Friday, December 7, 2018

What Is Wrong with Markelle Fultz?

Markelle Fultz and Thoracic Outlet Syndrome

Some Philly sports fans out there may have heard about Markelle Fultz’s new diagnosis of Thoracic Outlet Syndrome (TOS), which may be what is causing his shot to look awkward and unnatural. TOS is an injury in the area of the neck and shoulder that is classified as compression of nerves, arteries, and veins that travel through a small space called the thoracic outlet. At times one or all of these structures are being compressed. If the arteries or veins are obstructed than you can experience symptoms such as pain in the arm, numbness/tingling, discoloration, temperature changes, and a weakened pulse. When the nerves are affected symptoms involve muscle weakness, muscle wasting, numbness/tingling, and pain down the arm.

In Fultz’s case his nerves are being compressed, which makes it difficult for him to control the muscles needed to shoot a basketball due to the weakness and inability to coordinate the appropriate motions. The compression on these structures is caused by either tight muscles of the neck (scalenes) and/or the first rib or clavicle or also called collar bone. In rare cases an extra rib is present at birth, but this is not present in most of the population.

Fultz’s specialist has recommended physical therapy to help resolve this problem, which can help in a few different ways. One way is stretching of those particular neck muscles combined with soft tissue massage to increase flexibility and reduce the overall tension on the nuerovascular structures. A second way physical therapy can resolve TOS is by performing mobilizations of the first rib and clavicle to increase mobility and facilitate proper movement of the bones/joints, thereby relieving compression on the nerves or vascular structures. A third way physical therapy can help is by correcting poor posture which can be a contributing factor to the underlying issue. We can do this by educating patients on proper posture and certain stretching/strengthening techniques for affected muscles. Often times a combination of all three of these treatments techniques are used to help resolve the TOS. The report is that Fultz is going to be out 3-6 weeks while receiving physical therapy so that he can have sufficient time to address his specific deficits to reduce the compression on his nerves.

Mark Romano PT, DPT is the newest PTW Clinical Supervisor in  our Glenside location. To schedule an appointment or evaluation call Mark at (215) 887-2001 today!