brachial plexus - again

[Xaniel]

Hi there!

I just read Dianes post "Success with a brachial plexus pain lockdown" and now I have a patient quite similiar. She had breast cancer and undergo (or "underwent"?) surgery 2 weeks ago. Now she feels pain in her left arm (left breast was affectes). She can not lift her arm with her elbow extended. With the elbow flexed she was full ROM in her shoulder. You can really see her plexus brachialis in her left arm pit and in her left elbow (N. medianus?). It really sticks out and feels very very tight. I did not do ULTT1 on the left side because her pain is severe. But I did it on the right arm: left hand on belly - no positive findings. Left hand on the bed - pain in the left elbow at 90° elbow flexion (ULTT1 right arm).

So, what would you suggest I can start with? And Diane, may I ask you for a more detailed description of your taping. I do have some experience with taping (like Mulligan teach it) but never tried it on the shoulder like you wrote in the above mentioned post.

Thanks a lot in advance!


Daniel

[emad]

Hi Daniel :

Well done ,avoidance of applying ULNT1 with severe /irritable pain in case like that ,even i think trying to testing neural sensitivity every session could evoke the pain . A good idea to advise your patient to avoid sleep on the affected side .
Just neural sliders for both upper limbs are appropriate now .Touch therapy /gentle skin addressing are very good in the axillary region .

Avoid tapping flexor aspects .

Cheers
Emad

[Diane]

Hi Xaniel,
Welcome to somasimple.. I can't really add any more detail (because there isn't any.. it really is all there already) and Emad already added a completer thought, keep the tape off the flexor surfaces. If taping one way doesn't work, try another way. There is no real wrong way. I would do a lot of very slow skin stretch in the axilla, along the clavicle, throughout the arm, elbow (lots!), forearm.. and would be very patient. Good luck.

[Xaniel]

Thanks to both of you!

@emad
What do you mean with "flexor aspectes"? Does it mean that I must not tape over the biceps brachii but may put the tape over the triceps brachii?

@Diane
Do I get your point in taping when I say that the applied tape should hold the skin like the "ballon technique". How long should the patient leave the tape on - 24h?


Daniel

[Diane]

the applied tape should hold the skin like the "ballon technique" Xaniel, it doesn't have to do that. Just stick it on.

[emad]

Hello Daneil :

Correct ,what you understood ! Because i have applied taping for one of my patients at the elbow anterior aspect ,which caused redness and pain .I think i have mentioned that within the thread of Brachial plexus which you have mentioned above .

Here , i like to say breathing exercises ,cervical ,thoracic rotations just gentle are good ,besides to neural sliders of bpth upper limbs ,you can find that neural gliders at the section http://www.somasimple.com/forums/showthread.php?t=2039&highlight=Upper+Quadrant
Cheers
Emad

[Xaniel]

emad,

your link is dead - please correct it for me!


Daniel

[emad]

Daniel ,now it works .


Emad