and others say to keep it all moving and activate the serratus. I can tell light exercising focused on the serratus anterior and lower traps is a good start.
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    Registered User mattpollard's Avatar
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    This thread was very helpful for me as I went through Long Thoracic Nerve Palsy as a bodybuilder, so I wanted to put my story up to be helpful for anyone who is unfortunate enough to see this condition present itself.

    The initial injury had nothing to do with bodybuilding, even though I am very active in the sport. I live in the pacific northwest, and was out steelhead fishing for eight hours on November 24, 2013 (these injuries are known to be caused by activities such as fishing where you are doing the same repetitive motion away from your body for an extended time). That night I woke up with significant pain and pressure in the medial border of my scapula, and with most all the muscles involved with the shoulder blade spasming. The only way I could relieve the pain was by standing against a door jam and pushing the edge of my scapula back down towards my back. I struggled to make it through work that Monday, and made it to my massage therapist that evening. She was able to release the muscles, finally getting my right shoulder to chill out. The pain was much better, but I could still feel the pressure caused by my scapula lifting away from my back.

    I remembered hearing of this condition back in gross anatomy, the first year of medical school. Ironically, it was a question on my board exams. The long thoracic n. is one of the nerves in our bodies with a high vulnerability to traction injuries (stretching causing tearing apart of nerve axons). This makes it impossible for the nerve to propagate action potentials to the muscle, causing paralysis, and subsequent atrophy of the muscle down stream of that nerve.

    Over the next few weeks I continued lifting, because I found that it helped to relieve many of the symptoms. It didn’t take long for me to do the math on what was going on. Within a month I completely lost that huge chunk of muscle on my side, the serratus anterior. It was creepy, especially when compared to the normal left side. It would stay the same as a lifeless concavity for many months to come.

    I saw my orthopedic surgeon after six months of no progress in the area. You will find most of these physicians to be fairly clueless about Long Thoracic Nerve Palsy, and even more clueless about what to do about it. He scratched his head, called in another surgeon to take a look, and recommended an MRI and visit to a neurologist. In passing he mentioned a surgical procedure he has heard of to improve the scapular position (taking a portion of the pec minor tendon to “wire” the scapula down towards the spine…yikes!). I mentioned to him that I heard most cases resolve on their own in 12 to 24 months.

    You must understand that many surgeons will think this is nuts. The vast majority of time nerves do not heal well, especially when enough damage has been done to cause muscle atrophy. I decided to ignore his skepticism and run from his scalpel. I filed away the referral slips, and put my trust in the data I’d seen. My hope was that it would regenerate on its own by just leaving it alone (no knives), and doing what I could to manage symptoms, and improve functionality. Hurry up and wait was my approach…for the next two years if need be.

    During the long waiting period I continued lifting (I never stopped). The simple reason was that it felt better if I did. You can expect the development of substantial imbalances in your physique as your body tries to adapt to the malfunctioning limb. My right trap and posterior scapular musculature grew at least a third larger than the left side. You won’t be contest worthy for sure, but its alright, this is your body’s way of achieving homeostasis and do the best with what it has to work with. I credit bodybuilding with allowing me to avoid surgery. I can definitely foresee situations where an individual would indeed need to go the surgical route. If you can’t find a way to control the pain, and improve the function of your arm then you could be quite incapacitated by this condition. If you can find the grit, then avoid surgery and lift your way to increased stability!

    In March of this year (2015) I started experiencing some strange happenings. It had now been over a year and a half since the paralysis. That’s long enough to develop a major habit of serratus checking if my shirt ever happened to be off…"nope, still gone!” The odd symptom I was experiencing was shortness of breath when I did cardio, and when I did my shoulder routine (it was new pressure on the chest wall from the regenerating serratus constricting my breathing). It took another month or so before I started feeling strange sensations under my scapula. By mid-April I could see the fluttering of muscle fibers in that mostly muscleless depression on my side. The end of summer found me with the ability to flex the muscle and see the contractions with absolute certainty.

    It is now December 24, 2015 and I have regained at least half of the muscle volume back in my serratus. I was not too surprised that it was not easy for it to come back to life. While my body did a great job compensating for the injury, it meant that there would be another transformation on the way with a new muscle coming completely back online again in a system that was used to functioning without it. Remember that the serratus is “sandwiched” between the sub-scapular muscles and the thoracic wall. Since my right serratus had been gone for a year and a half, that space was now occupied by the “bread slices.” Now that new tissue is fighting to get it’s space back. This process had caused almost just as many symptoms as the original injury, but I couldn’t be more excited to watch it progress. Symmetry is returning much much quicker than I thought possible. My guess is another year to completely recover from the atropy.

    Best wishes to anyone struggling with this condition. Hang in there, don’t be afraid to lift cautiously, and most importantly be patient. Believe the good data out there, and if you can at least give it the full two years before considering any kind of medical intervention!
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    Originally Posted by mattpollard View Post
    This thread was very helpful for me as I went through Long Thoracic Nerve Palsy as a bodybuilder, so I wanted to put my story up to be helpful for anyone who is unfortunate enough to see this condition present itself.

    The initial injury had nothing to do with bodybuilding, even though I am very active in the sport. I live in the pacific northwest, and was out steelhead fishing for eight hours on November 24, 2013 (these injuries are known to be caused by activities such as fishing where you are doing the same repetitive motion away from your body for an extended time). That night I woke up with significant pain and pressure in the medial border of my scapula, and with most all the muscles involved with the shoulder blade spasming. The only way I could relieve the pain was by standing against a door jam and pushing the edge of my scapula back down towards my back. I struggled to make it through work that Monday, and made it to my massage therapist that evening. She was able to release the muscles, finally getting my right shoulder to chill out. The pain was much better, but I could still feel the pressure caused by my scapula lifting away from my back.

    I remembered hearing of this condition back in gross anatomy, the first year of medical school. Ironically, it was a question on my board exams. The long thoracic n. is one of the nerves in our bodies with a high vulnerability to traction injuries (stretching causing tearing apart of nerve axons). This makes it impossible for the nerve to propagate action potentials to the muscle, causing paralysis, and subsequent atrophy of the muscle down stream of that nerve.

    Over the next few weeks I continued lifting, because I found that it helped to relieve many of the symptoms. It didn’t take long for me to do the math on what was going on. Within a month I completely lost that huge chunk of muscle on my side, the serratus anterior. It was creepy, especially when compared to the normal left side. It would stay the same as a lifeless concavity for many months to come.

    I saw my orthopedic surgeon after six months of no progress in the area. You will find most of these physicians to be fairly clueless about Long Thoracic Nerve Palsy, and even more clueless about what to do about it. He scratched his head, called in another surgeon to take a look, and recommended an MRI and visit to a neurologist. In passing he mentioned a surgical procedure he has heard of to improve the scapular position (taking a portion of the pec minor tendon to “wire” the scapula down towards the spine…yikes!). I mentioned to him that I heard most cases resolve on their own in 12 to 24 months.

    You must understand that many surgeons will think this is nuts. The vast majority of time nerves do not heal well, especially when enough damage has been done to cause muscle atrophy. I decided to ignore his skepticism and run from his scalpel. I filed away the referral slips, and put my trust in the data I’d seen. My hope was that it would regenerate on its own by just leaving it alone (no knives), and doing what I could to manage symptoms, and improve functionality. Hurry up and wait was my approach…for the next two years if need be.

    During the long waiting period I continued lifting (I never stopped). The simple reason was that it felt better if I did. You can expect the development of substantial imbalances in your physique as your body tries to adapt to the malfunctioning limb. My right trap and posterior scapular musculature grew at least a third larger than the left side. You won’t be contest worthy for sure, but its alright, this is your body’s way of achieving homeostasis and do the best with what it has to work with. I credit bodybuilding with allowing me to avoid surgery. I can definitely foresee situations where an individual would indeed need to go the surgical route. If you can’t find a way to control the pain, and improve the function of your arm then you could be quite incapacitated by this condition. If you can find the grit, then avoid surgery and lift your way to increased stability!

    In March of this year (2015) I started experiencing some strange happenings. It had now been over a year and a half since the paralysis. That’s long enough to develop a major habit of serratus checking if my shirt ever happened to be off…"nope, still gone!” The odd symptom I was experiencing was shortness of breath when I did cardio, and when I did my shoulder routine (it was new pressure on the chest wall from the regenerating serratus constricting my breathing). It took another month or so before I started feeling strange sensations under my scapula. By mid-April I could see the fluttering of muscle fibers in that mostly muscleless depression on my side. The end of summer found me with the ability to flex the muscle and see the contractions with absolute certainty.

    It is now December 24, 2015 and I have regained at least half of the muscle volume back in my serratus. I was not too surprised that it was not easy for it to come back to life. While my body did a great job compensating for the injury, it meant that there would be another transformation on the way with a new muscle coming completely back online again in a system that was used to functioning without it. Remember that the serratus is “sandwiched” between the sub-scapular muscles and the thoracic wall. Since my right serratus had been gone for a year and a half, that space was now occupied by the “bread slices.” Now that new tissue is fighting to get it’s space back. This process had caused almost just as many symptoms as the original injury, but I couldn’t be more excited to watch it progress. Symmetry is returning much much quicker than I thought possible. My guess is another year to completely recover from the atropy.

    Best wishes to anyone struggling with this condition. Hang in there, don’t be afraid to lift cautiously, and most importantly be patient. Believe the good data out there, and if you can at least give it the full two years before considering any kind of medical intervention!
    Interesting story, specifically how your symptoms developed.

    Seems like I've got a light winged scapula as well, but my main symptom is the aching in the shoulder itself. Specifically when just sitting on the couch, or when leaning on the arm. Lifting goes reasonably well, it only hurts really bad afterwards.

    My chiropractor thinks in my case it's not the thoracic nerve that caused the winging and gave me a buttload of exercises to do as often as possible. In particular he wants me to make sure I "shred" the serratus after my normal gym exercices, by doing high amounts of reps (50) with elastic bands and such.

    I've only recently heard that I have a slight wing in the shoulder and have not had any MRI or neurological tests done to rule out the thoracic nerve.

    Also about the shortness of breath, that was one of my first symptoms to go to a physiotherapist (eventually ended up at the chiro because PT was taking too long in my opinion). Apparently one of the ribs as slightly out of place. I could definately feel improvement on that part after he popped the rib back into position. Note though that this is most likely very related to the status of your serratus anterior, as it makes sure the ribcage expands properly. Since that is not the case for most of us with this winging scapula, it could easily cause some issue there.

    Here´s some exercises, in addition to those you can find on youtube: htt p:// physiofitness. com. au/_literature_88457/Shoulder_and_Scapula_Exercises (you have to fix the link as I havent got enough posts..)
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    Just an update from me, it's been 6 months now and I've seen no improvement yet. Still hoping eventually it will be able to regenerate itself like others have experienced in this thread. I keep working out, although very minimally compared to before. Working out a little does seem to help manage the back pain I get on that side from sitting at work, I definitely notice an increase in pain and weakness when I stop.
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    Anything yet???
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    10 month update: Finally I'm seeing some improvement. I don't have that weird strained feeling when pushing forward and I'm beginning to look a lot more symmetrical with my scapula not sticking out as much as it did before. I'm also able to do overhead press again, I couldn't for several months because my right arm would not fully extend upward. Everything's looking very encouraging at this point and I think I'll be pretty much back to normal in a few more months.
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    Great thread

    I seem to have damaged my long thoracic nerve, and the reports of recovery here seem about as I would hope. The reality is that it takes a while to recover from nerve damage.

    A few weeks ago I had terrific shoulder joint pain, which made it very difficult to sleep comfortably for about two weeks, and then when that pain went away discovered I had lost the use of the serratus anterior (or at least it seems that way) for my right (dominant) arm and have some scapular winging and weakness. I had no exact idea of the cause, or any sense of when I hurt the nerve. Classic symptoms, I guess, except that I can raise my arm over my head and I can still throw. I feel fairly confident that the nerve will regenerate, in time, and I continue to exercise (tennis and light weights, and exercise to target serratus anterior and rotator cuff muscles. It just seems to me that keeping the nerve "active" is the way to go. Part of the issue has to be avoiding further shoulder damage while that muscle is not functioning as it should.

    My question is whether this loss of function in the serratus anterior is always entire and complete? Or are some injuries not a complete loss of function? I seem to have lost maybe 10% of range of motion: I can't easily get my arm straight up when standing, but I can when lying on my back. It seems like part of the muscle is working, and part not? Anyone else?
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    A five month update: It's getting better. I have full range of motion without weight, less when lifting directly vertical when standing or sitting. I have felt some muscle activity and some twitching of the muscle as it seemed to be trying to contract. I do rehab work almost every day, with light weights and resistance bands, and the rotator cuff exercises designed to control scapula movement. I also do heavier weights in the gym to make sure the whole system is being used. As I think back, I think I had something like this injury once before, and I wonder if I just over-stressed the muscles with too heavy a lift in bench press? It took me months to recover once before.
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    (excuse one handed typing)

    Been trying to figure out what is wrong with my shoulders and nerve pain for a year. Started when i got a new job where i was typing 7 hours straight a day. Lifting every morning.

    Left shoulder always snapping popping, raises higher, goes back much further and foward much further. Painful to externally rotate. Cannot do wall slides. Tapping the pec minor, post and ant delt all cause tingling down my arm. Scalene are tight but don't do the same. Been to pts who only give same rotator cuff and chest stretch that do not work. Could be sub scap? left side has no trigger points or cant get to it under my armpit, right side i can get to it.

    Need help to stabilize left scapula so that can fix rounded shoulders. Experiencing muscle wasting please help.

    Do any of u experience pins and needles or tingling in the hands?
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    Originally Posted by LP2500 View Post
    I've been dealing with this since February 2015. 90% sure it is a thoracic nerve injury as the first month with the injury was nothing but pure pain. When the pain subsided I was left with winged scapula. I'll finally be seeing a doctor in January due to health insurance finally being active. I hired a trainer online who has fixed many of these winged scapula issues and was thrilled to start working with him. I followed a routine for 3 months and got in good shape for having such an injury but the scapula didn't fall back in to place. Around late July I basically lost hope with this and have realized I have some real nerve damage on this whole right side. Such a ****ty injury to deal with Ive never been more depressed amongst this injury and what it has done to my life this year. I can feel I need I surgery but does that ever lead to a gym routine with weight lifting? I feel ill never have a bicep/tricep muscle contraction again and I have a seperate case of tennis elbow and forearm numbness as well. For just turning 29 it's been a mental battle. I feel for anyone who's gone through this through the cause of nerve injury. And if so what a day to celebrate once this ever gets resolved. I still do some resistant band stuff and surrounding shoulder work, lower traps, but it feels like most stuff just irritates the forearm numbness and the upper thoracic area near the chest/first rib. Would love to hear from anyone dealing with similar injury through thoracic nerve injury.


    I have ltn damage on my right side for about 4 years know and it hasn't recovered fully either. Serratus completely paralized and my triceps and forearm don't stimulate. Got Emg's as suggested by my chiro, tried Physical Therapy and even Cold Lazer Therapy. Of course those treatments didn't help and doctors couldn't help me either. I agree this is such a b**** injury to fn deal with. Mentally it has brought me in a state of hopelessness aswell.
    Last edited by Nousx; 04-21-2017 at 11:56 PM.
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    Maybe someone else will read this. I've had this for about 9 months now. I saw 24 people between MD's, DPT's, DO's, DC's, etc. I lifted for the first 4 months of it but then decided it wasn't going to do me any good and the time and energy I had spent the prior years building was going to have to be tossed down the toilet because muscle imbalances in the sport of weightlifting is a huge issue. My levator and upper trap began doing the work of the mighty serratus.

    Finally I saw a doctor that knew all about this stuff and ran an ultrasound scan from the nerve roots all the way to the muscle. They were trapped by a 3cm adhesion along the middle scalene - the nerve had swelled to about 3x it's normal size. The doctor cleared the adhesion via hydrodissection and said he would anticipate it should recover in 30-60 days. I am hoping so. I may have it on the left side as well but he also said that I could be feeling compensation problems and to wait until the right side recovers and then i'll really know if both are bad. It's been a wild time and I'm hoping he is right - I think he is.
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    I am experiencing long thoracic nerve palsy currently (July 2017), and this thread has been very helpful and reassuring. Sucks to know that other people are going through this, but good to know that others have recovered from this!

    elindenstein - I'd be eager to hear how the hydrodissection works out. Sounds like it could be another possible treatment option.

    I woke up in early December 2016 with an ache deep to my right scapula, medial to it, and where my right serratus anterior is (or used to be). It wasn't excruciating, but it was a good, steady ache. I tried working it out with a lacrosse ball and fiddled around with different positions to see what hurts/what doesn't. I got into a push up position and felt my right scapula fall out of place - wing. Freaked me out.

    I saw a PT the next day - he referred me to an orthopedist. I've been to that orthopedist twice, another one once, a massage therapist three times, and PT for about ten sessions. Thus far, nothing has made a noticeable difference.

    At this point, I don't have much pain, just significant weakness in my right shoulder; atrophy in my anterior delt, serratus, and lat; and posterior head and neck tightness. If I do any weights - just light stuff - the back of my head and neck get very stiff. I assume it's the upper traps taking over for the serratus anterior's work.

    As others have said, this definitely sucks - bites to not be able to lift (I do body weight stuff for lower body and core). The most recent othropedist said that lifting could be useful - would work the affected muscles, which would in turn re-innervate the damaged nerve - and that I should deal with the stiffness. Works for me - I'm happy to suck it up - I just don't want to cause more damage and set myself back.

    Did most everybody find lifting helpful? Any extra stiffness (beyond the usual tightness and wear and tear from lifting) from it that you had to suck up?
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