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Physica e-Newsletter

January 2014 

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Thoracic Outlet Syndrome

Symptoms arising from Thoracic Outlet Syndrome (TOS) are caused by compression of the blood vessels and nerves that pass through the thoracic outlet. This outlet is a pyramid shaped channel at the base of the neck that allows for the passage of the nerves and blood vessels from the neck to the upper limb.


Patients with this condition often complain of pain, tingling, numbness or weakness in the arm. Coldness and heaviness in the arm can also be present. These symptoms are often located along the inside of the upper limb and can extend to the little finger and ring finger due to irritation and compression of the ulna nerve.





Repetitive use of the arm in overhead positions, prolonged sitting and some neck movements are common aggravating activities.


Causes of TOS include;

  • Cervical rib (extra rib in the neck)
  • Overdeveloped neck muscles
  • Anomalies of the first rib
  • Spasm of the scalene muscles (muscles along the side of the neck)
  • Poor posture, in particular the scapula
  • Repetitive overuse in sports or occupations

Conservative treatment with physiotherapy is often the first line of management. Treatment is focussed on retraining poor postures, particularly the scapula, strengthening and re-training the scapula muscles to offload the irritated nerves in the neck. Other treatments may include neck and thoracic spine mobilisation along with taping the shoulder to retrain faulty positions.


All Physica staff have received further training in the diagnosis and management of TOS. We will assess your condition and organise a structured management plan to return you to full function ASAP.  





Chris and Sian from the Ringwood practice attended the MPA (Musculoskeletal Physiotherapy Australia) Victoria branch committee meeting this month. The meeting focussed on planning professional development courses for physiotherapists in Victoria lead by high quality speakers such as; Trish Wisbey-Roth, Mary Magarey and Michael Shacklock.


The Ringwood practice is saying goodbye to Kelly Gruber; we thank Kelly for her time with us and wish her all the best with her future career, and we welcome Marcus Rawlings who will be starting in the first week of February. 




Physica Spinal and Physiotherapy Clinics
25 Wantirna Rd
Ringwood Vic 3134
ph 9870 8193

also at
Physica Devonport
Physica Shearwater
Physica Latrobe