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The American Journal of Sports Medicine 36:369-374 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Exercise-Induced Scalenus Syndrome

Panagiotis Baltopoulos, MD, PhD*, Charalampos Tsintzos, MD*, George Prionas, MSc*,{dagger} and Maria Tsironi, MD, PhD{ddagger}

From the * Laboratory of Functional Anatomy and Sports Medicine, Department of Physical Education and Sports Science, University of Athens, Greece, and {ddagger} Department of Nursing, University of Peloponnese, Greece

{dagger} Address correspondence to George Prionas, MSc, Kalimnou & Tenarou, Dafni, Athens, Greece 17237 (e-mail: phgiorgio{at}yahoo.gr).

Background: Thoracic outlet syndrome is described as a group of distinct disorders producing signs and symptoms attributed to compression of nerves and blood vessels in the thoracic outlet region.

Purpose: To describe the exercise-induced scalenus anticus syndrome attributed to the anterior scalenus hypertrophy as a thoracic outlet syndrome underlying mechanism and to give recommendations for a safe and effective surgical treatment.

Study Design: Case series; Level of evidence, 4.

Methods: Twelve young professional athletes admitted for thoracic outlet syndrome (8 cases of neurologic thoracic outlet syndrome, 4 cases of mixed neurologic and vascular thoracic outlet syndrome) who reported numbness, tingling, early fatigue, muscle weakness, and pain were enrolled in the study. Scalenus hypertrophy was suspected to be the causative factor. Scalenectomy was performed in all cases.

Results: All patients had moderate to severe hypertrophy of the anterior scalenus muscle. Scalenectomy was performed, and there were no intraoperative or postoperative complications. Full activity was quickly achieved, and no recurrence of symptoms was documented.

Conclusion: Surgical intervention for scalenus anticus syndrome can allow an athlete to return to full activity and improve quality of life. Surgical intervention seems to be the treatment of choice in terms of restoring quality of life and physical activity.

Key Words: scalenus anterior syndrome • exercise • scalenectomy • brachial plexus






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