According to the National Institute of Rate Disorders, neck trauma, whiplash injuries, or repetitive stress injuries at work most commonly cause neurogenic thoracic outlet syndrome. For Minnesota Twins pitcher Josh Staumont, repetitive stress at work is a given. The 30-year-old pitcher has thrown 3,392 pitches between 2018 and 2024.
That would be considered repetitive stress.
Straumont first hit the injured list last season on June 6 with a neck strain. A month later, Staumont underwent a risky procedure to assist with his knee diagnosis of thoracic outlet syndrome (TOS). Staumont rejoined the Twins. To understand his journey back to the majors, it’s important to understand TOS, what his surgery entailed, and why TOS was once a career-ending injury.
“It’s frustrating,” Straumont told reporters on Wednesday, “but TOS is a lot more frustrating than something more simple.”
TOS is difficult to define. Typically, the injury is caused by nerves being pinched somewhere along a person’s upper thoracic vertebrae, specifically right above and behind the clavicle (collarbone). Without getting into unnecessary detail, this syndrome can occur when a grouping of nerves called the brachial plexus becomes compressed due to trauma or overuse, or the blood vessels in the area of the plexus become compressed.
Below is a diagram pointing out where the compression occurs:
In the most common neurogenic TOS (95% of cases), this is the compression of that brachial plexus. A person might feel numbness, tingling, and occasionally pain in the arm and shoulder. In more severe cases, people can suffer other neurological effects, such as slurred speech and vision issues. Living with TOS is an option because surgery isn’t always the answer. However, having TOS long-term can lead to muscle breakdown and irreversible effects. Needless to say, it’s not ideal for an MLB-caliber pitcher.
Positioning can cause similar symptoms to TOS. Imagine sleeping on your side, with your arm under your head. After a period of time, that position can cause similar symptoms, such as joint pain and numbness of the hand. However, when this is caused by positioning, alleviating the pressure will return the feeling and lessen the pain. On the other hand, this is a constant with TOS.
The causes of TOS are typically due to trauma, bone abnormalities, or long-term bad posture that cause the compression of nerves. However, baseball pitchers are at risk for this due to the frequent motion of pitching that can cause the nerve to become pinched.
Diagnosing TOS is pretty straightforward. An X-ray can suggest a problem, and an MRI can confirm it. Therapy, better posture, and weight loss can resolve the condition in most cases. However, if those don’t work or if a physical abnormality causes the condition, surgery may be the only option. That could involve removing scar tissue or shaving down brown abnormalities and stabilizing a loose shoulder joint.
TOS surgeries have come a long way. Generally, the surgery is just a same-day procedure that may require an overnight commitment. Most people will experience pain from the surgical sites but will notice the symptoms TOS causes to disappear almost immediately.
The road to recovery involves taking a couple of weeks off from normal everyday activities, such as lifting or using the arm. However, people can resume regular exercise shortly thereafter. However, the recovery time can be much longer for an MLB pitcher. The loss of grip strength and shoulder strength from the condition and the surgery can take months to recover fully.
“When you take yourself pretty seriously, and this is a job that you have to,” Staumont said when a reporter asked if he was excited to be back, “being able to kind of step back on, put this jersey on and wear it with pride, and know that you kind of earned it.”
Given what he went through with TOS, he has earned putting that jersey back on, hopefully, without pain or numbness.
