Zack Wheeler, Philadelphia Phillie’s elite pitcher, was diagnosed with venous thoracic outlet syndrome in August of 2025. Considering this is one of the league's best pitchers, this was a big blow to the team and fans. One can speculate that the outcome of the World’s series could have been different.
The thoracic outlet is a narrow space between the collarbone (clavicle) and your first rib. Structures including nerves, blood vessels, and muscles pass from the neck and chest down through the arm in this area.
When any of those structures are compressed, it results in thoracic outlet syndrome (TOS). There are three types of thoracic outlet syndrome; neurogenic, venous, or arterial. Symptoms can include shoulder, neck or arm pain, numbness or tingling in the arm or hand, and weakness.
In athletes like Zack Wheeler, numbness, loss of velocity, and endurance were major complaints. Zack required emergency surgery to remove a blood clot. He needed additional surgery for a first rib resection and removal of part of his scalene muscles in his neck. Hopefully with rehabilitation he will be back pitching again next season.
Not all people need surgery; traditional physical therapy can have amazing results with a dramatic reduction in symptoms. Here are two exercises that can help with thoracic outlet syndrome. If at any time this increases tingling, numbness or radicular symptoms, discontinue the exercise.
Pectoralis major and minor stretching in the doorway
- Stand in the doorway with your arms on the frame, elbows facing down.
- Take a small step forward until a gentle stretch is felt in the pectoral major muscle.
- Following this, raise your arms up on the frame a few inches higher, take a small step forward again until a stretch is felt in the pectoral minor muscle.
- Hold for 30 seconds, two times each.
Scalene stretches
- Keeping your nose forward, gently bend your ear to your shoulder.
- Tilt your head up towards one corner of the room or away from your shoulder.
- Then tilt your head towards the floor or towards your shoulder.
- Hold each for 30 seconds each. Repeat gently two times.
Get back to the life you love! Don’t settle for less. Physical therapy will be able to create a program tailored to you that will fit you and your individual needs.
