My Brachial Plexus Injury Story

I've past the 4 years milestone. This is a significant time because it is supposed to be reaching the apex of the recovery. For a normal day to day, you usually don't need to raise your arm more than 90 degrees. All my needs are pretty much covered at that angle. Higher than that, you need occasional motion that tends to be important at the moment. For example, getting something heavy off a shelf. I can manage most of the times I run into the scenario. What I noticed a few months ago is that I wasn't able to throw a basketball. A random ball made its way to me on the street, I grabbed it and when I threw it back, both my face and the owner's looked hilariously disappointed. Ever since I started practicing the motion, with a smaller rubber wall, against an imaginary ring on my room's wall. I thought it would be hard to see any improvement since the 4th anniversary mark. Surprisingly, after a month of a few minutes of practice per day, my throw is getting better. And

These past few months life have been really busy, barely managed to stick to my recovery exercises. Still, recovery goes on, and I can see some improvements on stability and strength \o/ Sensation on the thumb seems to be slightly improving too. Other sensory areas are more or less the same I think. This month makes 4 years since the accident. Always an emotional month !

I'm changing a bit the exercises. I usually work the lateral or front raise, now I'm trying to engage more the rear deltoid, supra and infra. The doctor recommended me to try badminton to improve arm stability, I think I would be really bad at it at this moment so I'm trying some exercises with a soft ball against the wall. I've quickly noticed an improvement. I think I'll try badminton or some racket game soon. As for now, I managed to do my first real push-up \o/ it was only one, but that's a start :) I'm actually OK doing planks, I guess I have not been exercising the triceps as I should, so I still have some pending work there.

  It has been 3 years after the surgery. I remember vividly the sensation on the way to the surgery room. The frustration of giving up hope for a full natural healing, and giving in to a calculated risk with estimated recovery level rates. My brachioradialis is still reminding me it was the right call. It is getting a bit stronger tho 💪. Everything related to the arm healing feels normal by now, and used to it by a long shot. Very grateful to Dr. Somsak and Dr. Kanchai for the fantastic work done on me. I continue my exercises as much as I can, and hopefully my self-discipline will help me to continue for at least a few more years.

A few days ago it was the 3 years mark since the accident. Always a scary anniversary. Things seem to keep improving, started doing easy push-ups, more weight exercises and anything I can think of to push the arm. These past two months have been quite stormy in Singapore, and the hyper sensitive areas were definitely reacting. I wonder how is it going to be during the upcoming Christmas in cold Europe. My back issue is getting better, and the core becoming more equally balanced. I've adjusted the bicycle's seat a bit lower, more than I should by my height, but seems to help me keep a better balance on the handlebar so the back stays firmer. My running seems to be getting better too. I'm less scared of hitting my arm against upcoming pedestrians, doors etc. Slowly regaining confidence on my right side :) 

So it has been 2 years and a half after the surgery. I continue to see significant improvements, traveling for the past few weeks I made good use of the arm pulling luggage, carrying stuff and of course, lots of eat and drink. It was cold in Scotland, but the hypersensitivity didn't bother too much. I see slight improvements on that side as well. In the place I stayed there was a lot of fire doors, kind of heavy. Most of the time I could use the arm to open them without much difficulty. As always, very happy with the result and continuing my daily arm exercise routines o/

Passed the 2 years mark, and very happy to see improvements. Strength is increasing, muscle mass too. From an outside viewer it appears my BPI arm is a healthy strong arm. Hypersensitivity still there. I recently spoke to an old friend whose partner got into a motorcycle accident and had a nerve injury in the leg. Several years later the hypersensitivity still there for that person, I guess this part takes a bit longer to heal. Life goes on as usual. I'm moving apartment next week and had to do a lot of physical movement, including a very tiring round of washing curtains. I was surprise to have muscle soreness on the BPI arm the day after, I guess that's a very good sign. I continue with my exercise routine, and I noticed I developed a bit of bad posture when raising the arm. I suspect this caused me to have a mild pull on the sciatica nerve last December, from what I'm still recovering too. I expect this will improve as it gets easier to raise the arm. The feeling I have w

It has been 2 years now since the surgery. Recently I went to visit a local orthopedic Doctor, to check on some lower back pain I'm having lately. He started to explain me about the nervous system, and I told him about my "training" in this area. He was surprised of how my recovery is going. That made my day! The major noticed improvements are the increase in muscle mass and the strength. The ability to raise the arm has increased noticeably, and the ease of performing day to day tasks. I continue my exercise routine, and I plan to continue for some time. I'm trying to build up the triceps, with a degree of success. My brachioradialis is building up a little more as well. I'm not sure if the muscle build up is currently being held up by the nerve recovery, or perhaps atrophy from the time I couldn't use those muscles. For the day to day, it feels great. I'm getting more confident using the right arm, and now I can use both arms to pull the bicycle up into

  Soon it will be two years since the surgery. Arm movement continues to improve, and feels like soon enough it would allow raise on a more natural motion. Elbow flexion is improving as well, still not forcing it too hard tho. Doing planks is possible again, and sometimes I can throw in a half-way push-up. I'm still doing daily exercises, and functional daily usage of the arm is now more comfortable. Muscle mass keep increasing for all the muscles. The biceps it is still sensible when being pressed. Hypersensitivity seems to be fading, but at a very slow rate. The elbow flexion still looks a bit crooked. Not sure if I can get it straight on my own, but anyway it is a small issue. Incredibly happy with the progress :)

Has been one year and a half since the surgery, and things continue to slowly improve. As usual, visual changes compared to 3 months ago are low profile. However, it doesn't feel that way at all. There's a very significant improvement of strength and usage of the affected arm, slowly making my right arm the dominant arm once again - at least for anything that doesn't require more than 90 degree elevation angle, then it needs some help. I barely keep track of new movements and "milestones" achieved nowadays, not as much because of wearing off from time consuming toil, but mostly because life as normal is mostly achieved at this point. Nevertheless, I still do keep my routine of recovery exercises. With the increased muscle mass in the deltoid, it's visual atrophy is less prominent and cracking noises are less frequent. Hypersensitivity of certain areas of the hand is improving. Mostly remaining in the thumb and lower part of the palm.

So 15 months have passed by... And feels great! Using the arm gets easier as time goes by.  Visually, doesn't seem to make a huge difference compared to 12 months mark. But I can feel quite a difference since.  A few weeks ago I started doing small planks, and I think I might be able to do one push up at some point. I started using my right arm to soap my hair and to brush my teeth, generally I try to make it the leading arm again. Some movements are easier than others, and most of them are not fluid yet.  To me, some of the key recovery points are achieving the movements needed to perform my hobbies. I'm a big fan of eating, so there goes one. Running, swimming and cycling are there too (although might not get on a road bike for some time, MTB or city bikes are good for now). The ultimate challenge will be riding my motorbike regularly again - or at least, have the choice to do it if I feel like it. Combined movements (flexion / abduction) are still a challenge and not very ac

During the first 10 months it will be easier to track progress. First contractions, start flexing the elbow, start moving the arm and so on. I found that around the 10th month it was harder to track progress, I felt the arm abduction was very similar week after week. And I often found myself thinking the arm improvements slowed down. Eventually I came up with measurements that showed me otherwise: The numbers are time references (10th month and 1 week, and so on). As you can see, there's a weekly improvement on the measurements. This keeps my motivation up for daily rehab exercises. I think finding your motivation is an essential key for the best final result, which can be 2 to 3 years down the road. What I do is, pick up a few movements I can do, and measure how high I get on them against the closet and mark them with a timestamp. There are other ways to measure progress, for example, how high you get while soaping your hair in the shower or how far you get trying to open that tal

It's been 1 year from my surgery. And I'm really happy with the progress. I'm back to running since the 10th month. That completes the last sport I used to practice (running, cycling and swimming).  I can eat with my right arm again. All the motions to turn the spoon and so on takes some adjusting, but the movement is there. After so long being a left-handed, it takes some "rewiring" to get used to do some things with the right arm again. Around this time, a measurement is done to find out the transfer efficiency (M2, M3, M4...). I am not sure which 'M' I have at this moment, but this is what I have: For some people, this could be seen as little. To me, this is great. After all the bad expectations I was put upon at the beginning, this feels like a second chance to have a full movement life. This might not be the final result. I've shared my progress with my physicians and they believe I could improve further - if I stick to my current rehab exercises

Reaching the 9th month life quality gets improved a lot. Elbow flexion is pretty good at this point. I was able to do 5 KG weights easily for biceps, and 3 KG weights for brachiallis. Arm abduction was not close to M3, but a good range of motion was achieved. A slight increase in muscle density could be felt in the deltoid. By the 8th month I started cycling again. Not on a road bike like before, but on a comfortable, stable and more upright city bike. Swimming became an everyday thing for me since the 7th month. I believe it helps with the recovery, since in the water you can easily move the arm it is more practical to get the muscles going. I developed a set of exercises that will be shared in a separate post. Long walks of more than 10 KM with minimal arm support were comfortable. The affected arm becomes of use for the day to day. At that time I opened doors with it, carried light objects, used it to get dressed etc. I was occasionally able to snack and reposition my specs with it.

The 6th month is usually the review point with your doctor. Results at this point may vary depending on individuals. This is just how it went down for me. Elbow flexion started to be functional since around 4.5 months. This is, for example, I was able to raise a small bottle of water (not to my mouth, but to pick it up from the table i.e.). It would get much better over months to come. Flexion after supination of the forearm wasn't good until around the 9th month, but at 6th month it started to get a decent range of motion while making a fist. This means I couldn't wash my hands following the old usual motions but it was a start. I could supinate and raise the forearm while making a fist, but not with an open hand.  At this point I was doing exercises with 1-2kg weights for elbow flexion. For arm abduction, I started to have some tiny movements while standing. Laying down was easier and I could sometimes raise my arm. It was around this time that I ditched the arm sling around

A few months after the surgery is when good things will start to happen. So slowly that will be difficult to appreciate, but they are happening. From this moment onward, you will start to notice that some of your atrophied muscles are slowly becoming less bony. This doesn't mean that the muscle is back at this point, but just a tiny bit. Nerve pain might be still at its peak. This could last for a while. Around this time you will start to observe small contractions when activating the innervating nerves for the elbow flexion. For example, with Oberlin transfer, making a fist will cause some feeling around the biceps. Those sensations will soon become small but visible contractions. From there, you will observe small movements but don't expect any anti gravitational force on elbow flexion anytime before 4 months after the surgery. Depending on what transfer was done for your supraspinatus, it is possible that you will observe changes there a few weeks or months after this point.

At this point the surgeons have cut about about half of selected working nerves and placed them in position to energize inactive muscles. There will be a decent amount of pills and you'll be feeling like badly hangover for a week or so. Your fingertips will have some degree of numbness. It happens frequently. For double Oberlin transfer, you may feel some degree of weakness in your hand, specially in the index finger. Weakness should recover in the upcoming months, so try to not worry too much about it. In another post I will cover my thoughts about single or double Oberlin transfer. It is possible that some new areas in your hand become hypersensitive. For me it was the lower part of the palm. This is supposed to go away with time, for me after 10 months it lowered the threshold just a bit. You'll be in immobilization period for one month. Depending on your Doctor, you will either be told to have the arm tightly immobilized, or to allow just a little bit of movement. At any ca

You will notice changes in your body. Both before, and after the surgery. Of course, it all depends on what kind of injury you have - what nerves are affected and how. For similar injuries to mine (c5 c6 rupture), this is what I noticed for the first 3 months. First, you will start to notice occasional cracking in the shoulder when there's some induced movement (i.e. when you are using your other arm to position the affected limb in a comfortable position). This is your deltoid getting atrophied and not holding your arm as it should. This will start a few weeks after the accident, and depending on your muscle mass it could be noticeable for 2 to 3 weeks. After that you might occasionally still notice it, but the arm is loose enough to be mostly out of its original position. Eventually you will notice there's almost no deltoid left. For me it was after 2 months or so, but it depends on how muscular you were before the accident (I wasn't). If a muscle doesn't receive nerv