In addition to their role in movement, muscles play an important role in supporting skeletal structures. TO The muscle must be long enough to allow for normal joint mobility, but short enough to effectively contribute to joint stability. When the range of motion is limited due to stiff muscles, treatment involves the use of several modalities and procedures that promote muscle relaxation and help stretch muscles. Stretching exercises are one of the most important procedures. Stretching should be gradual, and although it may cause mild discomfort, it shouldn't cause pain. When the range of motion is excessive, the most important part of treatment is to avoid excessive stretching. If the patient is unstable with or without pain, in many cases it is prudent to apply a support that allows to "tighten" the affected structures. Specific exercises may or may not be necessary because many muscles weakened by stretching resume with normal activity when excessive stretching is avoided.

Many neuromuscular conditions are characterized by muscle weakness. Some show definite patterns of muscle impairment; others show irregular weakness with no apparent pattern. In some cases, the weakness is symmetrical; in others, the weakness is asymmetrical. The site or level of a peripheral lesion can be determined by the muscles distal to the injury site will show weakness or paralysis. Careful and accurate tests Recording the test results will reveal characteristic results and help establish the diagnosis. Peripheral nerves are prone to trauma in many areas of the body and for a wide variety of causes. Some trauma can be invasive in nature. Invasive trauma can be accidental, such as lacerations, puncture wounds, drug injections, or nerves cut or injured during surgery. Invasive trauma can also be caused by necessary procedures, such as a nerve resection or rhizotomy. Many neurological problems result from non-invasive trauma that can cause compression or tension (i.e. traction) on a nerve. The trauma can be sudden or gradual, the latter type being the result of held positions or repetitive movements. Affection can range from being disseminated along a limb to being localized to a single nerve branch. Non-invasive trauma can be transient or cause permanent deficits.


Trauma can also result from an external force causing a nerve to be compressed. Examples include the following:

Radial, median, or ulnar nerve (or a combination of these), as in "Saturday night paralysis" of an arm hanging from the back of a bench or chair. Radial or median nerve (or both) from crutch palsy.

Radial, median and ulnar nerves of a tourniquet.

Median nerve from various sleeping positions

(eg, supine, arm above head; lying sideways on adducted arm)

Ulnar nerve from trauma to the elbow. Ulnar or median nerve from sudden or repeated trauma to the hypotenar or thenar eminence.

Anterior interosseous nerve of the cuff sling (forearm).

Brachial plexus of a strap over the shoulder. Peroneal nerve with plaster, adhesive bandage or

garter that produces pressure on the fibula's head or when sitting with the legs for a long time

crossed and one knee resting on the other. A transient external compressive force is exemplified

gives a blow to the elbow, hitting the "funny bone" (so called because it is the distal end of the humerus). The bruise hurts and causes tingling in the ring and little fingers, but the symptoms don't last long.

Trauma from an external force that stresses the nerves can occur to the brachial plexus, such as from an accident.

or manipulation that exerts excessive traction on the plexus. The long thoracic nerve is susceptible to stretching when carrying a heavy bag with a shoulder strap.

Internal compression or tension affecting the nerves generally occurs in areas of the body where the nerve is vulnerable due to close association with solid skeletal structures. Under normal conditions, a sulcus or tunnel can be a protection, but in the case of injury or inflammation with swelling and scar tissue, the confined

the area becomes a source of entrapment. Internal compression is exemplified by pressing on:

Spinal nerve root from calcium deposits in the foramen.

Suprascapular nerve which passes under the ligament and through the scapular notch.

Brachial plexus of a cervical rib. Brachial plexus of the coracoid process and a

pectoral minor tight

Axillary nerve in the quadrilateral space

Median nerve, as in carpal tunnel syndrome.

Nerve (usually) of the fourth toe, as in Morton's neuroma. Internal stress on a nerve is exemplified by:

Suprascapular nerve as it passes through the scapular notch, subject to lengthening with

Displacement of the shoulder and scapula.

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