My three-year old daughter had a brachial plexus injury at birth. She’s had physical therapy and is slowly getting better but she still can’t lift her arm over her head. Will this ever improve?

You didn’t say if she has had any surgery or just the physical therapy. Surgery is often advised when the child with a brachial plexus palsy doesn’t have full use of the arm. Doctors differ as to how soon that should be done. Most agree it should be at least evaluated by age 12 months.

Researchers at the Brachial Plexus Injury Center in Pittsburgh made a recent discovery. Ten children with brachial plexus palsy couldn’t raise their arms out to the side past 90 degrees.

Surgery was done and they found a second nerve called the axillary nerve was the problem. Scarring and muscle tightness had trapped the nerve. Releasing the nerve restored motion for eight of the 10 children.

Perhaps your child has a secondary problem. Has she been seen by an orthopedic surgeon or neurology specialist? It sounds like now would be a good time for some close follow-up.