Thoracic Outlet Syndrome

After sustaining a knee injury that required for surgical intervention while in high school, I struggled with recurring ailments throughout my intercollegiate career. It was not until my father, who is an Osteopathic physician, was performing manipulation on me did we begin to diagnose the potential causes. The issue was muscle imbalance and limited flexibility in certain areas of my body that was shifting majority of my weight onto my knees while performing certain movements. This went unnoticed by physicians because while performing examinations the scope was concentrated on the immediate areas around my knee. With the knowledge I obtained through manipulation I have been able to treat my knee ailments by strengthening and lengthening muscles throughout my body. Having this experience helped solidify that if I am to be the physician I aspire to be, it is imperative to be trained in this form of medicine.

Moore et al. (2003) looked at the percent agreement in clinical diagnostic accuracy (CDA) between orthopedic surgeons (OS), PTs, and non-orthopedic providers (NOP) including family physicians, internal medicine, pediatric, emergency, podiatrists, physician assistant, and clinical nurse practionier. Orthopedic surgeons had a CDA of 80.8%, PT of 74.5%, and non-orthopedic providers of 35.4%. There were significant differences between OS and PTs in comparison with NOP, but no significant difference between OS and PTs. When red-flags are present, screenings do not require consultation of a surgeon, simple imaging and lab tests, which PTs can run, can rule out tumors with 100% sensitivity. While PTs are not qualified or expected to diagnose non-mechanical musculoskeletal complaints, but they are trained to identify inappropriate patients for PT and refer

OrthoOklahoma is an orthopedic medical clinic with a physical therapy branch that provides outpatient physical therapy care. The facility has a staff of three licensed physical therapists and a physical therapy assistant along with four physical therapy techs. I was able to observe all three physical therapists, Megan Ripley, Joe Ogle and Ken Roberts. At OrthoOklahoma, the most common patients are post-surgery from repairs of muscles, bones or joints. While shadowing these therapists, I observed cases of total knee replacement, total hip replacement, ACL/meniscus repair, rotator cuff repair, frozen shoulder, labrum repair, and other ailments from wear-and-tear and aging. This experience allowed me to talk to physical therapists about the ins and outs of their job, learn about different exercises and routines for treatment of injuries, and really get an idea of the work it takes to become a well-respected physical therapist.

When I asked him about the situation, he said that he asked her if she had the flu recently because sometimes the brachial plexus can give off flu like symptoms such as a fever, fatigue, cough, and runny nose. He said this condition is called brachial neuritis. He said the majority of the time it affects one side of the shoulder and that’s why he asked the golfer is she had any of the symptoms or the flu during the break. He said that the muscles become weak and in some cases, paralyzed. For treatment, Dr. Wallace said he prescribes pain relievers so it won’t bother the patient as much. He said in severe cases, the patient will undergo surgery and then see a physical therapist to help regain strength in the shoulder. When I asked if he thought the golfer had had brachial neuritis he said most likely no since

injuries, such as: getting hit in the head by a pitcher, getting hit under the eye and knocked

Aaron Altherr: The 26-year-old outfielder for the Phillies is fantasy gold. An injury to Kendrick

Based on the progress report dated 03/28/16 by Dr. Bakhos, the patient presents for follow-up of his right knee

The Washington Post news article, “Stephen Strasburg Shutdown” discussed the Washington nationals decision that manager mike Rizzo made prior to the season start to shut down the former number 1 pick, there ace Stephen Strasburg after he reached the 160 innings pitch mark no matter where they were in the postseason race, they were shutting him down for the remainder of the season. This created controversy around the sports world for the whole year of 2012 and is still being talked about on sports talk shows today. The nationals finished the regular season with the best record in the major leagues and a lot of that success was because of #37. He carried the pitching staff all

Raney was experiencing any pain to the area and Mrs. Raney replied that the only pain is in the right shoulder. Mrs. Raney was able to supinate and pronate her right wrist 30-40 degrees. Her skin was dry. Dr. Mendelson replied that at this time Mrs. Raney no longer required to wear the wrist brace and she can use the extremity. Dr. Mendelson obtained x-rays of her right shoulder as Mrs. Rainey has limited range of motion. After reviewing this, Dr. Mendelson replied that Mrs. Rainey as tremendous arthritis in her shoulder. I inquired if it was traumatic arthritis and the result of the accident. Dr. Mendelson replied that it was not related directly to the accident necessarily but her shoulder was aggravated from the accident. Dr. Mendelson continued to state that symptomatically it will get better and at some point Mrs. Raney did have a glenoral crack. Dr. Mendelson inquired about how Mrs. Raney’s shoulder was prior to the accident and she stated that it was fine and she could raise her arm above her shoulder and head but now she can’t and has had limited movement since the accident. Dr. Mendelson assessed and evaluated her lower extremity and replied that Mrs. Raney’s left incision is now healed. Her right ankle is still healing, the wound is dry and her skin is consolidating over the area. Mrs. Raney has an avagus external rotation of her foot.

Dodgers’ pitcher Alex Wood had hoped to return to play soon, but the recovery process will take longer than he had hoped. Wood suffered an elbow impingement in late May, and was on the 60-day disabled list, making him eligible to potentially return to play on July 30. Unfortunately, after playing two innings of a simulated game at Dodger Stadium on July 17, it was determined that Wood’s injured elbow will require surgery. The surgery will put him out of commission for roughly eight weeks, which would put him at returning to rotation ideally in about mid-September.

Studies and surveys have shown that upper-extremity injuries are a common result of pitching through youth, high school, and collegiate baseball leagues. There have been surveys taken to show the relation of elbow and shoulder injuries and pitching. Statistics taken describe (1) the proportion of pitchers with a history of pitching related upper-extremity injury (2) proportion of pitchers with w history of pitching related elbow and shoulder injury that was treated through surgery (3)types of upper-extremity injuries sustained by pitchers and (4) types of upper extremity injuries sustained by a certain age category around the same time of injury.

Mobility grants opportunity and lifelong experiences through the gift of exploration and independence. Without autonomy of movement in one’s life, there are struggles accompanied by frustration do to the lack of freedom and ability. It is an orthopedic surgeon’s job to bring function to one’s life even if they have never been granted movement without restraint before. Orthopedic surgeons receive patients whose freedom of movement have been compromised and then return it back to them. Orthopedic surgeons give immeasurable opportunities and life experiences back to their patients because of their perseverance and commitment to their patients and careers.

Louis to see a specialist in thoracic outlet syndrome (TOS). TOS is a condition where a person suffers from numbness and pain in their upper extremities as a result of compression of their blood vessels and nerves. TOS can be common in pitchers, and a number of pitchers have had to undergo surgery as a result, such as Josh Beckett, Chris Carpenter, and Shaun Marcum. However, it’s difficult to glean any meaningful information about what their velocity was like immediately prior to their surgery, and Harvey has yet to be confirmed as suffering from TOS, so TOS is not a definitive answer – but it's possible that TOS could have been to blame for Harvey's issues.

Health History: A 25-year-old male injured his left knee in a recent skiing accident. The patient stated that he lost his balance because the inner edge of his right ski got caught while skiing. This resulted in the right leg being externally rotated followed by and audible “pop” as he lost footing. By evening, the right knee joint had become swollen, causing intense pain. The primary care physician referred the case to an orthopedist.

Thoracic Outlet Syndrome (TOS) is associated with the Muscular system and the cervical spine, scalene muscles and pectoralis minor tendon are affected by disorder. The Nervous system is involved due to peripheral nerves becoming impinged. TOS is a disorder caused by compression of the brachial plexus alone or along the subclavian artery called the neurovascular bundle. Scoliosis is the lateral curvature in the normally straight vertical line of spine, usually in the thoracic region. The lumbar and cervical regions may also be involved.