Thoracic Outlet Syndrome Massage ( TOS Massage )

neurovascular bundle neckThoracic Outlet Syndrome is a condition that involves the compression of the neurovascular bundle (brachial plexus ( C5-T1) and its accompanying artery and vein).

Types of TOS Thoracic Outlet Syndrome:

  1. Anterior Scalene Syndrome – TOS in the Anterior and middle scalene
  2. Pectoralis Minor Syndrome – TOS beneath the pectoralis minor muscle
  3. Costoclavicular Syndrome – TOS between the clavicle and the first rib

Thoracic Outlet Syndrome Massage Therapy Treatment:


Thoracic Outlet Syndrome Massage: HYDRO:

deep moist heat to Hypertonic muscles, cool hydro to edematous tissue

Thoracic Outlet Syndrome Massage: PRONE:

  • Basic Massage Techniques to the upper back
  •  Deep muscle stripping on Trapezius
  • Ischemic Compressions and Muscle Stripping to Trigger points that refer to the medial hand

Thoracic Outlet Syndrome Massage: SUPINE:

  • Myofascial Release to the neck, shoulder, chest.
  • Sternocleidomastoid treatment before treating scalenes
  • Origin and Insertion, Muscle Stripping, Petrissage, Ischemic Compressions on the Scalenes
  • Myofascial Release, Muscle Stripping, Petrissage, GTO on Pectoralis Major, then Pectoralis minor muscles
  • Muscle strippin on the Subclavius muscle

Thoracic Outlet Syndrome Massage: SIDELYING:

  • Myofascial release and petrissage to the to the neck, shoulders, latissimus dorsi
  • Petrissage to pectoralis major and minor

Considerations / Contraindications for : Thoracic Outlet Syndrome Massage ( TOS Massage )

  • Deep moist heat over the heart
  • Deep moist heat in the anterior neck if client has hypertension or atherosclerosis in the neck
  • Frictions with anti inflammatories
  • Deep Muscle Stripping on atrophied muscles
  • Avoid aggressive mobilization technique if client has a cervical rib, Rheumatoid Arthritis , or Degenerative Disc Disorder in the cervical spine

Signs and Symptoms for (TOS) Thoracic Outlet Syndrome:

  • Numbness and tingling in fingers and hand
  • Pallor, Purple or bluish fingertips
  • Venous compromise ( ischemia and edema in hand) –  Not seen with anterior scalene syndrome
  • Neuronal compression:
    •  Paresthesia and hyperthesia ( numbness and tingling ) primarily on ulnar side and can spread to entire hand
    • Pain ( diffuse, aching, throbbing) in the shoulder, forearm , hand
  • Pain triggered or increased by letting the arm hang
  • Motor Weakness or atrophy of the hypothenar muscle

SELF CARE for TOS ( Thoracic Outlet Syndrome):

  • Stretch Sternocleidomastoids, scalenes, pectoralis muscles
  • Strengthen upper trapezius, rhomboids