Contents
Definition
- Classified into 3 types depending on direction and location of fracture lines: 1
- Groove
- Intrascalene
- Posterior types
Causes
- Overhead throwing athletes have been identified as a sensitive group1
- Overhead explosive activities
- Weightlifting
- Tennis
- Baseball
- Swimming
- Eccentric contractions of muscles attaching to first rib:
- Scaleni
- Serratus anterior
- Intercostalis
Indications
- Pain at affected side, may be felt at:
- Base of neck
- Scapula
- Clavicula
- Pectoral area
- Spontaneous pain
- Pain after overhead activity or explosive swings
- Swinging bat
- Pitching ball
- Tennis swings and serve
Examination
Neck
- Active lateral flexion away from painful side – painful
- Passive lateral flexion away from painful side – painful
- Resisted lateral flexion towards the painful side – painful
Scapular
- All movements are more or less painful
Shoulder
- Active elevation – limited and very painful
- Passive elevation – full range but painful
Considerations
- May later lead to/ or be exposed for thoracic outlet syndrome