Clinical guidelines name pressure and shear as the cause of pressure ulcers, but rarely explain what the words mean. Drawing on thirty years in rehabilitation engineering, I unpack pressure, shear, stress and strain in plain language, show why the skin check can look normal while damage develops over the bone, and explain why the heels are so vulnerable. This one of our longer articles.

Nerve repair surgery—whether nerve grafting, nerve transfer, or direct repair—offers hope for people with peripheral nerve injuries, including brachial plexus injuries. However, surgery is just the beginning of the recovery journey. After the surgeon has reconnected or rerouted nerves, there's a waiting period while regenerating nerve fibres grow toward their target muscles. This process is slow, measured in months rather than weeks.

During this waiting period, a critical question arises: what happens to the muscles? Without nerve signals, they begin to atrophy and deteriorate. If the muscle degenerates too severely before reinnervation occurs, even successful nerve regeneration may not restore function—the nerve reconnects, but finds a muscle no longer capable of responding.

This is where electrical stimulation plays a crucial role. By keeping muscles viable during the reinnervation window, stimulation can significantly improve the chances of functional recovery. In this article, I'll explain how nerve regeneration works, when to consider electrical stimulation, and what to expect throughout the process.