Andere naam:
Borstkasuitgangsyndroom / Thoracic Outlet Syndrome

Korte omschrijving:
Verzameling van aandoeningen die gemeen hebben dat zij de vanuit de borstkas naar de arm verlopende bloedvaten en zenuwen kunnen afknellen.


Oorzaken hiervoor kunnen zijn

  • een extra halsrib,
  • een nauwe ruimte tussen de eerste rib en het sleutelbeen of
  • een verdikking van de halsspieren.

What causes it?
Various factors may contribute to the development of thoracic outlet syndrome. Repetitive activities involving a head-forward posture or drooped shoulders may lead to compression of the nerve or vascular tissues.
Partnering dance movements may stress the shoulder and result in compression of nerve or blood vessels.
Carrying heavy loads, instrument cases, and dance bags may also lead to tissue compression.
This can stress the shoulder-girdle structures (the clavicle, ligaments, and muscles). The most common cause of thoracic outlet syndrome is compression of nerves or blood vessels in the armpit.
Thoracic outlet syndrome may also develop following neck or shoulder trauma. Violin, viola, guitar, flute, and keyboard players have reported thoracic outlet syndrome.

The symptoms can mimic many other conditions, such as a herniated disk in the neck, carpal tunnel syndrome, and even bursitis of the shoulder.
Thus this syndrome can be very difficult to diagnose.


Vascular symptoms include:

  • Swelling or puffiness in the arm or hand
  • Bluish discoloration of the hand
  • Feeling of heaviness in the arm or hand
  • Pulsating lump above the clavicle
  • Deep, boring toothache-like pain in the neck and shoulder region which seems to increase at night
  • Easily fatigued arms and hands
  • Superficial vein distention in the hand

    Neurologic symptoms include:
  • Parasthesia along the inside forearm and the palm (C8, T1 dermatome)
  • Muscle weakness and atrophy of the gripping muscles (long finger flexors) and small muscles of the hand (thenar and intrinsics)
  • Difficulty with fine motor tasks of the hand
  • Cramps of the muscles on the inner forearm (long finger flexors)
  • Pain in the arm and hand
  • Tingling and numbness in the neck, shoulder region, arm and hand

(Bron: NISMAT)

Symptoms include
neck, shoulder, and arm pain,
numbness, or impaired circulation to the extremities (causing discoloration).
Often symptoms are reproduced when the arm is positioned above the shoulder or extended.
Patients can have a wide spectrum of symptoms from mild and intermittent, to severe and constant.
Pains can extend to the fingers and hands, causing weakness. (LomLin) 

Gerelateerde blessures:

Bekneld, Gevoeligheid, Gevoelloosheid, Huidskleur, blauw, Huidtemperatuur, koud, Koud hebben, Krachteloosheid, Pijn, chronische, Tintelend, Vermoeidheid, spieren, Zwaar gevoel, Zwelling,
Dwarsfluit, Altviool, Gitaar, Viool, Klavecimbel, Piano, keyboard,


The area between the base of your neck and your armpit is called the thoracic outlet and it is surrounded by muscle, bone and other tissue.
Naturally, if something causes the material that surrounds this "outlet" to become enlarged, it can't act as an opening or passageway.
This in turn means the nerves are compressed, and can't do their job of sending messages to your brain.

Bezoek huisarts nodig?:

Raadpleeg altijd eerst uw huisarts!

Zelf doen:

Geen zelfdiagnose !
Deelt symptomen met andere blessures!

But string players take note:
One medical expert from the U.S. says arm elevation - in other words, the position violinists and violists hold when practicing or performing - is "the essence of thoracic outlet syndrome symptom production or aggravation."

Chirurgische behandeling:
Surgery is consistent in relieving pain but muscle weakness and atrophy do not usually improve significantly.

Niet-chirurgische behandeling:
Conservative treatment usually includes local heat and a program which address postural retraining, shoulder strengthening and stretching exercises.

Algemene adviezen/preventie:

The key to preventing thoracic outlet syndrome is to minimize stress on the neck and shoulders.
Avoid awkward postures and minimize time spent using the neck and shoulder muscles in a static or continuous manner.
Active recovery (stretching during rest breaks) may further reduce the risk of developing symptoms.
To help minimize the recovery time should a traumatic injury occur, determine and maintain neck and shoulder posture that does not cause injury, as well as muscle strength and flexibility in these areas.(SHAPE)

The possibility that a raised arm can cause TOS doesn't mean you have to stop playing.
But it does mean you should develop some exercises such as shoulder shrugs, to relax the muscles that surround the thoracic outlet.
You should also build regular rest periods into your practice sessions.
If you are experiencing pain in that area, ice can provide some temporary relief. (KUN)



Bekijk een uigebreide beschrijving (met oefeningen) op de site van the Nicholas Institute of Sports Medicine and Athletic Trauma


med wp / lomlin / Shape / KUN / Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT)