I Am: Mike’s Long Thoracic Nerve

If you have ever seen the movie Fight Club you may remember Ed Norton’s dictation of certain discovered snippets from an unknown author that go something like this. “I am Jack’s Medulla Oblongata”. Throughout school I was always trying to figure out ways to remember random parts of the body and their functions better. As I caught Fight Club on TV a couple weeks ago, I could not shake the effectiveness of the simple phrase “I am” and wish I had remembered it years ago.

Due to the fact that if something is not well known, it is likely to be ignored, I am doing a tribute to the long thoracic nerve,  an often overlooked nerve originating in the cervical spine, that when dysfunctional can present similarly to rotator cuff injury, and/or cervical spine pain.

I am Mike’s Long Thoracic Nerve. I originate from the cervical spine nerve roots of C5-C7. I typically run through the middle scalene muscle but my C7  root likes to take a different path in front of the muscle. I’m usually not one for attention so I usually hang out in the shadows of the brachial plexus, where I finally find my way down to the surface of the Serratus Anterior.

I’m a pretty superficial guy, but sensitive at the same time. I tend to get hurt even taking part in high pressure situations (like carrying a heavy bag on the shoulder for a long time). I’m also frequently hurt by being stretched to my limits. When I’m not feeling well I tend get angry, making Mike feel a burning or tingling sensation under his shoulder blade. It is also possible that I can completely shut down, causing Mike’s scapula to wing.

I usually get ignored, like I said I am not one for attention, until all other parts have been checked out. Usually my well known friends the rotator cuff and the upper traps get all the focus. Once I am given some attention, what to do with me is the next question. Am I being squeezed by my origin at the cervical spine, or have I been irritated along my way to the Serratus Anterior? It’s up to you to figure out. Just remember as you are trying to figure out what’s wrong with Mike’s shoulder, I might be hanging out in the shadows waiting to be discovered. I am Mike’s Long Thoracic Nerve, and I am sick of being ignored.

For more information about the long thoracic nerve click here.

3 responses to “I Am: Mike’s Long Thoracic Nerve

  1. I had a client once that was a mail carrier and she was off with a workplace injury that no docs had figured out.

    Strangely, this was an obvious potential culprit since her scapula was winging like crazy. I couldn’t figure out why it had been missed. After I suggested this possibility and she had some tests this proved to be the case.

    With all the emphasis on strengthening the serratus out there, you’d think more people would be aware of this nerve.

    Thanks for pointing it out Mike!

    • Mark,
      All it takes is an extra second to think about what is really going on. Even opening an anatomy book is not a bad thing every once and a while.

      Unfortunately, many people just get frustrated when the serratus somehow will not get stronger or the winging does not improve with a million rows/ext/scap punches and THEN look for the L.T.N.

      As we know, most times the problem is the result of something from somewhere else (ex: cervical spine). Thanks for the comment Mark.

  2. Hi Mike,
    Sure could have used this site 10 years ago when my long thoracic nerve was severed in an auto accident. I saw 13 highly respected specialists who at least knew what the injury was, and then called in coworkers to stare in wonder at my “wing.” But no one knew exactly what to do. It’s been a wild ride!

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