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Thoracic Outlet Syndrome

Baseball is back, and some teams are hitting home runs from the gate, while others are just plain ol’ striking out. In recent Sports news coverage, you may have heard the foul ball goings of the teams physical health. The NY Mets have been riddled with injury since the last part of 2016, with Matt Harvey catching a shoulder injury (Harvey is a Pitcher), needing surgery for Thoracic Outlet Syndrome. Harvey who was still in recovery until recently, was just put in during Thursdays game; and you could see that Harvey was still in need of time to recover. According to interviews with Harvey, he pushed himself training on Wednesday and didn’t think he was going to be used in Thursday’s game… but he was, and he shouldn’t have been. He struggled, and it was evident. He incurred 6 runs over 4 1/2 innings and walking five batters, while striking out just one… not to mention his fastball velocity dipped down several times. He is becoming the example, showing what happens, when you jump into something (not saying it was his choice, as the NY Mets club has been making these type of mistakes since the beginning of the season so far), when you’re just not fully recovered to go back. What Harvey has, is Thoracic Outlet Syndrome (TOS), a potentially painful and disabling condition of the upper extremity. It results from the compression of structures in the thoracic outlet, a space just above the first rib, and behind the clavicle (collar bone). To treat a patient with Thoracic Outlet Syndrome, or TOS, a Physical Therapist would treat using these methods:

 

  • Adson/Scalene Maneuver: The examiner locates the radial pulse. The patient rotates their head toward the tested arm and lets the head tilt backwards (extends the neck) while the examiner extends the arm. If the pulse disappears, there is still a further need to treat and allow yourself to recover.
  • Manual (hands-on) therapy may be applied to manipulate or mobilize the nerves of the arm to help reduce symptoms, such as pain and numbness/tingling. Your physical therapist also may attempt to gently mobilize your first rib and/or collar bone.
  • Movement and Strengthening Exercises. Your physical therapist will teach you muscle-strengthening exercises to improve movement and strength in the affected area.
  • Your physical therapist will teach you strategies that can help minimize your symptoms while performing your daily functional activities.
  • Activity modification and postural strategiesyour physical therapist will teach you positions and strategies to place less stress on the structures involved with TOS.
  • Trigger Point Therapy may also be used. See examples below:

 

Subclavius                       Infraspinatus ex. 1    Infraspinatus ex. 2                              Pectoralis Minor                            

 

 

 

So remember- recovery cannot be expedited. It is not something guarenteed to arrive in 3-5 business days like your Syndergaard jersey you bought on Amazon. Take your time, and allow treatment to fully come to completion.

Featured Image: Courtesy of Noah K. Murray/USA TODAY Sports