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Affiliated Arm Shoulder & Hand Surgeons Ltd.
3104 E Indian School Rd * Suite 200
Phoenix Arizona 85016
(602) 954-9484 * Fax (602) 954-6433


Thoracic Outlet Syndrome

Thoracic outlet syndrome is a compression of the nerves and vessels that go to the arm as they emerge from the base of the neck. This compression can result in pain, numbness and odd feelings in the affected arm, especially when using the arm in overhead activities or in prolonged use of the arm. Fortunately, this condition is amenable to physical therapy, namely exercises to the shoulder girdle to prevent sloping of the shoulder, which tends to aggravate compression about the nerve and vessels at the base of the neck. These exercises can be done very easily by most patients at home and sometimes are done under the guidance of a physical therapist.

Eighty percent of patients will respond to the exercises. Of the 20% that do not respond to exercise, surgery is usually necessary to decompress the space where the nerve and vessels are compressed.


Stand erect with arms at side:
A Shrug shoulders forward and upward
B Relax
C Shrug shoulders backward and upward
D Relax
E Repeat 10 times. Add a two pound weight in each hand at the end of the first week

2. Stand erect with arms parallel to the floor:

A Keeping elbows straight touch back of hands above head
B Relax and repeat 10 times
C Add weights weekly starting with two pounds and gradually increasing to ten pounds

3. Standing erect, do a standard pushup against the wall. Repeat 10 times. Increase weekly.

4. Stand erect. Then bend the neck, trying to touch the ear to the shoulder, first right and then left. Repeat 10 times. Increase weekly.

5. Lying face down, arch the back, stretching and extending the neck for a count of 3, then repeat 10 times.

6. Lying on back with knees bent and arms at your side, extend arms to touch palms above the head on the floor.

If these exercises are carried out on a daily basis or a lest five days out of seven, most patients will notice improvement after the first 3 to 4 weeks. To these exercises, I would also supplement breast stroke swimming and side stroke swimming. Overhead swimming may aggravate the situation.