Thoracic outlet syndrome is a condition that may affect console and PC gamers alike. There are a couple variants including nerve vs. blood vessel impingement (compression) and structural vs. functional impingement.
Thoracic outlet syndrome occurs when there is impingement on the nerves or blood vessels in an area between your clavicle (collar bone) and ribs in the space between your neck and shoulder joint.
Most often, thoracic outlet syndrome in gamers will come secondary to poor posture—slouching forward in their chairs and leaning towards the screen while gaming.
It’s important to know some basic anatomy of the chest & upper back, also known as the thoracic region, in order to understand thoracic outlet syndrome.
The specific area that makes up the thoracic outlet is as follows:
Although not technically part of the anatomy, the term thoracic outlet also refers to the space between the clavicle and the ribs where nerves and blood vessels travel from the neck & thorax to the arms.
Thoracic outlet syndrome occurs when there is compression or irritation of the brachial plexus or subclavian artery between the neck/thorax and the shoulder.
For the general population, this impingement may occur for many different reasons including bony anomaly (i.e. cervical rib) or other issues with bone growth or position (structural impingement), inflammation, tumor or other mass, direct trauma or other injury, etc.
For thoracic outlet in gamers, the cause of impingement will most often occur due to hypertonicity or spasm in the muscles in the region of the thoracic outlet.
Hypertonicity is a word used to describe increased tone, otherwise described as “tightness” in a muscle while at rest. Spasm is a word used to describe an involuntary or unconscious contraction of a muscle.
In both cases, the muscle will be thicker than normal, taking up more space and crowding the structures nearby.
Thoracic outlet syndrome may be neurogenic; in other words, compression of the nerves. In thoracic outlet syndrome, the nerves being compressed may include nerve roots C5, C6, C7, C8, and T1 or the brachial plexus.
It may also be vascular where the blood vessels (arteries and/or veins) are compressed. In thoracic outlet syndrome, the blood vessel being compressed are the subclavian artery.
Since these structures are all in the same region surrounded by the same anatomy, both the nerves and blood vessels may be compressed at the same time.
There is not a large variation in the presentations of neurogenic vs. vascular thoracic outlet syndrome. And, ultimately, the treatment and prevention won’t be different since the pathophysiology is the same.
If you’re affected by thoracic outlet syndrome, you may experience one or more of the following symptoms:
Other findings may include:
Note: you should consult your doctor or visit the emergency room if you are concerned about any symptoms you experience
Thoracic outlet syndrome in gamers will usually occur due to muscle hypertonicity or spasm. In gaming, this is likely a direct result of chronic poor posture.
The simplest way to prevent and treat thoracic outlet syndrome is to monitor your posture. Visit our page on gaming posture to learn the most appropriate way to sit and protect yourself from injuries or ailments.
Since the most common mechanism of injury for thoracic outlet syndrome in gaming is muscle hypertonicity or spasm, it is important to keep those muscles active by both using them and stretching them.
Gently bend your head/neck side-to-side being careful not to shrug/elevate your shoulder during the movement
Pectoralis minor activation
Pectoralis minor stretch
To self-stretch the pectoralis minor, we utilize a pectoralis major stretch; it is difficult to isolate the stretch of the pectoralis minor on your own
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