The AAO Journal, 2009/12, 19(4):21-30, type of study: ,art,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

article [2635]
idiopathic scoliosis [6]
nonunion rib fractures [1]
OMT [3924]
osteopathic manipulative treatment [3945]
post-sternotomy pain [1]
postthoracotomy pain [1]
rib dysfunction [3]
thoracic outlet syndrome [26]
transversus abdominis [2]
transversus thoracis [1]

Abstract:

The transversus thoracis is a relatively little known muscle. Perhaps because of its somewhat obscure intrathoracic location, clinicians have given it scant attention. It is an expiratory muscle with attachments to posterior sternum, manubrium, and ribs two to six. My exploration of this muscle began after a young adult reported chest asymmetry and rib pain following a motor vehicle collision. Examination revealed a unilateral group exhalation dysfunction of ribs two to six, and thoracic scoliosis. This suggested the transversus thoracis muscle was involved. Both the scoliosis and rib dysfunction resolved following osteopathic manipulative treatment. A literature search showed no reference to treatment of the transversus thoracis muscle, and only a few articles regarding its physiology and function in humans. This article describes the anatomy, physiology, related pathology, and diagnosis and treatment of associated somatic dysfunction. Clinical cases are presented, which demonstrate positive outcomes of osteopathic manipulative treatment of thoracic outlet syndrome, upper airway obstruction, scoliosis, persistent chest pain and prolonged nonunion of rib fractures, associated with transversus thoracis dysfunction.