Shoulder

Axillary Nerve Injury

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Axillary Nerve Injury, Quadrilateral Space Syndrome

  • Causes
  1. Shoulder Dislocation
  2. Upward pressure from improper crutch use
  3. Repetitive overuse (pitching, swimming)
  4. Surgery (arthroscopy, rotator cuff repair)
  • Symptoms
  1. Arm Fatigue on throwing and other overhead activities
  2. Posterolateral upper arm Paresthesias may occur
  • Signs
  1. Weak abduction and external rotation at the Shoulder
  • Diagnostics
  1. Nerve Conduction Studies and EMG
    1. Consider repeating at 3-6 months after treatment
  2. Shoulder MRI
    1. Typically only helpful for evaluation of differential diagnosis (e.g. labral disorder)
    2. Compression of axillary nerve is unlikely to be visualized on MRI
  • Management
  1. Shoulder Range of Motion Exercises with posterior capsule Stretching
  2. Avoid heavy lifting
  3. Sport specific biomechanical modification to prevent reinjury
  • Course
  1. Anticipate a 3-6 month course with therapy