Anyone have/had it? Anyone traced down the cause of theirs? I’ve heard it can happen from swimming. I’ve heard it can happen from certain exercises in the weight room (don’t know which ones, but would like to).
What’s your experience/knowledge?
Thanks.
My uncle is a thoracic surgeon and happens to be an expert on thoracic outlet syndrome. I can ask him your questions.
See: http://thoracicoutlet.ca/
Graham
Okay, I spoke with my uncle. (I was going to call him anyway).
So, thoracic outlet syndrome starts with a congenital anomaly that occurs in about 40% of the population. If you don’t have the anomaly you won’t get it. But if you do have the anomaly, you may get it from just about any activity. Performance athletes push their bodies hard, so if they have the anomaly they have a higher chance of getting it. But again, a lot of activities can trigger it. Swiping cards as a cashier at the grocery store could do it. So swimming and weight lifting certainly could do it.
Hope this helps. If you would like more info let me know.
Graham
As I recall with TOS its important to differentially diagnose from cervical nerve root impingement due to disc issues or stenosis. Then its a matter of determining what is causing the TOS, ie scalenes or extra cervical rib. I remember the post surgical cases I saw years ago when I worked in PT not having great outcomes, but that may well have changed in the past 10 years with improvement in surgical technique. I would suggest exhausting all non-surgical options before going down that one way street.
As far as activities anything that involves repetitive overhead activities may aggravate symptoms by decreasing the size of the thoracic outlet, avoid lifting overhead and focus on exercises that build scapular stability. Hope some will chime in with more knowledge than I have.
Kevin
…caused by what scientists call a “cervical rib”. A cardiothoracic surgeon will take a bone shear and cut them out and then give you a coffee enema.
Kevin and Graham,
Thanks for both of your replies. I started to do a little weight training about 5 weeks ago. Noticed this came on shortly thereafter. Noticed it also seemed to be worse on days when I lifted. I did a really hard set this morning and it’s really been awful for the rest of the day … numb and cold fingers on both hands.
Last week a massage threapist told me he suspected Raynaud’s syndrome, but as I researched that, it seemed too episodic. This doesn’t come and go. It’s pretty constant, though it’s worse on the days I lift. I lift out in a cold out-building and with this cold snap, the weight plates feel like blocks of ice. I tried some gloves, but they didn’t help. Raynaud’s just doesn’t seem to be a good fit with my symptoms. (I’m not having discoloration of the fingers, either.)
85 Percent of my lifting routine is lower body. The upper body stuff is just chin pulls, tricep push-downs and seated pull-downs.
Right after I began the weight training, I also had a painful knot develop above my right shoulder blade. The massage therapist has worked on the knot and it’s gone, but sometimes I get a funny sensation like radiating electrical pulses from right in that area. If I’m reading things right, this could also be consistent with TOS.
I guess I’ll lay off the upper-body stuff and see what happens.
Thanks again.
How about we skip the coffee enema and have the surgeon just craft me a nice female from the rib?
I was told I had it after A/C seperated shoulder surgery. I was told by one of the top Thoracic Outlet Surgeons at UCLA that she was going to talk me into the surgery(rib removal) before she even said hello let alone examined me. I refused surgery. I think its a bunch of bull. It’s simply a bunch of nerves that are being compressed. Why? Why today and not last week, month, year? You say you started weight lifting recently. Pushups, Bench press? I have found that tight chest muscles, especially Pec Minor to be the culprit. Also a tight Pec Minor can refer pain at the shoulder blade. Think tight muscle or imbalance.
My understanding is that the syndrome is a lot more common than previously thought, and not well understood until recently, which is why it often goes undiagnosed.
The area affected is very small. So a repetitive movement or a sudden jarring can cause the nerve to be constricted by the bone, which then leads to loss of feeling etc.
The surgical method for treating it has gotten a lot better. It involves cutting off a small piece of bone to alleviate pressure on the nerve. If the syndrome is a serious, ongoing problem, and other treatments aren’t working, then it is worth looking into.
Good luck!
Graham
SQUATS! All the other exercises I’m doing I’ve done before over the years. What’s new is squats. Never did 'em before. I’ve been doing them on a machine where I’m driving upward against a weight bar that’s across the base of my neck and the back of my shoulders. The way I’ve put my little program together, the sessions build towards a couple of very hard sets of squats with a lot of weight. I’d bet dollars to doughnuts that’s what has brought this on.
I was told I had it after A/C seperated shoulder surgery. I was told by one of the top Thoracic Outlet Surgeons at UCLA that she was going to talk me into the surgery(rib removal) before she even said hello let alone examined me. I refused surgery. I think its a bunch of bull. It’s simply a bunch of nerves that are being compressed. Why? Why today and not last week, month, year? You say you started weight lifting recently. Pushups, Bench press? I have found that tight chest muscles, especially Pec Minor to be the culprit. Also a tight Pec Minor can refer pain at the shoulder blade. Think tight muscle or imbalance.
Well, that may be the case with you, but my wife had symptoms similar to the OP and then had a subclavian DVT (a clot in one of her central veins). She didn’t have a cervical rib but her first rib was compressing the vessels. She went to UCLA and had the clot lysed and her first rib removed. A subsequent MRV showed obstruction on the opposite side as well so she had that rib removed as well. She can do every exercise normally now. She doesn’t do tris but has run a marathon and seems to have no problems busting out the P90x.
Anyone have/had it? Anyone traced down the cause of theirs? I’ve heard it can happen from swimming. I’ve heard it can happen from certain exercises in the weight room (don’t know which ones, but would like to).
What’s your experience/knowledge?
Thanks.
This is frequently misdiagnosed. I have even done my share of misdiagnosing. Shoulder impingement syndrome is frequently misdiagnosed as thoracic outlet - I know. I once went to a conference where a thoracic outlet specialis was giving a talk and he presented a “typical” patient there (the patient was actually there). I actually talked to the patient and was convinced he was probably misdiagnosed. There are other diagnoses this could be also. This requires a major operation to fix and I would be very slow to go for it.
Listen to Frank Day and Flying Wombat on this. It is commonly misdiagnosed and can have many anatomical causes ranging from tight anterior neck, shoulder, chest muscles to and extra cervical rib. Stenosis and disc bulges of the cervical vertibra can also present in a similar light. Like the other have said, try to minimize overhead activities or make sure you do them with correct form. Also try to maintain correct posture with you shoulders back, as tight scalene and pectoralis muscles are often a culprit although this does not seem to be your case since it is bilateral. Anyways, the take home is get multiple opinions and do everything possible before getting cut.
Any new developments? Fixed?
Not sure if this is what I have, but it starts right in the center of my arm pit and goes down the inside of my bicep to my thumb/pad. Only happens with bicep curls and rows. Numbness comes on quickly and goes away quickly, but very odd. I have extremely tight scalenes and am getting them worked on, therapist seems to think this is the prob.