By Caroline Cromwell, MD, Director of Thrombosis Services at Mount Sinai Medicine and member of NBCA’s Medical and Scientific Advisory Board.
Phillies pitcher Zack Wheeler was recently diagnosed with deep vein thrombosis (DVT), or a blood clot in his right upper extremity, near his throwing shoulder. It’s an alarming condition for anyone, especially a professional pitcher.
Wheeler underwent a thrombolysis procedure, which is typically a minimally invasive, catheter-based surgery that dissolves or removes the clot. The aim of this procedure is to restore proper blood flow and prevent further complications.
What is thoracic outlet syndrome and why do athletes get it?
Thoracic outlet syndrome (TOS) is a condition where the nerves or blood vessels that travel from your neck into your arm get squeezed in a narrow space called the thoracic outlet. This space is located between your collarbone (clavicle) and your first rib.
What does it feel like?
Because the nerves and blood vessels are affected, people with TOS often experience:
- Numbness, tingling, or weakness in the arm or hand
- Pain in the shoulder, neck, or arm
- Swelling or discoloration in the arm (in some cases when blood vessels are involved)
Why does it happen?
TOS develops when something narrows or puts extra pressure on that space. Common reasons include:
- Anatomy you’re born with: Some people have an extra rib (called a cervical rib) or unusually tight muscles that crowd the space.
- Repetitive movements or posture: Jobs or sports that involve repeated overhead arm use (like swimming, baseball, or even sitting hunched over a computer) can tighten muscles and press on the nerves/vessels.
- Injury or trauma: Accidents (like a car crash or a fall) can change how the collarbone or ribs sit, narrowing the outlet.
- Poor posture: Slouching forward with rounded shoulders can shrink the space over time.
The Bottom Line
Thoracic outlet syndrome happens when the “highway” of nerves and blood vessels leaving your neck gets squeezed. The cause can be a mix of natural body structure, daily habits, or injuries. Treatment usually focuses on physical therapy to improve posture and strengthen muscles, and in some severe cases, surgery to open up space.
In the case of Zack Wheeler, the Phillies recently announced he will need thoracic outlet decompression surgery, likely involving the removal of a rib to relieve pressure.
For more information on athletes and blood clots, click here.
