MLB Pitcher Chris Archer Has Surgery to Treat NTOS, And He’s Not The First

As reported in Forbes Magazine, sports have been upended in 2020, causing many athletes to miss their seasons debuts. Chris Archer, starting pitcher of the Pittsburgh Pirates, will be off the pitch for the 2020 season, but the illness preventing his participation in the season isn’t coronavirus. Archer has made public his battle with neurogenic thoracic outlet syndrome, and he announced he has just undergone surgery at Washington University in St. Louis to treat the condition.

Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is the umbrella term for a type of disorder caused by injury or irritation to the neck and upper chest, damaging the thoracic outlet- consisting of the relevant nerves and blood vessels.  This causes pain in the neck, shoulder, and arm, numbness, weak hands, sensitivity to the cold, and impaired circulation. The unhealthy compression causing the symptoms can result from patients having an extra rib, an old fracture, bone or tissue abnormalities, as well as being likened by repeated injuries, bad posture, weightlifting, stress, depression, or sleep disorders. The disease can be treated using pain medication and physical therapy. If this isn’t effective, patients may need to undergo surgery.
Neurogenic thoracic outlet syndrome is a subset of the disease, due to the pinched nerves between the shoulder and the neck known as the brachial plexus.

Baseball and NTOS

Archer is not the first major league baseball player to receive the diagnosis- rather the high intensity impact of the sport on players bodies can be responsible for the disorder’s development. However, because the symptoms are similar to many other injuries that effect this part of the body, diagnosis is difficult, making treatment difficult too. The diagnosis relies on ruling out similar disorders rather than clearly identifying it.

NTOS Effect on Pitcher’s Careers

However, in the past once diagnosed and attended to, players have been able to return to the sport.  A study lead by Dr. Robert W. Thompson in 2017 found that of the 13 MLD pitchers that were diagnosed with NTOS and received surgery as treatment from 2001 to 2014, 10 were able to return to the pitch. On average, they missed 10.8 +/-1.5 months playing, but they found no significant negative impact on their gaming averages. They tended to score similarly on their run average, fielding independent pitching, walks per hit, and the other metrics used to evaluate a pitchers performance.  The study also reported, “There were also no significant differences between the 3 years before and the 3 years after surgical treatment.”
They hope these findings are positive for Archer, who is a two-time All-Star player. While his success has dwindled in recent years, hopefully the surgery can kickstart his career and he can undergo a quick recovery.

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