TOS Test


To view Adson’s TOS Test see:

TRAVEL’S TEST (Reverse Adson’s Test):

Thoracic Outlet Syndrome (TOS):

Thoracic Outlet Syndrome involves the compression at the superior thoracic outlet, resulting from excess pressure placed on a neurovascular bundle passing between the anterior scalene and middle scalene muscles. TOS can affect one or more of the nerves or blood vessels as they pass between the chest and upper extremity.

Thoracic Outlet Syndrome
symptoms include arm, shoulder, and/ or neck pain, numbness in the fingers, hand and/or arms, weakness and impaired circulation to the upper extremities.

Middle Scalene:

The middle scalene arises from the posterior tubercles of the transverse processes of the lower six cervical vertebraes. It inserts by a broad attachment into the upper surface of the first rib, between the tubercle and the subclavian groove. The brachial plexus and the subclavian artery pass anterior to the middle scalene. Because the middle scalene muscle elevates the upper ribs, it is also one of the accessory muscles of respiration. It is involved in thoracic outlet syndrome, which is compression of the subclavian arteries and nerves of the brachial plexus in the region of the thoracic inlet.

TOS Test: TRAVEL’S TEST (Reverse Adson’s Test):


  • Testing for: Neurovascular Compression (TOS) caused by the middle scalene.

Video Demo Instructions, Procedure, Positive Test:

Thoracic Outlet Syndrome Tests: TRAVEL’S TEST (Reverse Adson’s Test) Video Demo:


TOS Test: Reverse Adson’s Test / TRAVEL’S TEST: Procedure:

• Patient is seated
• Passively extend and slightly externally rotate their affected arm
• Monitor their radial pulse
• Patient rotates their head away from the affected side
• Patient takes a deep breath and holds it from 15-30 seconds.

TOS Test: Reverse Adson’s Test / TRAVEL’S TEST: Positive Sign:

  • Patient’s symptoms reoccur (numbness, tingling in hands and fingers) or the patient’s radial pulse diminishes.