Physiotherapy treatment for a brachial plexus injury focuses on maintaining joint mobility, preventing muscle contractures, rebuilding strength, and re-educating muscles as the damaged nerves heal. A registered physiotherapist uses passive and active range-of-motion exercises, progressive strengthening, sensory re-education, splinting, and pain management modalities to restore as much arm and hand function as possible. The timeline for recovery depends on the severity of the nerve damage, ranging from weeks for mild stretch injuries to years for surgical reconstructions. This guide covers what a brachial plexus injury is, how physiotherapy treats it at each stage, what to expect during rehabilitation, and how long recovery takes.

What Is a Brachial Plexus Injury?

A brachial plexus injury is damage to the network of nerves that runs from the cervical spine (neck) through the shoulder and into the arm and hand. The brachial plexus originates from the ventral rami of spinal nerve roots C5 through T1 and is responsible for all motor and sensory function in the upper limb, with the exception of the trapezius muscle. The plexus consists of five structural levels: roots, trunks, divisions, cords, and branches. Each level connects to specific muscles and skin areas in the shoulder, arm, forearm, and hand.

When the brachial plexus sustains damage, the result is partial or complete loss of movement, sensation, or both in the affected arm. The severity depends on which nerve roots are involved and how badly the nerve fibres are disrupted. A mild stretch may cause temporary numbness and weakness that resolves in days. A complete avulsion, where nerve roots tear away from the spinal cord, can cause total paralysis of the arm and severe neuropathic pain that persists for years. According to a meta-analysis published in Neurosurgical Review, 53% of traumatic brachial plexus injuries involve complete plexus lesions affecting all nerve roots from C5 to T1.

The muscles connected to the brachial plexus include the deltoid, biceps, triceps, brachialis, brachioradialis, rotator cuff group (supraspinatus, infraspinatus, teres minor, subscapularis), forearm flexors and extensors, and all intrinsic muscles of the hand. Damage at different levels of the plexus produces different patterns of weakness and sensory loss. Physiotherapy addresses these specific deficits based on which muscles and nerves are affected.

What Causes a Brachial Plexus Injury?

A brachial plexus injury is caused by forceful stretching, compression, or tearing of the nerve network between the neck and shoulder. The two primary mechanisms are traction (stretching) and direct impact. Traction injuries occur when the head and neck are forced away from the shoulder, pulling the nerve roots beyond their tolerance. Impact injuries occur when a blow to the shoulder compresses or ruptures the nerves against surrounding bone and tissue.

Motorcycle accidents are the leading cause of traumatic brachial plexus injuries in adults. According to Neurosurgical Review, 67% of closed brachial plexus injuries result from motorcycle crashes. Motor vehicle collisions account for approximately 14%, followed by falls, contact sports, and workplace accidents. The same meta-analysis found that 93% of patients with severe brachial plexus injuries requiring surgery are male, with the highest incidence among men aged 15 to 25.

Birth-related brachial plexus injuries, known as obstetric brachial plexus palsy, occur when the baby’s shoulder catches on the mother’s pelvic bone during delivery. This type of injury most commonly affects the upper roots (C5 and C6) and produces what is called Erb’s palsy. Less commonly, brachial plexus injuries result from surgical complications, radiation treatment, tumours compressing the nerve network, or inflammatory conditions like Parsonage-Turner syndrome. Regardless of the cause, early assessment by a physiotherapist or physician establishes the baseline for treatment planning. Many patients recovering from motor vehicle accidents benefit from combining chiropractic care with physiotherapy to address both nerve and spinal alignment issues simultaneously.

What Are the Types of Brachial Plexus Injuries?

The types of brachial plexus injuries are classified by the severity of nerve damage, the location within the plexus, and the pattern of functional loss. The most widely used severity classification divides nerve injuries into three categories based on the work of Seddon (1943) and Sunderland (1951): neurapraxia, axonotmesis, and neurotmesis.

Injury Type	What Happens to the Nerve	Recovery Potential	Typical Recovery Time	Treatment Approach
Neurapraxia	Nerve stretched but not torn; myelin sheath temporarily disrupted; axon intact	Full recovery expected	Days to 3 months	Physiotherapy: range of motion, monitoring
Axonotmesis	Axon disrupted but surrounding connective tissue (endoneurium) intact; nerve can regrow along existing pathway	Good recovery likely, but may not reach full strength	12 to 18 months	Physiotherapy: progressive ROM, strengthening, motor re-education
Neurotmesis	Nerve completely severed or avulsed from spinal cord; no intact pathway for regrowth	No spontaneous recovery; surgical repair required	1 to 3+ years (post-surgery)	Surgery (nerve graft, nerve transfer, muscle transfer) followed by long-term physiotherapy

According to NHS Scotland’s brachial plexus physiotherapy protocols, damaged nerve fibres regenerate at a rate of 1 to 3 millimetres per day once the pathway for regrowth is intact. That slow regeneration rate explains why recovery from axonotmesis takes 12 to 18 months and why post-surgical recovery from neurotmesis can take several years.

By anatomical location, brachial plexus injuries are classified as upper plexus (Erb’s palsy, affecting C5-C6), lower plexus (Klumpke’s palsy, affecting C8-T1), or total plexus (C5-T1). According to the PMC review on brachial plexus injuries in adults, 70-75% of traumatic injuries are supraclavicular, meaning the damage occurs above the collarbone where the nerve roots and trunks are most exposed. Upper plexus injuries account for 20-25% of cases and produce weakness in the shoulder and elbow. Lower plexus injuries account for 2-3.5% and affect the wrist and hand. Total plexus injuries, which involve all roots, make up 53% of surgical cases and produce the most severe functional loss.

Can a Brachial Plexus Injury Heal on Its Own?

Yes, a brachial plexus injury can heal on its own, but only in cases of neurapraxia, the mildest form of nerve injury. Neurapraxia involves temporary disruption of the nerve’s myelin sheath without damage to the underlying axon, and full recovery typically occurs within days to three months. These injuries are common in contact sports, where they are often called “stingers” or “burners,” and produce transient numbness, tingling, or weakness in the arm that resolves as the myelin repairs itself.

Axonotmesis injuries, where the axon itself is disrupted, can also heal without surgery because the surrounding connective tissue remains intact and provides a pathway for the nerve to regrow. Recovery from axonotmesis takes significantly longer, typically 12 to 18 months, and the final outcome may not reach the same level of function the patient had before the injury. During this long recovery window, physiotherapy plays a critical role in maintaining joint mobility and preventing the muscle wasting and joint contractures that would otherwise develop while the nerve slowly regenerates.

Neurotmesis injuries do not heal on their own. When the nerve is completely severed or avulsed from the spinal cord, there is no intact pathway for regrowth. These injuries require surgical intervention, and Mayo Clinic research indicates that delaying surgery beyond 2 to 6 months can reduce the likelihood of a successful repair. Early physiotherapy services are important even before surgery to preserve joint range of motion and prevent secondary complications.

What Are the Physiotherapy Treatment Options for Brachial Plexus Injuries?

The physiotherapy treatment options for brachial plexus injuries include passive and active range-of-motion exercises, progressive strengthening, motor re-education, sensory re-education, splinting and positioning, pain management modalities, and functional retraining. The specific combination of treatments depends on the severity of the nerve injury, the muscles affected, whether surgery has been performed, and the stage of recovery.

Range-of-motion exercises form the foundation of all brachial plexus rehabilitation. When muscles are paralysed or weakened because the nerve supply is disrupted, the joints those muscles control stiffen quickly. Shoulder external rotation, elbow flexion and extension, forearm supination and pronation, wrist flexion and extension, and finger flexion and extension must all be maintained through gentle passive movement performed by the physiotherapist and by the patient at home. Without consistent range-of-motion work, joint capsules shorten, soft tissues contract, and even if the nerve recovers fully, the joint may not move because the surrounding structures have tightened.

Progressive strengthening begins once the physiotherapist detects signs of nerve recovery through muscle testing. As motor function returns, typically graded on the Medical Research Council (MRC) scale from M0 (no contraction) to M5 (normal strength), the physiotherapist introduces gravity-eliminated exercises, then gravity-resisted exercises, then resistance exercises using bands and light weights. Motor re-education helps the brain relearn how to activate muscles that have been dormant for months. The physiotherapist uses visual feedback, tactile cueing, and repetitive task-specific practice to rebuild the neural pathways between the brain and the recovering muscles.

Sensory re-education is equally important for patients who have lost feeling in parts of the arm or hand. The physiotherapist uses graded tactile stimulation, texture discrimination exercises, and proprioceptive training to retrain the sensory cortex as nerve fibres regenerate into the skin and joints. Patients with persistent sensory deficits also need education on protecting insensate skin from burns, cuts, and pressure injuries.

What Are the Best Exercises for Brachial Plexus Injuries?

The best exercises for brachial plexus injuries are those that match the current stage of nerve recovery and target the specific muscles affected by the injury. In the early phase, passive range-of-motion exercises performed by the physiotherapist or a trained caregiver keep the shoulder, elbow, wrist, and finger joints mobile. Pendulum exercises for the shoulder, gentle elbow flexion and extension with support, and assisted wrist circles prevent the joint stiffness that develops rapidly in a paralysed limb.

As nerve function returns, active-assisted exercises transition to active exercises. Shoulder abduction against gravity, elbow curls without resistance, wrist extension with the forearm supported on a table, and finger spread exercises all rebuild the connection between the recovering nerve and the target muscle. An exercise rehabilitation programme prescribed by a physiotherapist progresses the difficulty in small increments to match the nerve’s slow regeneration rate. Resistance is added only when the muscle consistently achieves at least MRC grade 3 (movement against gravity).

For patients with upper plexus injuries (Erb’s palsy), shoulder external rotation exercises, deltoid strengthening, and biceps curls are priorities. For lower plexus injuries (Klumpke’s palsy), grip strengthening, finger dexterity exercises using therapy putty, and intrinsic hand muscle retraining take precedence. A systematic review published in Revista de Neurologia confirmed that physiotherapy interventions including constraint-induced movement therapy, kinesiotaping, electrotherapy, and splinting produce positive outcomes for upper limb function in brachial plexus palsy.

What Modalities Do Physiotherapists Use for Brachial Plexus Injuries?

Physiotherapists use several modalities alongside exercise to support brachial plexus injury recovery. Transcutaneous electrical nerve stimulation (TENS) delivers low-voltage electrical impulses through electrodes placed on the skin to reduce neuropathic pain. Neuromuscular electrical stimulation (NMES) sends targeted impulses to weakened muscles to maintain muscle bulk and facilitate early motor re-education while the nerve regenerates. A 2026 case report published in Frontiers in Rehabilitation Sciences documented full motor recovery after six months when physiotherapy was combined with NMES and progressive resistance training for a brachial plexus injury.

Therapeutic ultrasound promotes tissue healing by increasing blood flow and reducing inflammation around the injured nerve. Kinesiotaping supports weakened muscles, improves proprioceptive feedback, and stimulates blood circulation in the affected area. Acupuncture addresses neuropathic pain through targeted nerve stimulation, and Physiopedia’s clinical reference on brachial plexus injuries lists acupuncture alongside TENS and biofeedback as physiotherapy-delivered pain relief options. Laser therapy reduces inflammation and accelerates tissue repair at the cellular level, making it a useful adjunct for patients experiencing persistent pain or slow healing around the injury site.

What Is the Rehabilitation Protocol for a Brachial Plexus Injury?

The rehabilitation protocol for a brachial plexus injury follows a phased progression that matches the pace of nerve recovery. Because no two brachial plexus injuries are identical, the protocol must be individualised, but the general framework moves through three phases: early protection and maintenance, active recovery and strengthening, and functional retraining.

1. Phase 1: Early protection and maintenance (0-6 weeks post-injury or post-surgery). The goals are to prevent joint stiffness, manage pain, protect the healing nerve, and maintain muscle length. Treatment includes gentle passive range-of-motion exercises for the shoulder, elbow, wrist, and hand performed two to three times daily. Splinting may be used to keep the wrist and fingers in a functional position and prevent contractures. Pain management combines medication prescribed by the physician with physiotherapy modalities like TENS. Oedema control through compression garments and elevation prevents swelling from restricting joint movement.
2. Phase 2: Active recovery and strengthening (6 weeks to 6-12 months). As the physiotherapist detects early signs of nerve recovery through manual muscle testing, the programme transitions from passive to active-assisted and then fully active exercises. Gravity-eliminated exercises come first (moving the arm on a smooth surface or in water), followed by gravity-resisted exercises, then progressive resistance. Motor re-education and sensory re-education begin in this phase. The physiotherapist monitors nerve recovery regularly using the MRC grading scale and adjusts the programme accordingly.
3. Phase 3: Functional retraining and return to activity (6-12 months onward). The focus shifts to task-specific training that prepares the patient to return to daily activities, work, sports, or other functional goals. Activities of daily living practice (dressing, eating, grooming), grip and dexterity training, endurance building, and sport-specific or work-specific exercises dominate this phase. The physiotherapist sets measurable functional milestones and works with the patient to achieve them progressively.

Rehabilitation duration for brachial plexus injuries spans months to years, not weeks. NHS Scotland’s physiotherapy protocols emphasise that patients need to understand this timeline from the beginning, because unrealistic expectations about the speed of recovery can lead to frustration and poor adherence to the home exercise programme. Understanding physiotherapy frequency helps patients plan their commitment to the rehabilitation process.

When Should You Start Physiotherapy After a Brachial Plexus Injury?

You should start physiotherapy after a brachial plexus injury as soon as the injury is identified and the treating physician clears you for rehabilitation. For non-surgical cases, physiotherapy typically begins within the first one to two weeks after injury. For post-surgical cases, the surgeon specifies when movement can safely begin, usually after a period of immobilisation lasting two to four weeks to protect the nerve repair. The 2026 case report in Frontiers in Rehabilitation Sciences demonstrated that very early physiotherapy intervention optimises functional outcomes and prevents secondary complications like muscle atrophy even in patients with potential for spontaneous recovery.

How Does Physiotherapy Help After Brachial Plexus Surgery?

Physiotherapy helps after brachial plexus surgery by maintaining joint mobility during the immobilisation period, facilitating nerve-muscle reconnection as the repaired nerve regenerates, and rebuilding functional strength over the long recovery timeline. Post-surgical rehabilitation for brachial plexus repair is a long-term commitment that typically lasts one to three years or longer, because nerve tissue grows slowly and the muscles need extensive retraining once the nerve signal reaches them.

In the immediate post-surgical phase, the physiotherapist works within the restrictions set by the surgeon. Gentle passive range-of-motion exercises for joints not immobilised by the surgical splint prevent stiffness from spreading. Once the surgeon permits movement of the operated area (usually at two to four weeks), the physiotherapist begins careful passive range-of-motion exercises for the shoulder and elbow, gradually progressing based on healing.

A 10-year retrospective study published in PMC found that 85.3% of patients who underwent nerve transfer surgery achieved shoulder function recovery at MRC grade M3 or M4, and 84.38% achieved elbow flexion recovery at M3 or M4. The first signs of clinical reinnervation of the biceps muscle appeared at an average of 3 months and 9 days after surgery, according to a separate nerve transfer outcomes study in PMC. These milestones guide the physiotherapist’s progression of the exercise programme. When the physiotherapist detects the first flicker of voluntary muscle contraction, that is the signal to begin active-assisted exercises for that muscle group. Massage therapy during the post-surgical phase helps manage soft tissue tightness, reduce scar tissue adhesion around the surgical site, and improve circulation to the healing area.

What Is the Recovery Time for a Brachial Plexus Injury?

The recovery time for a brachial plexus injury ranges from a few weeks to several years, depending on the type and severity of the nerve damage. Neurapraxia injuries recover within days to three months, axonotmesis injuries take 12 to 18 months, and neurotmesis injuries treated with surgery require one to three years or more of rehabilitation before the final outcome becomes clear.

The slow pace of nerve regeneration drives the timeline. Damaged nerve fibres regrow at 1 to 3 millimetres per day, according to NHS Scotland’s brachial plexus protocols. For perspective, the distance from the neck to the fingertips in an average adult is approximately 80-90 centimetres. A nerve regrowing at 1mm per day would take more than two years to reach the hand from a neck-level injury. Nerve growth at the faster rate of 3mm per day reduces that to approximately 9-10 months, but the regenerating nerve must also form functional connections with the target muscles once it arrives, and those connections take additional months of motor re-education to become strong enough for practical use.

Age, overall health, the specific nerve roots involved, the quality of the surgical repair (if applicable), and the patient’s adherence to the physiotherapy programme all influence the final outcome. Younger patients generally recover faster because nerve regeneration is more efficient in younger tissue. Patients who attend physiotherapy consistently and follow their home exercise programme between sessions achieve better outcomes than those who do not.

What Are the Signs That a Nerve Is Healing?

The signs that a nerve is healing include tingling or “pins and needles” sensations moving down the arm (known as an advancing Tinel sign), the return of light touch sensation in previously numb areas, and the first visible flickers of voluntary muscle contraction in previously paralysed muscles. The physiotherapist monitors these signs at each session using manual muscle testing, sensory mapping, and the Tinel sign test (tapping along the nerve path to identify where the regenerating nerve front has reached). As the nerve regrows, the Tinel sign moves progressively further down the arm toward the hand, providing a measurable marker of regeneration progress.

Can Physiotherapy Restore Full Arm Function After a Brachial Plexus Injury?

Physiotherapy can restore full arm function after a brachial plexus injury in cases of neurapraxia and some cases of axonotmesis. For more severe injuries, physiotherapy significantly improves function but may not achieve a complete return to pre-injury levels. The final outcome depends on the severity and location of the nerve damage, whether surgery was performed, and the quality and consistency of rehabilitation. Even when full recovery is not possible, physiotherapy helps patients develop compensatory strategies, adaptive techniques, and sufficient functional strength to perform daily activities, return to work, and maintain independence. Knowing physiotherapy benefits for nerve injuries helps patients set realistic goals from the start.

How Painful Is a Brachial Plexus Injury?

A brachial plexus injury can be extremely painful, particularly when nerve roots are avulsed from the spinal cord. Neuropathic pain from brachial plexus avulsion has been described as a severe, crushing, or constant burning sensation that can persist for months or years. According to Mayo Clinic, this pain resolves within three years for most patients, but for some it becomes a chronic condition requiring ongoing management.

The pain from a brachial plexus injury differs from typical musculoskeletal pain because it originates from the damaged nerve itself rather than from injured tissue. Neuropathic pain responds poorly to standard painkillers like acetaminophen and ibuprofen. Medications commonly used include anti-epileptic drugs such as gabapentin and carbamazepine, and antidepressants such as amitriptyline, though Physiopedia notes that fewer than a third of patients report significant pain relief from medication alone. This is where physiotherapy-delivered pain management becomes critical.

Physiotherapists address brachial plexus pain through TENS, biofeedback, pain neuroscience education (PNE), and graded motor imagery. Pain neuroscience education helps the patient understand the neurological basis of their pain, which research has shown reduces the threat value the brain assigns to pain signals and improves the patient’s ability to engage in rehabilitation. For patients in Markham dealing with persistent neuropathic pain, a multidisciplinary approach that combines physiotherapy with complementary modalities produces the best outcomes.

Does Acupuncture Help With Brachial Plexus Injury Pain?

Yes, acupuncture helps with brachial plexus injury pain by stimulating the nervous system, improving local blood circulation, and triggering the release of endorphins, the body’s natural pain-relieving chemicals. Physiopedia’s clinical reference on brachial plexus injuries lists acupuncture as one of the physiotherapy-delivered modalities for pain control alongside TENS and biofeedback. Acupuncture is particularly useful for patients whose neuropathic pain responds poorly to medication, and it can be combined with other rehabilitation treatments without interference.

What Happens If a Brachial Plexus Injury Is Left Untreated?

If a brachial plexus injury is left untreated, the consequences include permanent joint contractures, irreversible muscle atrophy, chronic neuropathic pain, and permanent loss of arm function. The window for surgical repair narrows significantly after 6 months, and muscles that remain denervated for too long undergo irreversible fibrotic changes that no surgery or physiotherapy can reverse.

Without physiotherapy to maintain range of motion, the shoulder joint can develop adhesive capsulitis (frozen shoulder), the elbow can lock into a flexion contracture, and the wrist and fingers can curl into a fixed position. These secondary complications make recovery far more difficult even if the nerve eventually heals or is surgically repaired. Muscle atrophy begins within weeks of denervation. After approximately 18-24 months without nerve input, muscle tissue undergoes fibrosis, replacing contractile muscle fibres with scar tissue that cannot be reactivated even when the nerve regenerates.

Early intervention is critical. Even when the final treatment plan is not yet determined, starting physiotherapy immediately preserves the joints and muscles in a state ready to receive and respond to returning nerve signals. Patients who delay both medical evaluation and physiotherapy face significantly worse functional outcomes.

What Kind of Doctor Treats Brachial Plexus Injury?

A brachial plexus injury is treated by a team that may include a neurologist, an orthopaedic surgeon or neurosurgeon with peripheral nerve expertise, a physiotherapist, an occupational therapist, and a pain specialist. No single practitioner manages a brachial plexus injury alone; the complexity of the condition requires a coordinated multidisciplinary approach.

The neurologist or surgeon performs the initial diagnostic workup, including electromyography (EMG), nerve conduction studies, and imaging (MRI or CT myelography) to determine the type, location, and severity of the injury. The surgeon decides whether operative repair is needed and, if so, performs the nerve graft, nerve transfer, or muscle transfer procedure. The registered physiotherapist manages the rehabilitation process from the earliest stage through to the final recovery phase, coordinating with the surgeon on exercise progression and activity restrictions.

In Ontario, physiotherapists are primary care practitioners, meaning patients can access physiotherapy directly without a physician referral. For brachial plexus injuries specifically, however, most patients are referred by the treating surgeon or neurologist because the rehabilitation programme must align precisely with the nerve injury type and any surgical repair performed. A clinic that offers custom orthotics can also fabricate supportive splints for the wrist and hand during the recovery process.

Frequently Asked Questions

What Is the Best Sleeping Position for Brachial Plexus Injury?

The best sleeping position for a brachial plexus injury is on your back with the affected arm supported on a pillow at your side, keeping the shoulder in a neutral position and the elbow slightly bent. This position avoids stretching the healing nerves and reduces pressure on the injured area. Side sleeping on the unaffected side with a pillow supporting the injured arm is an alternative. Avoid sleeping on the affected side, as the body’s weight compresses the shoulder and can increase nerve irritation and pain.

How Long Does Physiotherapy Last for a Brachial Plexus Injury?

Physiotherapy for a brachial plexus injury typically lasts several months to several years, depending on the severity of the nerve damage and whether surgery was performed. Mild neurapraxia injuries may require only 4-8 weeks of physiotherapy. Axonotmesis injuries require 12-18 months of progressive rehabilitation. Post-surgical cases involving nerve grafts or transfers often need 1-3 years of structured physiotherapy, with visits tapering from multiple times per week in the early phase to periodic check-ins during the later stages of recovery.

Can You Drive With a Brachial Plexus Injury?

Whether you can drive with a brachial plexus injury depends on the severity of your arm impairment and the requirements of your provincial driving regulations. Patients with significant weakness or paralysis in the affected arm may not be able to safely control a vehicle. Your physiotherapist and physician can assess your functional capacity and advise on when returning to driving is safe. Some patients with permanent upper limb impairment can drive with adaptive vehicle modifications.

Is Brachial Plexus Injury Covered by Insurance in Ontario?

Yes, physiotherapy for a brachial plexus injury is typically covered by extended health insurance plans in Ontario from providers like Sun Life, Manulife, Canada Life, Green Shield, and Desjardins, subject to plan limits. Brachial plexus injuries caused by motor vehicle accidents are covered under Ontario’s automobile insurance system, and workplace injuries are covered by WSIB. Seniors aged 65 and older can access OHIP-funded physiotherapy. No physician referral is required to start physiotherapy in Ontario.

What Is the Difference Between Erb’s Palsy and Klumpke’s Palsy?

Erb’s palsy involves damage to the upper brachial plexus nerve roots (C5-C6), causing weakness in the shoulder and elbow. The arm hangs at the side in a position called “waiter’s tip.” Klumpke’s palsy involves the lower nerve roots (C8-T1), causing weakness in the wrist, hand, and fingers, often producing a “claw hand” deformity. Erb’s palsy accounts for 20-25% of traumatic brachial plexus injuries, while Klumpke’s palsy accounts for only 2-3.5%, according to clinical reviews published in PMC.

Can Massage Therapy Help With Brachial Plexus Recovery?

Yes, massage therapy helps with brachial plexus recovery by managing chronic oedema, reducing soft tissue tightness around the shoulder and neck, improving blood circulation to the affected arm, and breaking down scar tissue adhesions after surgery. Physiopedia lists massage therapy alongside compression garments and education as part of the oedema management strategy for brachial plexus patients. Massage therapy also addresses compensatory muscle tension that develops in the neck, upper back, and unaffected arm as the patient adapts to using one arm during recovery.

The Takeaway

A brachial plexus injury disrupts the nerve network that controls movement and sensation in the entire arm. The severity ranges from mild, self-resolving stretch injuries to complete avulsions that require surgical reconstruction and years of rehabilitation. Physiotherapy is the constant across all severity levels. From the earliest days after injury through the final stages of functional recovery, a physiotherapist maintains joint mobility, prevents contractures, rebuilds strength as nerves regenerate, retrains motor and sensory pathways, and manages pain through evidence-based modalities.

The research supports early and sustained physiotherapy. Post-surgical studies show 84-85% of patients achieving functional recovery at MRC grade M3 or M4 with proper rehabilitation. The key is starting early, staying consistent, and working with a physiotherapist who understands nerve injury rehabilitation. For patients in the Markham area, KC Rehab offers comprehensive physiotherapy and multidisciplinary rehabilitation built around treating the root cause of every condition. Call 905-205-1668 or book online to schedule your initial assessment.