Thoracic Outlet Syndrome

I received an email from Miles Kelly regarding the surgery procedure being performed on Brant Rustich:

Howdy Mack,

Love the blog and read it all the time. Hope everything is going well for you.

I wanted to comment on your blurb about Brant Rustich getting TOS surgery. I'm really glad that they finally came to this diagnosis, as I believe TOS is far more common than most people think. A lot of athletes probably get unnecessary wrist/forearm/hand surgery when what they really have is TOS (just look at the case of Noah Lowry and the Giants). I really hope to see Rustich healthy, because, from everything I've read about him, a healthy Rustich might just have the best stuff in the entire minor league system.

I'm not sure if Mr. Rustich told you what TOS surgery entails, and I thought I would enlighten you in case he didn't. I have intimate knowledge of the procedure (TOO INTIMATE, some might say) because I've had the procedure done twice. Once on each shoulder. I developed severe TOS because of surfing, which of course has a similar overhead motion to swimming, pitching, etc.

The surgery to "decompress" the thoracic outlet involves an incision underneath the armpit where the surgeons go in and cut out the patient's first rib. The first rib is pretty small and sits just behind the clavicle. It's not visible from outside the body.

From the patients point of view, the surgery is incredibly painful. I was pretty much incapacitated for three weeks after each of them. Doctors tend to make light of the surgery (I have no idea why), but truly, I felt like someone had smashed my back and chest with a sledge hammer. After the initial post-surgical pain, there are many common side effects, but the one I found most odd and unnerving was the numbness in my tricep and armpit. A very strange feeling that happens because of all the nerves that are cut when they make the incision. The numbness went away about six months after each surgery when the nerves restored themselves.

I'm being a little long winded, but the upshot is that I believe that surgery was successful, although not entirely. I wasn't magically cured of all my symptoms, but there was definite improvement. Residual symptoms usually occur because of scar tissue where the rib was. I'm positive he will have the best surgeons performing the surgery and that they will work hard to reduce the scarring, but sometimes symptoms can continue (as they did with me). I hope that the surgery alone will take care of all Mr. Rustich's symptoms, but if it doesn't he should know that there are other things he can do to improve the left over symptoms.

After my surgeries, I started doing physical therapy to get rid of the residual pain and numbness in my right hand. It didn't work. My physical therapist seemed far more interested in collecting money from me forever than getting rid of my ailments. What HAS worked (miraculously so) is Bikram Yoga, sometimes called "Hot" Yoga. Some athletes might not want to try yoga and think it's silly or whatever. I was one of them. I considered yoga unnecessary, new age-y crap, but I cannot ignore the fact that, in two short months, it has taken away all of the residual TOS pain and numbness.

I don't know how well you know Mr. Rustich, but if he does have any residual symptoms, you might let him know that Bikram Yoga really works. Heck, if you know Reese Havens, you might let him know too! It'll help his back and legs. And F-Mart. Get these guys more flexible and they'll all be in the bigs in the next couple years.

At any rate, sorry for the long email, Mack. TOS is a real bummer, but I'm glad they've diagnosed it and can get Rustich the treatment he needs.

Keep doing great work.


Miles Kelly


Jonathan E said...

Great Information! Thanks

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