RESIDENTS CASE REPORT: MUSCULOCUTANEOUS NERVE INJURY IN A COLLEGIATE BASEBALL PITCHER. 2020

Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
Baylor University, Waco, TX, USA.

BACKGROUND Literature regarding musculocutaneous nerve injuries among the athletic population is scarce, with only several reported clinical cases among baseball and softball pitchers. OBJECTIVE To present a unique case of a musculocutaneous nerve injury to aid in clinician awareness and propose innovative rehabilitation practices that may facilitate improved patient outcomes during recovery. METHODS A 23-year-old Division 1 NCAA collegiate baseball pitcher presented with vague anterior arm pain following a pre-season game. The athlete described the pain as an "intense stretch" of his right arm that occurred during his last pitch. The initial evaluation identified tenderness over the right distal bicep. All shoulder and elbow orthopedic tests to assess shoulder impingement, labral pathologies, and glenohumeral instability were unremarkable. Increased neural tension was also noted with upper limb neurodynamic testing of the median and ulnar nerves on the right arm compared bilaterally. Electromyography (EMG) testing confirmed a right upper and mid-brachial plexus stretch injury with the primary involvement of the musculocutaneous nerve. Rehabilitation focused on restoring strength deficits and diminishing neural tension. Blood flow restriction (BFR) was introduced on the uninvolved limb to reduce deficits in bicep musculature strength. Once the athlete regained bicep strength and forearm sensation, he was progressed from flat-ground throwing activities to throwing off the mound. RESULTS A reduction in neural tension during neurodynamic testing of the right arm, improvement of bicep brachii deficits seen between the right and left limbs, and restoration of sensation in the right lateral forearm enabled a progressive return to sport. CONCLUSIONS Due to vague reports and inconclusive findings, the initial presentation of musculocutaneous nerve injuries may be mistaken for other conditions such as a biceps brachii strain. Further -documentation of this injury and rehabilitation procedures are needed to enhance patient outcomes.

UI MeSH Term Description Entries

Related Publications

Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
November 2025, Cureus,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
March 2021, Journal of orthopaedic case reports,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
October 2025, Journal of orthopaedic case reports,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
January 1999, The American journal of sports medicine,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
October 2022, JBJS case connector,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
November 2014, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
October 2013, JBJS case connector,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
December 2011, Journal of child neurology,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
September 2008, Clinical orthopaedics and related research,
Ashlyne P Vineyard, and Andrew R Gallucci, and Samuel R Imbus, and James C Garrison, and John E Conway
July 1995, International journal of occupational and environmental health,
Copied contents to your clipboard!