Brachial plexus palsy following a training run with a heavy backpack

Area of Science:

• Neurology
• Sports Medicine
• Military Health

Background:

• Brachial plexus injuries are uncommon, especially in the infraclavicular region.
• Heavy load carriage during strenuous exercise can pose risks to peripheral nerves.

Observation:

• A 23-year-old soldier experienced progressive sensory loss and weakness in his right arm after a 12km run with a 70kg load.
• Symptoms persisted for 3 months, with no identifiable compression on MRI or USS.
• Surgical exploration revealed ischemic neuropathy with post-injury fibrosis.

Findings:

• The patient's brachial plexus injury was attributed to prolonged, strenuous activity with heavy load carriage.
• Ischemic neuropathy and fibrosis were confirmed as the underlying pathology.

Implications:

• This case underscores the rarity of infraclavicular brachial plexus injuries from backpack use in military training.
• Military training regimens require critical appraisal to mitigate risks of exercise-induced nerve damage.
• Awareness of such injuries is crucial for timely diagnosis and management in physically active populations.