Treatment of Thoracic Outlet Syndrome: Addressing Shoulder and Upper Thoracic Limitations

presented by Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

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Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Accreditation Check:

Now that you’ve determined that your patient has disputed neurogenic thoracic outlet syndrome (TOS), how should you address issues at the shoulder and upper thoracic spine? Following the first TOS course, this course addresses limitations at the glenohumeral joint and cervicothoracic junction and introduces neural flossing techniques.

CHTs, when submitting this for recertification through HTCC, this course can be used for CAT B (hand therapy courses < 3 hours in length); however, if this course certificate is submitted with the following course certificates listed below (or any combination totaling 3 hours or more), they can be submitted under CAT A (hand therapy courses > 3 hours in length).

Identification & Evaluation of Thoracic Outlet Syndrome (2 hours)

Thoracic Outlet Syndrome: Assessing the Elevation Chain (1.25 hours)

Treatment of Thoracic Outlet Syndrome: Where to Begin (1.75 hours)

Treatment of Thoracic Outlet Syndrome: Addressing Shoulder and Upper Thoracic Limitations (1.5 hours)

Meet Your Instructor

Ann Porretto-Loehrke, PT, DPT, CHT, COMT, CMTPT

Ann Porretto-Loehrke is a skilled clinician and dynamic instructor. She is the therapy manager of a large department at the Hand to Shoulder Center. Ann is a Certified Hand Therapist (CHT) and a Certified Orthopedic Manual Therapist (COMT) for treatment of the upper quadrant through the International Academy of Orthopedic Medicine (IAOM). She has extensive…

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Chapters & Learning Objectives

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1. Joint-Specific Treatment to Address Glenohumeral Joint Limitations

Posterior glenohumeral joint (GHJ) tightness can contribute to poor scapular mechanics. In addition, end-range GHJ limitations can contribute to TOS “compressor” symptoms. This chapter covers how to treat posterior GHJ tightness and limitations at end-range.

2. Joint-Specific Treatment to Address Limitations at the Cervicothoracic Junction

Stiffness in the upper thoracic spine can be a culprit with poor scapular mechanics and brachial plexus issues. This chapter covers how to address upper thoracic extension and rotation limitations.

3. Treatment Strategies for Addressing Adverse Neural Tension Issues and Chronic Pain

Patients with TOS often present with longstanding issues. Nerve gliding must be performed cautiously to avoid an exacerbation of the patient’s symptoms. This chapter covers neural flossing techniques and chronic pain considerations with TOS.