Expert: Dr. Victor Dolan, DC, DACBSP - 12/9/2008

Question
Having been diagnosed with a long thoracic nerve injury, that has caused paralysis to the serratus anterior muscle, which has resulted in a winged scapula, i am wondering if i can continue to cross country ski. I have skied the Birkebiener several times and would like to do so again. I am 55 years old and in reasonably good shape. On the scale of 1-10 the Dr. said my injury is a 9 . I have absolutely no pain and am concerned about hampering the possible healing of the nerve. Thank you very much for your answer. Sincerily, tony

Answer
pinched nerve , nerve injury , long thoracic nerve injury , serratus anticus , winged scapula , no pain , yes paralysis ,

Hello Tony,

Sorry to hear of your condition.

I will give you my best answer, this answer will include questions that you should answer yourself, questions that would help me give a better explanation/ reply to you.  If you feel this is incomplete, do not hesitate to re-contact me here at AllExperts.com  
( http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm ).

You have seen a Doctor for exam and diagnosis. Should you ski, will the nerve heal? - Have you asked the Doctor treating you these very same questions?, If not, communicate, do not be afraid to ask.  Your Doctor that sees you 'in the flesh'- in person can beter answer these questions.

If you are looking for a second opinion,,,,, please give more weight to the Doctor that has seen you, touched you, evaluated in person.

Diagnosis: Winged Scapula (paralysis of serratus anticus) due to Long Thoracic Nerve damage.
         How did this happen? How long ago did this happen?  Has it been progressing slowly over time?  Did you 'wake up' like this? Was there an accident, injury?  How long and is it changing for better worse?  Have you had nerve tests- EMG/ncv?  Have you been to a Neurologist or Chiropractor?

If this diagnosis / condition is new, it will be more likely to respond to treatment.  If this condition has been with you a while (months, year, years), it is far less likely to resolve.

This is a NERVE problem.  The 'Winged Scapula'- a bone moving into an improper position, due to a muscle paralysis, due to a nerve not functioning properly.  Get to the CAUSE to get the best correction.
There are surgical interventions, but before proceeding towards the invasive surgical route with inherent risks and complications, I would recommend conservative care, such as Chiropractic.

See a local Doctor of Chiropractic for evaluation. Xray of the Cervical and Thoracic Spine, MRI if Xray indicates further evaluation is necessary.  EMG to evaluate extent of nerve damage.  Chiropractic Spinal Adjustment if appropriate.  Targeted nutrition to help restore nerves.

If this has been with you a longer while, this winged scapula may be permanent or take monthSS (year)to resolve.  If this is relatively new (acute), depending upon cause, resolution could be quick- weekss or months.

You have a nerve problem. You have a paralyzed muscle. Your shoulder joint will not function properly with this imbalance.  Your thoracic spine is imbalanced. The Serratus anticus is an accessory muscle of respiration, you will not breathe properly.  No, I do not recommend any sports, competitive activity, strenuous exercise, repetitive activity, until you have this resolved.

Interesting Web Talk on the winged scapula:
 http://forum.bodybuilding.com/archive/index.php?t-2195941.html
 Surgical Information: http://www.drnathwingingscapula.com/#

Information on Chiropractic:

‘VSC’-  the    Vertebral  Subluxation  Complex     
(aka:  the  “Subluxation”)

Many times a patient will come to the Doctor of Chiropractic – ‘…as a last resort…’,  often  after  ‘….everything else has been tried….’.  This is frustrating to the Doctor (the DC),  yet also satisfying.  Frustrating?, Satisfying?, ,,,why?-  Many times a symptom, an ache a pain, a condition can be caused by the ‘Subluxation’ – the ‘Chiropractic Lesion’.  Just as germs, the Virus or Bacteria- is the ‘medical lesion’ (- the MD looks for germs, the DC looks for subluxation).   Many times an unexplained condition, after exam after exam, blood tests, Xray, MRI, EKG, EMG, etc., etc., --- Chiropractic can help the patient.  Why- because only a Doctor of Chiropractic will check for subluxation- as well as run the ‘traditional’ tests.




           Only a Doctor of Chiropractic will evaluate and treat for VSC, as well as other pathology.




The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

Subluxation  is  a  serious  condition  identified  by  its  five  parts:

            Spinal Kinesiopathology:        This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.

            Neuropathophysiology:         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.

            Myopathology:           Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.

            Histopathology:       A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.

            Pathophysiology:     The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
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I hope this helps answer you, give you info.

My Stten Island Chiropractic office works with pinched nerves like this all the time.  See your local DC.

I wish you good luck and Good Health Naturally,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com     (email newsletter)