Shoulder Strengthening Exercises for Children With Erb's Palsy

Erb's palsy is a type of brachial paralysis resulting from birth complications or trauma to newborns. Although Erb's paralysis and other types of birth complications are steadily decreasing thanks to medical advances and technologies, the American Academy of Orthopedic Surgeons reports that Erb's palsy still occurs in one to two babies of every 1,000 born. Children with Erb's palsy can be easily diagnosed and treated, however, with physical and occupational therapy.

The Role of the Doctor

• If your child develops Erb's paralysis as a result of birth complications, your doctor may be able to diagnose the condition immediately. Most parents, however, notice their child's brachial palsy within the first few weeks, when the child does not move the arm when rolled to one side. If your child appears to have brachial paralysis, ask your doctor about diagnosing the specific condition and severity before beginning a therapy plan for strengthening the arm.

The Role of the Therapist

• In treating Erb's palsy, you should work with a physical therapist and occupational therapist to develop strength and mobility in the entire arm and to help your child develop effective functional use of the affected hand. The therapist will assess the type of shoulder strengthening that needs to be done by looking at the range of motion, sensitivity and strength of the joint, as well as how the child uses the arm. The physical therapist will do shoulder strengthening exercises for Erb's paralysis that focus on alleviating tension in the joint and developing the ability to move the arm, while the occupational therapist will help the child strengthen the shoulder, arm, wrist and hand through play and activities that put the affected arm to use.

The Role of the Parent

• As a parent, you can also participate in the therapy for your child's Erb's palsy, employing range of motion exercises at home as directed by your therapist. Children with Erb's palsy benefit from gentle massaging of the arm and shoulder, as well as regular range of motion exercises. If the child's joint is stiff, however, do not force the exercises. Instead, use a mild heat pack to loosen the stiffness and perform only slight movements until the joint loosens. You can also help your child's recovery from brachial paralysis by stimulating sensation in the arm and shoulder using different textured objects.

Ongoing Treatment

• While the recovery time for most cases of brachial paralysis is three to six months after birth, some severe cases of Erb's palsy will require surgery for nerve grafting, tendon transfer or scar tissue removal to facilitate use of the affected arm. Many children with Erb's palsy also will continue to favor one arm throughout development, and occupational therapy exercises that encourage the child to use and strengthen the affected arm may be necessary throughout early childhood.