Ace Physiotherapy and Sports in Singapore
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+65 81535374 -
ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
#08-03 Singapore 428766 -
Opening Hours
Mon to Fri: 08:00am - 8:00pm -
Opening Hours
Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Long Thoracic Nerve Release
Long Thoracic Nerve (LTN) release is a surgical procedure carried out to relieve pressure on the long thoracic nerve. The LTN is a peripheral nerve that arises from the cervical spine (neck vertebrae), travels through the middle scalene muscle, extends down the shoulder, and runs along the outer surface of the serratus anterior muscle. This muscle plays a vital role in stabilizing the scapula against the rib cage and enabling forward and outward shoulder movements.
When the long thoracic nerve is compressed or injured, the serratus anterior loses its function, resulting in scapular winging — a condition where the shoulder blade protrudes outward like a wing. This abnormal movement pattern, known as scapular dyskinesia, can cause pain and increase the risk of future shoulder problems. To correct this, an LTN release surgery is performed.
Compression often occurs due to contraction of the middle scalene muscle, which pinches the nerve and leads to muscle dysfunction. In some cases, trauma or overstretching, such as from a fall on an outstretched arm, can also damage the nerve. During the procedure, part of the middle scalene muscle is resected to allow the nerve to glide freely without obstruction. After surgery, physiotherapy is essential to retrain the shoulder muscles, restore stability, and reduce the likelihood of recurring issues.
Physiotherapy Before Long Thoracic Nerve Release
Pre-surgical physiotherapy is highly recommended prior to long thoracic nerve (LTN) release. At Acephysiosports.com, physiotherapy can help manage symptoms conservatively, maintain shoulder function, and ensure correct movement patterns. Pre-surgery rehabilitation also prepares your shoulder for surgery and creates a strong foundation for post-operative recovery, helping to speed up rehabilitation. Treatments typically include:
- Cryotherapy (ice therapy)
- Pain management
- Strengthening of surrounding musculature
- Massage and myofascial release
- Advice on surgery and post-operative care
Symptoms After Long Thoracic Nerve Release
Following LTN release surgery, your arm will usually be supported in a protective sling to aid recovery and protect the shoulder. Common post-operative symptoms include:
- Pain and swelling
- Stiffness
- Temporary numbness from anesthesia (usually resolves within a few hours)
- Nausea
Physiotherapy After Long Thoracic Nerve Release
Post-surgery physiotherapy is critical to restore normal shoulder function, retrain muscles, and prevent future complications. Acephysiosports.com provides a personalised rehabilitation programme tailored to your needs. Treatment initially focuses on acute symptom management and gradually progresses to restoring full movement, strength, and functional use.
Weeks 1–3
Early rehabilitation focuses on minimizing post-operative complications, managing pain, and initiating gentle movement. Treatment includes:
- Cryotherapy (ice) and pain control
- Gentle passive and active range of motion exercises
- Sling management (day and night) with recommended exercises
- Scapular stabilisation
- Active movement of fingers, hand, wrist, and elbow to prevent stiffness
- Wound care and education
Weeks 4–8
During this phase, therapy aims to restore functional movement through targeted strengthening, scapular control, and correct biomechanics. Treatment includes:
- Active and passive shoulder range of motion exercises
- Scapular stabilisation and serratus anterior re-education
- Proprioceptive and neural mobilisation exercises
- Progressive strengthening
- PNF (Proprioceptive Neuromuscular Facilitation) techniques
- Stretching and taping
Weeks 8+
Physiotherapy continues to progress exercises to strengthen the scapula and serratus anterior muscles, correct biomechanical faults, and improve endurance. Due to the delicate nature of nerves, full recovery may take 6–12 months.
Summary
Long thoracic nerve release is a surgical procedure performed to relieve compression of the LTN. Damage to this nerve can paralyse the serratus anterior, causing scapular winging, abnormal shoulder mechanics, pain, and increased risk of further shoulder problems. A comprehensive physiotherapy programme with Acephysiosports.com is essential both before and after surgery to restore strength, movement, and normal shoulder function, ensuring optimal recovery and preventing recurrence.
To arrange an assessment with AcephysioSports.com, please contact us or call +65 8153 5374. Alternatively, you can book an appointment online today!
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