Course Description:

Neurogenic Thoracic Outlet is a syndrome that can be elusive and difficult to treat. The term “Thoracic Outlet Syndrome” includes compression of several neurovascular structures. Proper investigation is necessary to decide the best course of treatment. Compromise to vascular structures requires immediate referral to a vascular surgeon whereas compression of the neurologic structures can be successfully treated with physical therapy in most cases. For these reasons, interdisciplinary communication is critical.

Dr. Kimball will describe the work up and diagnostics done by his Vascular Surgery team. He will discuss vascular diagnostics. He will describe the anatomy from the inside out and present the surgical options describing infraclavicular first rib resection or supraclavicular scalenectomy, first rib removal and neurolysis. Participants will feel confident in knowing when vascular surgery consult is indicated.

Anne Clancy, PT will go in depth on a physical therapy evaluation of neurogenic thoracic outlet syndrome. We will discuss differentiation of commonly diagnosed conditions with similar presentation such as carpal tunnel and cervical radiculopathy. Participants will learn evidence-based evaluation of posture with the use of tools easily found and known to general physical therapy practice. The class will have some hands-on practice with palpating common thoracic outlet offenders such as pec minor, scalenes and first rib. As well as practicing some neck and lower scapular postural exercises.