PERIPHERAL NERVE INJURIES OF THE UPPER EXTREMITY IN OVERHEAD ATHLETES

Authors

  • Gerald Rolanson Yudy Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Mataram
  • Nour Hatem Mohamed Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Mataram
  • Warlia Mursida Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Mataram
  • Ayeshia Ryasti Mustario Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Mataram
  • Bayu Firdaus Siradz Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Mataram

DOI:

https://doi.org/10.36002/js.v5i2.5893

Keywords:

Peripheral nerve injury, Overhead athletes, Neuropathy, Upper extremity

Abstract

Peripheral nerve injuries (PNIs) present unique diagnostic and therapeutic challenges in overhead athletes due to the complex biomechanics of sports involving rapid, high-velocity arm elevations and rotations. These injuries result from repetitive microtrauma, traction, and dynamic compression, often masked by overlapping musculoskeletal pathologies. This literature review synthesizes current findings regarding the mechanisms, pathophysiology, clinical presentations, classifications, diagnostic modalities, and management strategies for upper extremity PNIs in overhead athletes. Diagnostic pathways rely on clinical history, targeted physical examinations, electrodiagnostic (EDx) studies, and advanced imaging such as neuromuscular ultrasound and magnetic resonance neurography. While the majority of cases respond well to structured conservative rehabilitation and activity modification, refractory lesions or severe axonal loss require surgical decompression or neurolysis. In conclusion, early functional diagnostic tools, standardized severity scoring models, and evidence-based rehabilitation protocols are essential to optimize patient outcomes and safe returns to competitive play.

References

Akuthota, V., & Herring, S. A. (2009). Nerve and vascular injuries in sports medicine. New York: Springer. https://doi.org/10.1007/978-0-387-76600-3

Bottros, M. M., Aubuchon, J. D., McLaughlin, L. N., Altchek, D. W., Illig, K. A., & Thompson, R. W. (2017). Exercise-enhanced, ultrasound-guided anterior scalene muscle/pectoralis minor muscle blocks can facilitate the diagnosis of neurogenic thoracic outlet syndrome in the high-performance overhead athlete. The American Journal of Sports Medicine, 45(1): 189–194. https://doi.org/10.1177/0363546516665801

Bowers, R. L., Cherian, C., & Zaremski, J. L. (2022). A review of upper extremity peripheral nerve injuries in throwing athletes. PM & R : the journal of injury, function, and rehabilitation, 14(5), 652–668. https://doi.org/10.1002/pmrj.12762

Chan, J. S. Y., & Ip, J. W. Y. (2018). Upper limb nerve injuries in sport. In Hand and wrist injuries in combat sports: A guide to diagnosis and treatment (pp. 297–303). Springer International Publishing. https://doi.org/10.1007/978-3-319-52902-8_18

Conti, M. S., Camp, C. L., Elattrache, N. S., Altchek, D. W., & Dines, J. S. (2016). Treatment of the ulnar nerve for overhead throwing athletes undergoing ulnar collateral ligament reconstruction. World Journal of Orthopedics, 7(10): 650–656. https://doi.org/10.5312/wjo.v7.i10.650

Dowdle, S. B., & Chalmers, P. N. (2020). Management of the ulnar nerve in throwing athletes. Current Reviews in Musculoskeletal Medicine, 13(4): 449–456. https://doi.org/10.1007/s12178-020-09639-7

Dutton, R. A., Norbury, J., & Colorado, B. (2024). Sports-related peripheral nerve injuries of the upper limb. Muscle & Nerve, 69(5): 527–542. https://doi.org/10.1002/mus.28057

Erickson, B. J., Chalmers, P. N., D’Angelo, J., Ma, K., & Romeo, A. A. (2019). Performance and return to sport after ulnar nerve decompression/transposition among professional baseball players. The American Journal of Sports Medicine, 47(5): 1124–1129. https://doi.org/10.1177/0363546519829159

Farag, J. I., McDougall, A. N., & Catapano, M. (2025). Common sports-related nerve injuries seen by the electrodiagnostic medical consultant. Muscle & Nerve, 71(5): 715–731. https://doi.org/10.1002/mus.28298

Hussain, G., Wang, J., Rasul, A., Anwar, H., Qasim, M., Zafar, S., Aziz, N., Razzaq, A., Hussain, R., de Aguilar, J. L. G., & Sun, T. (2020). Current status of therapeutic approaches against peripheral nerve injuries: A detailed story from injury to recovery. International Journal of Biological Sciences, 16(1): 116–134. https://doi.org/10.7150/ijbs.35653

John, T. S., Fishman, F., Sharkey, M. S., & Carter, C. W. (2020). Current concepts review: Peripheral neuropathies of the shoulder in the young athlete. The Physician and Sportsmedicine, 48(2): 131–141. https://doi.org/10.1080/00913847.2019.1676136

Lolis, A. M., Falsone, S., & Beric, A. (2018). Common peripheral nerve injuries in sport: Diagnosis and management. In Handbook of clinical neurology (Vol. 158, pp. 401–419). Elsevier. https://doi.org/10.1016/B978-0-444-63954-7.00038-0

Lorei, M. P., & Hershman, E. B. (1993). Peripheral nerve injuries in athletes. Sports Medicine, 16(2): 130–147. https://doi.org/10.2165/00007256-199316020-00005

Matzkin, E., Suslavich, K., & Wes, D. (2016). Swimmer's shoulder: Painful shoulder in the competitive swimmer. Journal of the American Academy of Orthopaedic Surgeons, 24(8): 527–536. https://doi.org/10.5435/JAAOS-D-15-00313

Menorca, R. M. G., Fussell, T. S., & Elfar, J. C. (2013). Nerve physiology. Hand Clinics, 29(3): 317–330. https://doi.org/10.1016/j.hcl.2013.04.002

Niemann, A., Juzeszyn, L., Kahanov, L., & Eberman, L. (2013). Suprascapular neuropathy in collegiate baseball player. Asian journal of sports medicine, 4(1), 76–81. https://doi.org/10.5812/asjsm.34537

Olivo, R., & Tsao, B. (2017). Peripheral nerve injuries in sport. Neurologic Clinics, 35(3): 559–572. https://doi.org/10.1016/j.ncl.2017.03.010

Petraglia, A. L., Bailes, J. E., & Day, A. L. (2015). Handbook of neurological sports medicine: Concussion and other nervous system injuries in the athlete. Human Kinetics.

Povlsen, S., & Povlsen, B. (2018). Diagnosing thoracic outlet syndrome: Current approaches and future directions. Diagnostics, 8(1), Article 21. https://doi.org/10.3390/diagnostics8010021

Radić, B., Radić, P., & Duraković, D. (2018). Peripheral nerve injury in sports. Acta Clinica Croatica, 57(3): 561–569. https://doi.org/10.20471/acc.2018.57.03.20

Robb, A., & Sajko, S. (2009). Conservative management of posterior interosseous neuropathy in an elite baseball pitcher’s return to play: A case report and review of the literature. Journal of the Canadian Chiropractic Association, 53(4): 300–310.

Silver, S., Ledford, C. C., Vogel, K. J., & Arnold, J. J. (2021). Peripheral nerve entrapment and injury in the upper extremity. American Family Physician, 103(5): 275–285. https://www.aafp.org/pubs/afp/issues/2021/0301/p275.html

Sunderland, S. (1951). A classification of peripheral nerve injuries producing loss of function. Brain, 74(4): 491–516. https://doi.org/10.1093/brain/74.4.491

Troyer, W., Gardner, J. E., & Bowers, R. L. (2023). Neurogenic thoracic outlet syndrome in the overhead and throwing athlete: A narrative review. PM&R, 15(5): 629–639. https://doi.org/10.1002/pmrj.12816

Zampeli, F., Marin Fermin, T., & Hagert, E. (2024). Throwing athletes and the role of nerves in shoulder pain. Aspetar Sports Medicine Journal. 13: 28-36.

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Published

2026-08-29

How to Cite

Yudy, G. R., Mohamed, N. H., Mursida, W., Mustario, A. R., & Siradz, B. F. (2026). PERIPHERAL NERVE INJURIES OF THE UPPER EXTREMITY IN OVERHEAD ATHLETES. JURNAL KESEHATAN, SAINS, DAN TEKNOLOGI (JAKASAKTI), 5(2), 376–385. https://doi.org/10.36002/js.v5i2.5893

Issue

Vol. 5 No. 2 (2026): JURNAL KESEHATAN, SAINS, DAN TEKNOLOGI (JAKASAKTI)

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Articles

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.