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Eur J Phys Rehabil Med. 2019 Aug;55(4):510-514. doi: 10.23736/S1973-9087.18.05165-1. Epub 2018 Dec 21.

Conservative treatment after axillary nerve re-injury in a rugby player: a case report.

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Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy -
Department of Physical and Rehabilitation Medicine, University of Padua, Padua, Italy.
Venezia Football Club Medical Staff, Venice, Italy.
Hospital "Casa di Cura Santa Maria Maddalena" Occhiobello, Rovigo, Italy.
Section of Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.


Axillary nerve injuries are uncommon, although the incidence is higher in athletes, both related to direct contusion or quadrilateral space syndrome. While few studies have investigated conservative strategies that could be proposed to avoid surgery, no previous case report documented the possible role of rehabilitation in axillary nerve reinjuries. Our patient is a 27-year-old male professional rugby player who experienced a recurrent episode of deltoid strength loss, after a previous axillary nerve injury. The MRI of the brachial plexus showed increased signal intensity of C5 spinal root, together with denervation edema in infraspinatus muscle, related to a recent traction injury while the EMG confirmed the persistence of traumatic paresis of axillary nerve and the chronic sufferance of C5 myotome. Our conservative treatment consists in a 2-phases rehabilitation protocol builded up on the basis of a shoulder kinematic test, electrostimulation test and a further EMG. The purpose of this report was to bring attention on axillary nerve conservative management. Premature return to sport may predispose the patient to the risk of re-injury. A prompt diagnosis and a timely specific rehabilitation protocol allow to a safe full-return to professional sport activity and may prevent recurrences.

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