Planet Muscle

Q: Jeff, I herniated a cervical disc causing immediate flaccid paralysis of my left triceps long head, left pectoralis major and left latissimus dorsi. I had a discectomy about 3 weeks after paralysis started setting in. My pec, triceps and lat have all undergone atrophy despite hours of hard work in my home gym. I know I had degeneration of the C 7 nerve root and need to wait at least 200 days for the nerve to regenerate back and hopefully re-fire. Any recommendations?

A: It is difficult to know the ultimate course as one does not know the extent of actual denervation and/or damage to the nerve roots. With some severe denervation, if too much time has past, little can return the muscle from recovering from subsequent atrophy. Axonal regeneration is slow and may not be complete. To rehab the long head, put your training partner to work. Have him give you resistance as you get in the skull crusher position with you arm way over your head (bent and straight), at your elbow. When you do manual and light DB triceps kickbacks, as you finish elbow joint extension, try to extend the humerus up and back. This will also work the lat in its extension function.

Also, standing, (in anatomical position), both with your arm flexed at the elbow (and straight); move your arm back as far as you can into extension while he applies resistance. He can apply resistance closer to the shoulder to start and then work down your arm over time, as you get stronger.

As well, move into an arm fully-extended position and try to hold this position, as he pushes your arm into flexion. You are stronger negatively so it may be wisest to start with this approach.

Try using ‘quick icing’, tapotement and vibration before trying any exercise. Your training partner can lightly tap (repetitively), or shake your upper triceps, or tap over the motor point which is a couple of inches superior to the elbow joint (avoid the ulna nerve). He can also do the same ‘light thudding’ into your lats for 20 seconds or so, before you try any exercise.

The “quick ice” is done by taking an ice cube and stroking it across that motor point in the direction of the line of your muscle fibers for 2-5 seconds. Rest 2-3 seconds, repeat, and do that 20 times before trying triceps exercise. Do this in addition to ultrasound, diathermy, varying other heat and electrical stimulation, all before exercise. Don't 'over push' the muscles either.