{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:48:43Z","timestamp":1777387723466,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>High-intensity repetitive athletic activities may predispose the brachial plexus to repetitive stretch, compression, and subsequent injury, although painless shoulder weakness is a rare event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The physical examination and electrodiagnostic findings in a series of United States Navy special warfare trainees who presented with acute painless shoulder weakness are presented, along with subsequent treatment and return-to-duty timeline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Case series; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From August 2005 to August 2006, a total of 11 of 212 (5%) Navy Basic Underwater Demolition School trainees were identified with acute onset (&lt;3 weeks) painless shoulder weakness without any prior shoulder injury. In all shoulders, symptoms began during a telephone pole lift-carry drill. All trainees underwent serial examinations, electrodiagnostic testing, and a comprehensive rehabilitation program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Physical examination revealed universal weakness in flexion and abduction and electrodiagnostic studies confirmed injury to the C5-6 area of the brachial plexus (axillary, suprascapular, and musculocutaneous). All 11 patients were removed from training and started on a physical therapy program until functional recovery at a mean of 21 weeks after onset of symptoms (range, 12-24). All 11 resumed military activities; however, only 6 completed the Navy Basic Underwater Demolition School program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In physically intense training or athletic environments, injuries to the upper brachial plexus may present with various forms of upper extremity dysfunction, including painless shoulder weakness. This information provides insight into a potentially debilitating shoulder problem and offers guidance on future training principles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546508328101","type":"journal-article","created":{"date-parts":[[2009,1,5]],"date-time":"2009-01-05T18:13:04Z","timestamp":1231179184000},"page":"175-180","source":"Crossref","is-referenced-by-count":9,"title":["Acute Painless Shoulder Weakness during High-Intensity Athletic Training"],"prefix":"10.1177","volume":"37","author":[{"given":"LT Tyler","family":"Vachon","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Naval Special Warfare Center, San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher B.","family":"Dewing","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel J.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander Y.","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew T.","family":"Provencher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,1,7]]},"reference":[{"key":"bibr1-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410120320"},{"key":"bibr2-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503260731"},{"issue":"3","key":"bibr3-0363546508328101","first-page":"277","volume":"96","author":"Doi K.","year":"2002","journal-title":"J Neurosurg."},{"key":"bibr4-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-200209000-00011"},{"key":"bibr5-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8619(01)00007-X"},{"key":"bibr6-0363546508328101","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198163030-00032"},{"key":"bibr7-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMicm970647"},{"key":"bibr8-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1007\/BF00343859"},{"key":"bibr9-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1177\/036354658901700512"},{"key":"bibr10-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.5.1407"},{"key":"bibr11-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.54.3.241"},{"key":"bibr12-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199911000-00006"},{"key":"bibr13-0363546508328101","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199609000-00018"},{"key":"bibr14-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2004.09.004"},{"key":"bibr15-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.79B5.7679"},{"key":"bibr16-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1979.03290400040019"},{"key":"bibr17-0363546508328101","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.08.003"},{"key":"bibr18-0363546508328101","unstructured":"SongcharoenP., ShinAY Brachial plexus injury: acute diagnosis and treatment. 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