Thoracic Outlet Syndrome in the Overhead Athlete

Ciampi, P.; Agnoletto, M; Scotti, Celeste; Ballis, Rosa; Gerevini, Simonetta; Peretti, Giuseppe M.; Fraschini, G.

doi:10.1097/jsm.0000000000000329

Cited by 20 publications

(5 citation statements)

References 9 publications

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“…Indeed, athletes combine nonspecific factors (such as cervical rib or coagulation anomaly) and more specific factors such as muscle hypertrophy, especially of the pectoralis minor, inducing the compression of the adjacent neurovascular bundle. This hypothesis is sustained by the frequent observation of muscle hypertrophy during TOS surgical procedure ( Katirji and Hardy, 1995 ; Ozcakar et al, 2005 ; Simovitch et al, 2006 ; Almeida et al, 2007 ; Aydoğ et al, 2007 ; Baltopoulos et al, 2008 ; Fitzgerald, 2012 ; Herbst and Miller, 2013 ; Jourdain et al, 2016 ; Norinsky et al, 2016 ; Ciampi et al, 2017 ). Bottros et al (2017) also proposed a diagnostic test of N-TOS based on ultra-sound guided scalenus anticus anesthesia.…”

Section: Resultsmentioning

confidence: 98%

Thoracic Outlet Syndrome in Sport: A Systematic Review

et al. 2022

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Thoracic outlet syndrome (TOS) is a rare and heterogeneous syndrome secondary to a compression of the neurovascular bundle in the thoracic outlet area. Muscle hypertrophy is recognized to induce vascular or neurogenic compression, especially in sports involving upper-arm solicitation. Athletes represent a distinctive population because of a specific management due to an ambitious objective, which is returning to high-level competition. We evaluated the scientific literature available for the management of TOS in athletes. Article research extended to March 2021 without other restriction concerning the date of articles publication. The search was performed independently by two assessors. A first preselection based on the article titles was produced, regarding their availability in English or French and a second preselection was produced after reading the abstracts. In case of doubt, a third assessor’s advice was asked. Case reports were selected only if the sport involved was documented, as well as the level of practice. Cohorts were included if data about the number and the sport level of athletes were detailed. Seventy-eight articles were selected including 40 case reports, 10 clinical studies and 28 reviews of literature. Baseball pitchers seem to be highly at risk of developing a TOS. The surgical management appears particularly frequent in this specific population. The prognosis of TOS in athletes seems to be better than in the general population, possibly due to their better physical condition and their younger age. Some studies showed interesting and encouraging results concerning return to previous sport level. Literature shows a strong link between TOS and certain sports. Unfortunately, this syndrome still lacks rigorous diagnostic criteria and management guidelines for athletes.

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Section: Resultsmentioning

confidence: 98%

Thoracic Outlet Syndrome in Sport: A Systematic Review

et al. 2022

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“…One study reported that adding subclavius muscle resection to NTOS palliative treatment could improve results 13) . Another study suggested that botulinum toxin injections into the subclavius muscle could serve as a potential TOS treatment option 4) .…”

Section: Discussionmentioning

confidence: 99%

Neurogenic Thoracic Outlet Syndrome Induced by Subclavius Muscle Hypertrophy: A Case Report

Lee

Beak

et al. 2023

Nerve

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Neurogenic thoracic outlet syndrome (NTOS) is a complex disorder characterized by compression of the brachial plexus, resulting in pain, weakness, and sensory changes in the upper extremity. Traditional surgical treatments, such as first rib resection or anterior scalene muscle resection, can be invasive and associated with significant morbidity. We present a unique case of a patient diagnosed with NTOS who underwent a preoperative magnetic resonance imaging with the shoulder in an abduction position to identify the cause of NTOS. A minimally invasive subclavius muscle resection was subsequently performed, resulting in a dramatic reduction in pain and significant improvement in motor symptoms. This less invasive approach led to a quicker recovery time and reduced morbidity compared to traditional surgical methods. This case report suggests that before surgery, thoroughly investigating the causes of NTOS and selectively performing decompression only on the structures requiring intervention could also be considered a viable treatment option.

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“…Similarly, only 2 of the 25 items of the "Fantastic lifestyle assessment" tool relate to activity, one of which is not specific while the other concerns the lower limbs [51]. The only thing that is frequently reported in TOS series and case reports is the profession of the patient when the study deals with work-induced upper-limb disease and the types of sport activities pursued by athletes [52][53][54][55][56][57][58][59][60][61][62][63].…”

Section: Methods For Lifestyle Evaluation In the Clinical Routine Of ...mentioning

confidence: 99%

Role of Lifestyle in Thoracic Outlet Syndrome: A Narrative Review

Abraham,

Lecoq,

Mechenin

et al. 2024

JCM

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Introduction: The presence of a positional compression of the neurovascular bundle in the outlet between the thorax and the upper limb during arm movements (mainly abduction) is common but remains asymptomatic in most adults. Nevertheless, a certain number of subjects with thoracic outlet positional compression will develop incapacitating symptoms or clinical complications as a result of this condition. Symptomatic forms of positional neurovascular bundle compression are referred to as “thoracic outlet syndrome” (TOS). Materials and methods: This paper aims to review the literature and discuss the interactions between aspects of patients’ lifestyles in TOS. The manuscript will be organized to report (1) the historical importance of lifestyle evolution on TOS; (2) the evaluation of lifestyle in the clinical routine of TOS-suspected patients, with a description of both the methods for lifestyle evaluation in the clinical routine and the role of lifestyle in the occurrence and characteristics of TOS; and (3) the influence of lifestyle on the treatment options of TOS, with a description of both the treatment of TOS through lifestyle changes and the influence of lifestyle on the invasive treatment options of TOS. Results: We report that in patients with TOS, lifestyle (1) is closely related to anatomical changes with human evolution; (2) is poorly evaluated by questionnaires and is one of the factors that may induce symptoms; (3) influences the sex ratio in symptomatic athletes and likely explains why so many people with positional compression remain asymptomatic; and (4) can sometimes be modified to improve symptoms and potentially alter the range of interventional treatment options available. Conclusions: Detailed descriptions of the lifestyles of patients with suspected TOS should be carefully analysed and reported.

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Thoracic Outlet Syndrome in the Overhead Athlete

Cited by 20 publications

References 9 publications

Thoracic Outlet Syndrome in Sport: A Systematic Review

Thoracic Outlet Syndrome in Sport: A Systematic Review

Neurogenic Thoracic Outlet Syndrome Induced by Subclavius Muscle Hypertrophy: A Case Report

Role of Lifestyle in Thoracic Outlet Syndrome: A Narrative Review

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