Thoracic Outlet Syndrome (TOS) is a condition our board certified vascular surgeons often see at the start of the new year when people are eager to get in shape and work out more. It is not uncommon, however, that we see this serious condition all year round in dedicated athletes.

TOS can occur when the blood vessels and nerves in between the collarbone and upper ribs (or thoracic outlet) become compressed or irritated. This sudden compression may cause acute pain, numbness, or tingling through the neck, shoulders, arms, and fingers.

It typically results from unexpected physical trauma, such as whiplash, or from overuse motions in sports with repetitive movements and swings like baseball or basketball.

If left untreated, TOS can lead to permanent nerve damage or in extreme cases, a blocked artery, which can have serious consequences.

Why do athletes frequently suffer from TOS?

Because athletes engage in regular repetitive motions, there is constant wear and tear on a certain set of bones, muscles and nerves. This can lead to damage in these overused areas. TOS is more prevalent in those who play sports with overhead arm motions engaging the chest and upper body, like baseball, basketball, football, tennis, and swimming, and it tends to be more common in women than men.

What are symptoms of TOS?

Common symptoms of TOS include:

  • Numbness or tingling in the neck, shoulder, arms, wrists, and fingers
  • Sudden or shooting pain in the neck or shoulders
  • Aching or throbbing feeling in the chest area
  • Purple or blue discoloration in the hand or fingers
  • Muscle spasms
  • A weakened pulse or dizziness

If you experience any of these symptoms for more than a day or two, we recommend you seek medical attention.

TOS can be hard to differentiate from other common overuse sports injuries, but it can be confirmed by a series of diagnostic tests such as X-rays, an MRI to check for blockages in arteries, or an EMG to gauge muscle strength. It is important that you see a medical professional with experience in treating TOS to prevent complications, such as permanent nerve damage or blood clots.

How is TOS treated?

Most cases of TOS will respond to simple measures like:

  • Physical therapy with targeted exercises to strengthen chest muscles
  • Non-steroidal anti-inflammatory or muscle relaxing medications
  • Thrombolytics medication to break up and prevent blood clots

In rare cases of TOS, decompression surgery may be needed to alleviate the pressure in the chest and correct this condition.

For questions about any of our vascular, cardiac, or thoracic services, please visit or call us at (512) 459-8753 to schedule an appointment.

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