Unilateral cervical nerve injuries: brachial plexopathies

Brachial plexus injuries are frequently encountered in sports. Classically, the symptoms include transient burning, pain, and occasionally weakness of an isolated upper extremity resulting from a peripheral nerve injury of varying degrees. Persistent symptoms or recurrent injuries may necessitate imaging such as electromyography. Medical personnel should be familiar with brachial plexus anatomy and the common nerve injury mechanisms of compression or traction. On-field assessment includes evaluation for potentially more serious neurologic injuries and possible return to play when symptoms have resolved and the athlete has good range of motion and strength. Evidence-based guidelines are largely lacking, resulting in challenging evaluation and return-to-play decisions. Management focuses on improving neck range of motion and strength in addition to assessing for proper sport-specific technique. Additionally, enhancing protective equipment may prevent brachial plexus injuries. Currently, global screening via imaging of athletes is not recommended.