Medscape is available in 5 Language Editions – Choose your Edition here.


Brachial Plexus Injury in Sports Medicine Follow-up

  • Author: Thomas H Trojian, MD; Chief Editor: Sherwin SW Ho, MD  more...
Updated: Nov 26, 2014

Return to Play

Clinical findings are key in determining an athlete's possibility of returning to play. Full recovery of affected muscles must be determined to prevent further injury and recurrence of burner syndrome. Athletes in contact sports involving the neck should be able to support their weight at the neck leaning at a 45° angle. If this is possible without symptoms, then return to play is highly probable.

Some athletes may have very mild residual asymmetry in strength as a result of the initial injury. Close attention should be paid to the degree of disparity in extremity strength as the athlete returns to participation. Serial EMGs may be of little utility in this setting, as EMG changes can persist for months to years. However, in the setting of an acute change in strength pattern, reassessment may be warranted.

Recurrent stingers warrant assessment of equipment, inclusion of a cowboy collar for football players, and the coach to assess tackling technique.



Chronic burner syndrome



Use protective equipment (eg, neck rolls, air cushions) in football players. Proper technique in contact sports (eg, tackling) is necessary, and improper methods (eg, spearing) should be discouraged. Coaches and referees involved with heavy contact sports also should discourage unnecessary tackling and contact. Cervical and paracervical muscular strengthening and conditioning are recommended.



Prognosis is good, yet some possibility of chronic symptoms may remain.



For excellent patient education resources, visit eMedicineHealth's First Aid and Injuries Center. Also, see eMedicineHealth's patient education articles Shoulder and Neck Pain and Neck Strain.

Contributor Information and Disclosures

Thomas H Trojian, MD Professor of Family Medicine, Sports Medicine Fellowship Director, Department of Family Medicine, Associate Chief, Division of Sports Medicine, Drexel University College of Medicine; Lead Team Physician, Drexel Athletics

Thomas H Trojian, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Society of Teachers of Family Medicine

Disclosure: Nothing to disclose.


Melissa Mascaro, MD Fellow in Sports Medicine, University of Connecticut School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

Janos P Ertl, MD Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopedic Surgery, Wishard Hospital; Chief, Sports Medicine and Arthroscopy, Indiana University School of Medicine

Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, Sierra Sacramento Valley Medical Society

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Federico E. Vaca, MD, FACEP, and Oniel Young, BS, to the development and writing of this article.

  1. Charbonneau RM, McVeigh SA, Thompson K. Brachial neuropraxia in Canadian Atlantic University sport football players: what is the incidence of "stingers"?. Clin J Sport Med. 2012 Nov. 22(6):472-7. [Medline].

  2. Starr HM Jr, Anderson B, Courson R, Seiler JG. Brachial plexus injury: a descriptive study of American football. J Surg Orthop Adv. 2014 Summer. 23(2):90-7. [Medline].

  3. Chao S, Pacella MJ, Torg JS. The pathomechanics, pathophysiology and prevention of cervical spinal cord and brachial plexus injuries in athletics. Sports Med. 2010. 40(1):59-75. [Medline].

  4. Terzis JK, Kokkalis ZT. Selective contralateral c7 transfer in posttraumatic brachial plexus injuries: a report of 56 cases. Plast Reconstr Surg. 2009 Mar. 123(3):927-38. [Medline].

  5. Bengtson KA, Spinner RJ, Bishop AT, Kaufman KR, Coleman-Wood K, Kircher MF, et al. Measuring outcomes in adult brachial plexus reconstruction. Hand Clin. 2008 Nov. 24(4):401-15, vi. [Medline].

  6. Colbert SH, Mackinnon SE. Nerve transfers for brachial plexus reconstruction. Hand Clin. 2008 Nov. 24(4):341-61, v. [Medline].

  7. Amrami KK, Port JD. Imaging the brachial plexus. Hand Clin. 2005 Feb. 21(1):25-37. [Medline].

  8. Bertelli JA, Ghizoni MF, Loure Iro Chaves DP. Sensory disturbances and pain complaints after brachial plexus root injury: a prospective study involving 150 adult patients. Microsurgery. 2011 Feb. 31(2):93-7. [Medline].

  9. Sulaiman OA, Kim DD, Burkett C, Kline DG. Nerve transfer surgery for adult brachial plexus injury: a 10-year experience at Louisiana State University. Neurosurgery. 2009 Oct. 65(4 Suppl):55-62. [Medline].

  10. Terzis JK, Barmpitsioti A. Wrist fusion in posttraumatic brachial plexus palsy. Plast Reconstr Surg. 2009 Dec. 124(6):2027-39. [Medline].

  11. Clancy WG Jr, Brand RL, Bergfield JA. Upper trunk brachial plexus injuries in contact sports. Am J Sports Med. 1977 Sep-Oct. 5(5):209-16. [Medline].

  12. Sallis RE, Jones K, Knopp W. Burners. Offensive strategy for an underreported injury. Phys Sports Med. 20(11):47-55.

  13. Meeuwisse WH, Hagel BE, Mohtadi NG, Butterwick DJ, Fick GH. The distribution of injuries in men's Canada West university football. A 5-year analysis. Am J Sports Med. 2000 Jul-Aug. 28(4):516-23. [Medline].

  14. Padua L, Di Pasquale A, Liotta G, Granata G, Pazzaglia C, Erra C, et al. Ultrasound as a useful tool in the diagnosis and management of traumatic nerve lesions. Clin Neurophysiol. 2013 Jun. 124(6):1237-43. [Medline].

  15. Zhu YS, Mu NN, Zheng MJ, Zhang YC, Feng H, Cong R, et al. High-resolution ultrasonography for the diagnosis of brachial plexus root lesions. Ultrasound Med Biol. 2014 Jul. 40(7):1420-6. [Medline].

  16. Lapegue F, Faruch-Bilfeld M, Demondion X, Apredoaei C, Bayol MA, Artico H, et al. Ultrasonography of the brachial plexus, normal appearance and practical applications. Diagn Interv Imaging. 2014 Mar. 95(3):259-75. [Medline].

  17. Cramer CR. A Reconditioning Program to Lower the Recurrence Rate of Brachial Plexus Neurapraxia in Collegiate Football Players. J Athl Train. 1999 10. 34(4):390-396.

  18. Dorsi MJ, Hsu W, Belzberg AJ. Epidemiology of brachial plexus injury in the pediatric multitrauma population in the United States. J Neurosurg Pediatr. 2010 Jun. 5(6):573-7. [Medline].

  19. Kuhlman GS, McKeag DB. The "burner": a common nerve injury in contact sports. Am Fam Physician. 1999 Nov 1. 60(7):2035-40, 2042. [Medline].

  20. Levitz CL, Reilly PJ, Torg JS. The pathomechanics of chronic, recurrent cervical nerve root neurapraxia. The chronic burner syndrome. Am J Sports Med. 1997 Jan-Feb. 25(1):73-6. [Medline].

  21. Markey KL, Di Benedetto M, Curl WW. Upper trunk brachial plexopathy. The stinger syndrome. Am J Sports Med. 1993 Sep-Oct. 21(5):650-5. [Medline].

  22. Stracciolini A. Cervical burners in the athlete. Pediatr Case Rev. 2003 Oct. 3(4):181-8.

  23. Weinberg J, Rokito S, Silber JS. Etiology, treatment, and prevention of athletic "stingers". Clin Sports Med. 2003 Jul. 22(3):493-500, viii.

  24. Weinstein SM. Assessment and rehabilitation of the athlete with a "stinger". A model for the management of noncatastrophic athletic cervical spine injury. Clin Sports Med. 1998 Jan. 17(1):127-35. [Medline].

  25. Williams J, Hoeper E. Brachial plexus injury in a male football player. Curr Sports Med Rep. 2004 Jun. 3(3):125-7.

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.