Brachial plexus injuries in the contact athlete: a narrative review

Brachial plexus injuries (BPIs) are a rare but potentially devastating injury among contact athletes. More common injuries, such as "burners" or "stingers", indicate a temporary and less severe insult to either the nerve roots or plexus. The aim of this review is to discuss this spectrum of injuries in their epidemiology, mechanism in contact sports, diagnosis, and treatment.

This literature review utilized key terms to search manuscripts available in English from inception to October 2024 within three research databases.

BPIs among contact athletes occur on a spectrum from neuropraxia to neurotmesis. Neuropraxia is very common among contact athletes with approximately a 49-65% incidence among career football players with the most common mechanism being a traction injury. Most of these resolve within minutes to hours. Axonotmesis and neurotmesis can be far more severe injuries and require further investigation if not resolved by 2-3 weeks. The majority of athletes who suffer neuropraxic injuries will return to sport with minimal to no time missed, however, more severe injuries portend variable outcomes.

BPIs are common among contact athletes and involve a spectrum of nerve damage, of which most are self-limiting. However, further evaluation is warranted when symptoms last beyond 2-3 weeks. Future studies should focus on treatment algorithms and long-term outcomes, including return to sport.