PERIPHERAL NERVE INJURIES OF THE UPPER EXTREMITY IN OVERHEAD ATHLETES

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.