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Injuries to the Long Thoracic Nerve

The long thoracic nerve supplies the serratus anterior muscle which holds the scapula in position. An isolated injury to this nerve can occur during violent shoulder movements, e.g. during weightlifting.

Backstroke swimmers may also sustain similar damage as their arm is moved through a combination of external rotation and forwards and upwards lifting.
When the long thoracic nerve is damaged, there is usually a dull ache which disappears spontaneously. The ability to lift the arm is impaired and, at the same time, ‘winging’ of the scapula is seen—the medial
side of the scapula protrudes backwards on the damaged side. One way of revealing the injury is to ask the athlete to perform press-ups (push-ups) against a wall; the medial side of the scapula will protrude
posteriorly. The treatment consists of anti-inflammatory medication and gradually increasing strength training.

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