Thoracic Outlet Syndrome in College Rower

What is your story about?
I am a 23 year old female who has been active my entire life, from soccer and basketball in high school to rowing in college. This is the story of my experience with TOS. I attempted to resolve it with multiple surgeries in an effort to reduce pain and preserve an active lifestyle. Ultimately, I'm glad I had the surgeries and have seen significant benefits from the procedures.
What is your athletic background?
I played soccer and basketball in high school and continued on to rowing in college. I rowed for a division 1 program so I had to maintain a very high level of workouts.
When did you first notice symptoms of your TOS appear?
My symptoms first presented during sophomore year of college. I was doing a side plank and my left shoulder collapsed from underneath me. My arm went numb and I was unable to move it. My symptoms came and went with the intensity and duration of my workout. As a college athlete, my workouts were generally several hours a day at a high intensity. However, it came to the point where even 5 minutes would bring on symptoms. To start, my fingers would begin to tingle and my forearm would have a deep dull-like feeling to it. The tingling would then travel up my arm and quickly my entire arm would g ...(more)
What was the diagnosis process like?
My trainers at school told me I had a tear of my labrum and would need surgery. The orthopedic surgeon I saw was in a small town near my college. He confirmed it was a small labral tear but that was not his main concern. He told me I had loose ligaments and in order to ever regain total function of my shoulder I would need surgery to reroot all the ligaments that hold my shoulder in place.
Did you seek a second opinion?
I scheduled a date to have the operations for a few weeks out but also scheduled an appointment with another orthopedic surgeon at a well known hospital in Boston. I was able to schedule a quick appointment in Boston so I could have a second opinion before the surgery. The Boston surgeon told me I had loose ligaments but in order to reroot my ligaments, the surgery could limit my range of motion to the point I cannot move my arm above my head. if the surgeon ties the ligaments too tight it would be game over for my shoulder. The Boston surgeon also mentioned it may be coming from my neck rathe ...(more)
Were there any non-surgical treatments you tried first?
I went through months of PT, several MRIs, many X-rays, a round of Botox, and several rounds of trigger point injections.
How did you eventually get to your first surgery?
Eventually it was recommended I see a TOS specialist. The MRI confirmed TOS as compression was present. He said he there is a 2-step surgery that has seen positive effects in helping to decrease symptoms, not necessarily cure them. I decided at the age of 23 I was not ready to stop any type of physical activity so I proceeded with the first surgery, a pec minor release. It was an outpatient surgery with a recovery rate of a few weeks. He went in through my armpit so the scar is not visible.
What was the outcome of the pec minor release?
Several months after surgery I tried to return to rowing and finish out my career. I raced the Head of The Charles, and when it was over, my entire arm and neck were completely numb. It took about an hour to regain feeling.
Did you decide to pursue further surgery?
I decided to proceed with the second surgery, a first rib removal. This was an inpatient operation that required my to stay in the hospital for 2 nights. He went in right behind my clavicle so the scar is visible but he did a great job at stitching it up well. When he came to visit me after the surgery he told me that the original 12 month recovery rate was not extended to 18 months due to the amount of scar tissue that had built up around my nerve.
What was the recovery process like for the first rib resection?
The next few weeks were extremely difficult. The dilated they prescribed made me sick and I could not get up from my bed by myself. My saving grace was acupuncture. I had treatment multiple times a day for the first few weeks following my surgery. I could not pick up anything over 5 pounds for the first month post-op and could not drive for the first few weeks. As there was no physical therapy that can help this recovery, I relied on acupuncture and occupational therapy to begin my range of motion recovery.
What are your outcomes from the surgery?
Right now, I am a bit over 2 years post op and I am back to running and light lifting! My arm has not gone numb since the surgery and I am hoping to continue this path. I do have cramping in my hand from time to time but that could also be that the nerve is not fully healed.
Overall, would you recommend the first rib resection for TOS?
I would definitely recommend TOS surgery to those who are young and active. But it is extremely important to understand the kind of recovery process post surgery. You will need a support system and someone to help dress you, help you out of bed, cook for you etc.