What is Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome (TOS) is a complex and often misunderstood condition that affects the neurovascular structures between the neck and the armpit (axilla). In order to restore optimal function and quality of life, we at Elite Physiotherapy and Sports Injury Centre specialize in the thorough evaluation and upscale physiotherapy treatment of TOS.
The term “TOS” describes a collection of conditions caused by compression of the subclavian vein, subclavian artery, or brachial plexus as they leave the thoracic outlet. The clavicle, first rib, and adjacent muscles, such as the pectoralis minor and scalene, enclose this area.
There are three primary types of TOS:
- Neurogenic TOS (most common): The most prevalent neurogenic TOS is brachial plexus compression.
- Venous TOS: Causes the subclavian vein to compress.
- Arterial TOS (least common): Compression of the subclavian artery is the least common type of arterial TOS.
Causes of Thoracic Outlet Syndrome
- Bad posture (forward head, rounded shoulders)
- Repetitive overhead tasks (such as those performed by manual laborers or sportsmen)
- Anatomical anomalies (long C7 transverse process, cervical rib)
- Trauma (clavicle fracture or whiplash damage)
- Tightness or Hypertrophy of certain muscles (scalenes, pectoralis minor)
The neurovascular bundle is compressed as a result of the thoracic outlet narrowing, leading to TOS. This compression is made worse by muscular imbalance, repetitive motions, and poor biomechanics. Over time, discomfort, numbness, and functional restrictions are brought on by vascular deterioration and nerve irritation.
Signs and Symptoms of Thoracic Outlet Syndrome
Neurogenic TOS:
- Tingling or numbness in the fingers, hand, or arm
- Poor grip strength
- Hand muscle atrophy, particularly in the thenar and hypothenar eminence
- Pain in the arms, shoulders, or neck
Venous TOS:
- Arm swelling
- Discoloration that is bluish
- Arm heaviness
Arterial TOS:
- Pallor or coldness of the hand
- Absent or weak pulse
- Activity-induced arm fatigue
Diagnosis of TOS at Elite Physiotherapy and Sports Injury Centre
At our centre, we utilize a combination of thorough physical assessment, clinical reasoning, and special orthopedic tests to diagnose TOS accurately.
Functional and Physical Assessment Includes:
- Postural Analysis: We evaluate the thoracic, cervical, and scapular alignment.
- Range of Motion (ROM): We look for restrictions or pain in the cervical and shoulder movements.
- Testing for Muscle Length and Strength: Assessment of the pectoralis minor, trapezius, and scalene muscles.
- Neurological Examination: To evaluate muscle weakness, reflexes, and sensory deficiencies.
Special Physiotherapy Tests Used:
- Adson’s Test
- Roos Test (Elevated Arm Stress Test)
- Wright’s Hyperabduction Test
- Costoclavicular Maneuver
Physiotherapy Management of Thoracic Outlet Syndrome at Elite Physiotherapy
At Elite Physiotherapy and Sports Injury Centre, we take a holistic and evidence-based approach to treating TOS. Our focus is on correcting biomechanical dysfunctions, reducing compression, and restoring normal movement patterns.
1. Manual Therapy
- Myofascial release of scalene and pectoralis minor muscles
- Cervical spine mobilization for restoring segmental mobility
- First rib mobilization to decompress the thoracic outlet
2. Postural Re-education
- Scapular stabilization exercises
- Ergonomic corrections for sitting, standing, and overhead tasks
- Training deep neck flexors and scapular retractors
3. Stretching and Strengthening
- Stretching tight muscles: scalenes, levator scapulae, upper trapezius, and pectoralis minor
- Strengthening weak muscles: lower trapezius, serratus anterior, and rhomboids
- Closed-chain scapular stabilization exercises
4. Neurodynamic Mobilization
- Sliding and tensioning techniques for the brachial plexus
- Improves neural mobility and reduces irritation
5. Breathing Pattern Retraining
- Diaphragmatic breathing techniques to reduce scalene overuse
- Rib mobilization to enhance thoracic mobility
6. Advanced Modalities for Thoracic Outlet Syndrome at Elite Physiotherapy
Super Inductive System (SIS)
- Uses high-intensity electromagnetic fields to reduce pain and stimulate muscle contractions without physical strain.
High-Intensity Class 4 Laser Therapy
- Deep tissue laser therapy promotes cellular regeneration, reduces inflammation, and accelerates healing in affected neurovascular structures.
Cryotherapy
- Effective for reducing acute inflammation, especially in venous TOS or post-traumatic swelling.
CRET Therapy
- Enhances circulation, reduces muscle spasm, and supports tissue healing through controlled radiofrequency energy.
Shockwave Therapy
- Selective use in chronic muscular tension or fibrotic changes near the thoracic outlet (only when neurovascular structures are not at risk).
Hydrotherapy
- Used in selected patients to improve mobility and reduce joint load while performing postural and neuromuscular retraining.
Why Choose Elite Physiotherapy and Sports Injury Centre?
- Expertise in sports and orthopedic physiotherapy
- Personalized care plans
- Comprehensive assessment protocols
- High-end physiotherapy technology
- One-on-one therapist-led sessions
- Focus on long-term recovery and recurrence prevention
Conclusion
Although Thoracic Outlet Syndrome is a difficult illness, it can be efficiently treated with focused Physiotherapy. At Elite Physiotherapy and Sports Injury Centre, we use the most up-to-date methods and techniques to provide individualized, evidence-based treatment. Don’t wait if you or someone you know is exhibiting TOS symptoms. Allow our knowledgeable Team to carefully and precisely lead your recovery process.