Reinnervation
This represents diagrammatically a surviving nerve fiber – represented by the blue lines, capturing or reinnervating, the light colored muscle fibers (see EDX) muscle fibers that had lost their nerve supply. This reinnervation takes place over several weeks and can continue for up to three years. The result is that long and finally large motor units are observed on the EMG and from knowledge of anatomy an accurate assessment of the site of previous nerve damage can be made. Moreover these EMG changes usually remain fixed for life, so even years after damage and repair have occurred the EDX physician can report on past nerve involvement.
I have observed that at the time of reinnervation, when the axons are thinly myelinated or insulated, the nerve is very susceptible to the effects of alcohol so while reinnervation is being established it is wise to reduce alcohol consumption to a minimum. In addition to the large, long units there is frequently a reduction in the number of units firing, so clearly although strength may have been restored by the reinnervation the remaining axons are supplying a much greater territory of muscle than they were designed for, and this can, over years lead to fatigue. The way to counter this is to consistently undertake an exercise program of ten minutes twice a day to help these "stressed" nerves maintain their function.
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