Chief Complaint Numbness Or Tinglingparesthesias

There are a number of conditions that may lead the athlete to seek treatment for numbness or tingling. If one rules out the possible cervical pathologies discussed previously, then the initial differential should concentrate on sources of peripheral nerve compression. The pertinent sources include thoracic outlet syn drome, burners, and brachial neuritis. If distal in the arm, com pression of the median and ulnar nerves may also be considered.

Thoracic outlet syndrome is an uncommon, but important source of paresthesias in the athlete. It is associated with neurologic symptoms in over 90% of patients and presents with primary vascular symptoms in only 3% to 5% of cases.43 This syndrome often presents in throwers and racquet sports athletes, is often insidious, and can present as pain or heaviness. Neurologic findings can vary, but usually involve the lower brachial plexus and affect the forearm and hand.44 However, thoracic outlet syndrome has also been reported to manifest as a high radial nerve palsy with triceps weakness in tennis players.45,46

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