Ever had tingling or numbness in the arms and thought it was something sinister only to be told your heart is in tip top shape? Read on as Dan explains what Thoracic Outlet Syndrome is and how you can relieve the symptoms.

Thoracic Outlet Syndrome (TOS) is a super common neural (meaning nerve) issue that can affect many different people. TOS presents as numbness and tingling down either one or both arms and in a lot of cases to the hands as well. This is caused by compression to the brachial plexus which is the nerve that feeds from the neck all the way down to the hands and fingers.

TOS is common in desk workers, cyclists, bodybuilders/weightlifters and anyone who has previously been subject to a shoulder injury.


Some symptoms related to TOS can include

  • Neck pain
  • Shoulder pain
  • Arm pain
  • Numbness/tingling in hands and fingers
  • Lack of circulation to upper extremities

The thoracic outlet itself is the space between your collarbone and the first rib on both sides of the body. This space houses nerves and blood vessels that feed down the arm all the way down to the hands and fingers.

Thoracic outlet syndrome occurs when these nerves and vessels are compressed through the thoracic outlet space causing decreased blood circulation and numbness and tingling to the upper extremities, often felt all the way down to the hands and fingers.

Compression through the TO can be caused by tightness through the neck, shoulder and chest muscles or a compromised alignment of the bones through the neck and shoulders (mainly collarbone), secondary to having tight muscles. This is especially common in body builders who tend to train the chest and shoulders quite heavily in some cases causing a postural imbalance and cyclists who spend long periods of time in a posture which can shorten the anterior shoulder muscles.

Some other causes of TOS can include:

  • Physical trauma (car accident, shoulder or neck injuries)
  • Postural inefficiency
  • Repetitive injury
  • Certain anatomical defects (extra rib etc)
  • Pregnancy
  • Overuse of muscles around the Thoracic outlet

Regular massage and PROPER foam rolling/spikey ball use can go a long way to keeping these muscles loose and lessening the chances of getting TOS.

Early intervention/treatment of thoracic outlet syndrome can be very effective in reducing it’s affect and even getting rid of the problem, though as with most injuries that occur over time it is important to address the root cause of the issue whether it be postural, biomechanical or secondary to other injuries.


Here are some exercises you can do yourself that can assist in reducing the symptoms of TOS.

neck bending

Neck Side bending

This exercise stretches the trapezius muscles. Bring the ear of your affected side towards the shoulder of the same side without shrugging the shoulders and hold for 5 seconds.

neck bending

Side Neck Extension

This exercise stretches the scalene muscles and the flexors. Bend and elongate the neck backwards to the opposite corner of the room and hold for 5 seconds then return the head to it neutral position. It’s really important not to drop the head back and compress the vertebrae, rather stretch up and away as though there is a string attached to your head and someone is pulling on it.

Repeat 5 times or how times feels comfortable.

Chin tucks

This exercise stretches the cervical extensors and strengthens the paraspinal muscles. Try to make a double chin, feeling a stretch behind the neck and hold for 5 seconds. Repeat 5 times, relaxing between efforts.

Spikey ball through pecs (once every 2 or 3 days)

Place the spiky ball under the collarbone and roll around until you find a tight tender spot. Hold the spikey ball there and with your arm at 90 degrees from shoulder to hand, press the spiky ball against the wall applying as much pressure as feels comfortable.

Pec Stretch

With your arm at 90 degrees from shoulder to hand, place your hand on the wall or doorframe (making sure your elbow is in line with your shoulder), and take a small step forward pressing the chest forward and the arm back.

Another variation of this stretch is to creep the hand further up the wall so the elbow is higher than the shoulder by an inch and repeat the stretch.

For some people (particularly athletes) the symptoms of thoracic outlet syndrome can be inevitable and possibly un avoidable due to the nature of the sport or postures involved in the sport (i.e. Cycling, body building), but these symptoms can be managed and reduced or even eliminated. Have a go at using these exercises to get on top of your TOS symptoms and be sure to let us know how you go.