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Thoracic Outlet Syndrome

Updated: Jan 22, 2023

This is probably the holy grail of my work.


Several years ago, I went to a fantastic human massage therapy program that specialized in structural integration and nerve release work.


Of all of the amazing syndromes and injuries I learned to work on, the one that I was always the most fascinated by, and most gifted with, was Thoracic Outlet Syndrome.


If you aren’t familiar, it’s a painful and complicated group of disorders that occur when blood vessels or nerves (brachial plexus) in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause shooting pain, numbness and/or tingling in your shoulders, neck, down into your arm and fingers or even your ribs and mimic heart attack like symptoms.



Once I graduated and began practicing in a clinic I realized that the majority of humans have this in some grade or another. Mostly due to our day to day postures. It became something that I ended up specializing in as a result.


Many clients would come to see me once diagnosed before being sent down to surgery where they would have part of their clavicle shaved down to make more space in the thoracic outlet.

Alternatively, they could have 1-3 sessions with me and do some P/T homework, and all would be well.


One of the things that blew my mind when I went to human school was how much more education we received around things like this than what is available for equines. Even Veterinarians are not educated around pinched nerves and how to manually release them. They can do nerve blocks, but that doesn’t ever solve the the core issue, it merely numbs it.


So, let’s jump into how it translates to the horses, shall we?


Aside from them not having a clavicle, we’re actually built quite similar, and after spending the last several years carefully translating my nerve release work on humans over to the horses, in my opinion there is nothing left to argue that they also suffer from just as many syndromes as we do; they just aren’t yet named.


So how does this translate to Thoracic Outlet Syndrome in Equines?


Most horses are severely underdeveloped in their thoracic sling, which is extremely important because it holds up the entire front end of their body. Roughly 58% of its body weight, in fact.

When these muscles are not developed correctly, the horse then loses the muscle density that it is supposed to serve as a cushion between their scapula and C7, T1 and most importantly in this case - the brachial plexus. So while I’m not a Veterinarian and I will never “diagnose” any horse with anything, I will absolutely tell you that there is something to explore here, and I invite you to do it.


When the compression I explained above happens, the horse also will get a wide array of symptoms:

  • Head shaking syndrome.

  • Head shyness.

  • Hypertension of the neck.

  • Girth/Saddle fit issues.

  • Undiagnosed Lameness in the front end (which ends up shutting down the front end over time and then causes undiagnosed lameness in the hind end).

  • And in severe cases, you’ll see horses become over at the knee.


It’ll be slight at first, just looking like they can’t quite lock it all the way.


Sometimes they’ll start to trip more, and then over time it’ll be full-fledged where the horse will stand and tremble with instability. This is typically due to them not being able to activate the correct musculature in attempts to either avoid the pain or due to the numbness from the nerves lack of ability to communicate.


So… Shooting pain, numbness and/or tingling, all in the parts of the body that we see effect in humans as discussed above. So what about relieving it?


Well, the same manual nerve release work that I do to alleviate my human patients, also works on the horses for the cases listed above. And while it’s handy to be able to release the nerve impingements, our real focus is getting to the heart of WHY it’s happening and then targeting the isolated muscles required through careful training to help heal and prevent them from coming back.




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