A member of the forum contacted me by PM to inquire how the nerve problem associated with my injury was diagnosed. I think it maybe informative to others to post my reply to their inquiry here, so I've started this post to capture that.
Five months after the accident, I simply was not gaining strength so my PT suspected that either there was a rotator cuff tear that was not showing up on the MRI or there was a nerve problem. So she sent a note to my orthopedic surgeon, and he thought that there might be a nerve issue. He then referred me to a physiatrist, who conducted an EMG (electromyography) study. The EMG study uses electrical probes that are placed at predetermined locations on the skin to excite the nerve, with an ability to read the connection of the nerve to the muscle as well as, as I understand it, the location of any interruption in the circuit. So the EMG can be a very useful diagnostic tool to identify the location of a nerve problem.
The results of my EMG study found that there was no connection between the suprascapular nerve and the two muscles it attaches to, the infraspinatus and the supraspinatus. These muscles are responsible, in part, for external rotation of the humerus and the first few degrees of shoulder flexion. The surgeon and the physiatrist thought that there was a likelihood that the nerve was compressed in the suprascapular notch, which is a notch in the scapula. So the surgery enlarged the notch, presumably freeing the nerve and giving it a chance to regenerate. A nerve grows about a millimeter a day starting 30 days after surgery, so it is still too early to determine if it will solve the issue and there are no guarantees, but the surgeon thought it was the best chance for a recovery. So far, I think I getting a bit of strength, but it is still a bit early to tell.
One thing to realize is that if it is a nerve without a connection to a muscle, you only have 1.5 years for the connection to be regenerated. After that time, there's no chance of recovery. So you have to budget the time for the surgery, nerve regeneration, etc.
Of course, anyone should consider the value of this information, which is uneducated, uninformed, a case study of one, and provided by a lay person. Your doctor and physical therapist should be the source of your care, not the internet.
Best of luck!
Mike
Five months after the accident, I simply was not gaining strength so my PT suspected that either there was a rotator cuff tear that was not showing up on the MRI or there was a nerve problem. So she sent a note to my orthopedic surgeon, and he thought that there might be a nerve issue. He then referred me to a physiatrist, who conducted an EMG (electromyography) study. The EMG study uses electrical probes that are placed at predetermined locations on the skin to excite the nerve, with an ability to read the connection of the nerve to the muscle as well as, as I understand it, the location of any interruption in the circuit. So the EMG can be a very useful diagnostic tool to identify the location of a nerve problem.
The results of my EMG study found that there was no connection between the suprascapular nerve and the two muscles it attaches to, the infraspinatus and the supraspinatus. These muscles are responsible, in part, for external rotation of the humerus and the first few degrees of shoulder flexion. The surgeon and the physiatrist thought that there was a likelihood that the nerve was compressed in the suprascapular notch, which is a notch in the scapula. So the surgery enlarged the notch, presumably freeing the nerve and giving it a chance to regenerate. A nerve grows about a millimeter a day starting 30 days after surgery, so it is still too early to determine if it will solve the issue and there are no guarantees, but the surgeon thought it was the best chance for a recovery. So far, I think I getting a bit of strength, but it is still a bit early to tell.
One thing to realize is that if it is a nerve without a connection to a muscle, you only have 1.5 years for the connection to be regenerated. After that time, there's no chance of recovery. So you have to budget the time for the surgery, nerve regeneration, etc.
Of course, anyone should consider the value of this information, which is uneducated, uninformed, a case study of one, and provided by a lay person. Your doctor and physical therapist should be the source of your care, not the internet.
Best of luck!
Mike