What is the role of rehabilitation in the treatment of a spinal accessory nerve (SAN) injury?

Updated: Mar 04, 2020
  • Author: Rohan R Walvekar, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Rehabilitation in the form of physical and occupational therapy can provide significant functional benefit and improvement of pain. The goal of rehabilitation is to promote wide passive range of motion and gradually active motion to prevent shoulder dysfunction due to adhesive capsulitis or frozen shoulder. [5]

Maintaining proper shoulder alignment is extremely important for effective rehabilitation because it reduces the mechanical tension on the scapula and shoulder girdle. Elevation and medialization of the scapula reduces the level of functional deficit of the trapezius muscle. [44]

The affected limb can be "unloaded" with the following recommendations to the patient: [20]

  • Avoid carrying heavy weights on the affected side.

  • Hook the thumb in a pants pocket or put the hand of the affected side in the pocket, which can provide significant relief.

  • Use an arm sling to reduce pain; however, this can be counterproductive because it can prevent functional activities of the affected arm.

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