4. Baker CL, Liu SH. Neurovascular injuries to the shoulder. Journal of Orthopaedic and Sports Physical Therapy 1993;18:360–364 5. Mochizuki T, Isoda H, Masui T, Ohkawa Y, et al. Occlusion of the posterior humeral circumflex artery: detection with MR angiography in healthy volunteers and in a patient with quadrilateral space syndrome. American Journal of Roentgenology 1994;163:625–627 6. Thrush A, Hartshorne T. Peripheral vascular ultrasound: how, why and when? Churchill Livingstone 1999. ISBN 0443060495 7. Spencer MP, Reid JM. Quantitation of carotid stenosis with continuous-wave (C-W) Doppler ultrasound. Stroke 1979;10:326–330 8. Strandness D. Hemodynamics of arterial stenosis and occlusion. In: Strandness D (ed.) Duplex scanning in vascular disorders, 3rd edn. Lippincott Williams and Wilkins 2002. ISBN 078172631X 9. Plewa MC, Delinger M. The false-positive rate of thoracic outlet syndrome shoulder maneuvers in healthy subjects. Academic Emergency Medicine 1998;5:337–342 10. Stapleton C, Herrington L, George K. Sonographic evaluation of the axillary artery during simulated overhead throwing arm positions. Physical Therapy in Sport 2008;9:126–135 11. Rohrer MJ, Cardullo PA, Pappas AM, Phillips DA, Wheeler HB. Axillary artery compression and thrombosis in throwing athletes. Journal of Vascular Surgery 1990;11:761–768 12. Ouriel K. Noninvasive diagnosis of upper extremity vascular disease. Seminars in Vascular Surgery 1998;11:54–59 13. Schep G, Schmikli SL, Bender MHM, Mosterd WL, et al. Recognising vascular causes of leg complaints in endurance athletes. Part 1:

validation of a decision algorithm. International Journal of Sports Medicine 2002;23:313–321 14. Abraham P, Bickert S, Vielle B, Chevalier EM, Saumet JL. Pressure measurements at rest and after heavy exercise to detect moderate arterial lesions in athletes. Journal of Vascular Surgery 2001;33:721–727

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THE AUTHOR Claire

T

Claire Stapleton is a chartered physiotherapist currently completing her PhD at Liverpool John Moores University. Her research focuses on the mechanisms and diagnosis of vascular compression syndromes at the shoulder. In addition,

erpool John Moores H

Claire maintains a clinical caseload with the English Institute of Sport and sport scholarship students at the university. Before undertaking her PhD, Claire lectured in sports therapy and sports science at the University of Hertfordshire and worked at the Commonwealth Games and the World Transplant Games in 2002.

online Videos and animations

just £15 per year or comes automatically with a clinic subscription (clinic subscription comes with 5 individual online logins)

To add online access to your paper subscription costs

Step 1: Deep inhalation - closing down the costoclavicular space

Step 2: Scapula retraction - further compression of the costoclavicular space

Step 3: Combined cervical rotation and extension - targets the scalene triangle

Step 4: The Hyperabduction manoeuvre

Step 4: Hyperabduction manoeuvre in quadrilateral space syndrome

sportEX/Primal Pictures: Anatomy of compression syndrome animations

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sportEX medicine 2009;40(Apr):23-26