Therapist Notes – Subclavius


Paget-Schroetter syndrome is a specific form of thoracic outlet syndrome where the subclavian artery moves medially until it is restricted with pressure from the subclavius muscle. The arm becomes chronically swollen and bluish. It is more common among athletes that weight lift or play tennis.

In one case, I noticed that a woman’s arm was swollen a bluish.  The arm turned bright red, and the swelling went down when I released the subclavius and pecs, and lifted the collar-bone. Her arm was swollen and bluish again the next morning. I referred her out immediately, and she was able to verify the structural anomaly and restricted vein with ultrasound. She resolved the problem by having a section of her rib surgically cut out to provide room for the vein.

This post on Thoracic Outlet Syndrome has a video and document detailing the structures including the layout of the subclavian vein.

Subclavius seldom presents as the primary problem but generates intense sensation under static pressure when the trigger point is active. It is easily overlooked but can be a critical piece in resolving thoracic outlet problems. It not only pulls the rib down on the neurovascular bundle but can occlude the bundle, especially the subclavian vein, when it becomes stiff and hypertrophied.

Subclavius is covered by clavicular pectoralis major and can be tedious to work. Mobilizing fixations in the sternoclavicular joint will reduce proprioceptive feedback that perpetuates trigger points in the subclavius.

This post has the is the Anterior Thorax Supine routine from The Workbook of Classical Neuromuscular Therapy.

Treatment of the subclavius muscle shown in the featured image of the post.


This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


Weekly Featured Post

Optimizing Tension for
the Best Day Ever

This post explores this idea and optimizing tension for our best performance.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

Question? Comment? Typo?
IntegrativeWorks.com
(404) 226-1363
integrativeworks@gmail.com

Please note that some of the product links in the posts are affiliate links. At no additional cost to you, I may earn a commission when you purchase through that link. I’ve personally used most of these products and believe are genuinely helpful. Some products aren’t appropriate for me so I recommend it based on my experience with clients or the reviews online. The commissions I make are small and not worth promoting lesser products that would not produce suitable value. And please note, I do not advocate buying something that you can’t afford or that you’re not yet ready to implement.