In recent years, we’ve seen a significant increase in TOS injuries among pitchers, from youth leagues all the way to MLB.

Thoracic Outlet Syndrome occurs when nerves or blood vessels are compressed in the narrow space between the collarbone and first rib.

This often results in tingling, pain, reduced strength, and a “dead” feeling in the throwing arm – usually from repetitive overhead pitching.

⚡ The Real Cause

From a #MotorBall perspective, the root cause of TOS – just like Tommy John (TJ) surgeries – is failing to respect the two core principles of a pitcher’s individual motor preferences.

These principles form the athlete’s natural blueprint and determine the healthiest, most effective, efficient, and energy-saving arm slot.

Ignoring this blueprint – for example, by forcing an unnatural arm slot or using a standard biomechanical template – creates compensation patterns, increases stress on the arm, and elevates the risk of TOS or TJ surgery.

🏋️ Hip vs. Shoulder Strategy

Every pitcher has a natural way to generate power:

• Hip strategy
• Shoulder strategy

This relates to where the spine is most mobile:

• High mobile point
• Low mobile point

⚾ Optimising the Release Point

By combining these individual traits – vertical or horizontal organisation and high or low mobile point – we can identify the most efficient, safest, and energy-saving release point for each pitcher.

Respecting this natural blueprint minimises compensations, reduces injury risk, and maximises performance.

💡 Key Takeaway:

Both TOS and TJ injuries share the same root cause:

ignoring the core principles of a pitcher’s motor preferences, which dictate the optimal, healthy, and efficient way to throw.