Dr. Mark Schwartz weighs in on diagnosis of thoracic outlet syndrome for Markelle Fultz

Dr. Mark Schwartz weighs in on diagnosis of thoracic outlet syndrome for Markelle Fultz

Markelle Fultz has been diagnosed with thoracic outlet syndrome.

If you’re not a medical professional, chances are you’re unfamiliar with his new diagnosis.

Dr. Mark Schwartz, medical director for Virtua Sports Medicine, gave more insight into Fultz’s diagnosis and the medical prognosis for the Sixers’ second-year guard on Tuesday in a phone interview with NBC Sports Philadelphia.

Schwartz is not treating Fultz. 

The treatment

Sixers vice president of athlete care Dr. Daniel Medina said in a statement that Fultz will begin physical therapy immediately.

While the Sixers say Fultz is out indefinitely, ESPN’s Adrian Wojnarowski reports that there’s optimism he can return within three to six weeks. 

The typical physical therapy program for thoracic outlet syndrome focuses on relieving pressure from the nerves, according to Schwartz.

“The physical therapy, a lot of it is stretching exercises to help take the pressure off the nerves. The goal of stretching is to relieve compression in that thoracic outlet area. So there will be stretching exercises, followed by postural exercises to help the alignment around the neck and then also strengthen the muscles around that area, with the goal of taking the pressure off the nerves.”

Is this connected to the reported wrist issue?

According to a report by The Athletic on Nov. 21, Fultz had been “been playing with an apparent injury in his right wrist area that has adversely affected his ability to shoot.”

Though TOS affects the nerves between the neck and shoulder, Schwartz said the syndrome can also cause symptoms in the wrist area.

Typically, Thoracic outlet syndrome gives you sensations of some pain, burning sensation, numbness, tingling. If those were the symptoms he was experiencing distally, it is possible. People with thoracic outlet syndrome, classically their symptoms are pain, numbness, tingling in the arm, which is exacerbated by certain motions involving the neck and shoulder. Sometimes they notice that when they turn their neck or rotate the shoulder their symptoms worsen because the nerves up in that area are getting pinched. It’s not uncommon to have symptoms down in the wrist and hand. Those symptoms classically are pain, burning sensation, and tingling.

The "bumps and bruises" 

Fultz said on Nov. 6 that, while he wasn’t 100 percent healthy, he was just dealing with typical “bumps and bruises.” While TOS can cause pain and a burning sensation, it’s not inconceivable that Fultz was experiencing numbness and tingling judged by himself and by the Sixers to be “normal.”

“That’s the tough part,” Schwartz said. “Lots of basketball players get lumps, bumps and pain in their hands and wrists — typical signs of neurogenic thoracic outlet are neurogenic signs, which are classically numbness and tingling. That’s what you generally see in the hands and fingers with people with thoracic outlet. They generally will complain of a burning sensation or numbness and tingling. A true wrist problem, if he had one, he would have localized tenderness in the wrist, some swelling, stuff like that. That’s more of a wrist problem rather than a nerve problem.”

The unusual free-throw routines 

In his last few games, Fultz’s routines at the foul line were unorthodox, to say the least. 

On Nov. 12 in Miami, Fultz double-pumped on a free throw. Afterward, he said the ball slipped

Against the Jazz on Nov. 16, Fultz juggled the ball up from his waist to his release point. 

Those routines may have been a way for Fultz to try to relieve the symptoms he was experiencing. 

“It’s possible,” Schwartz said. “If he developed this thoracic outlet from the repetitive use of his shoulder, maybe these things we’ve seen in his motion lately, they might have been compensatory things to do to try to release some of the symptoms.”

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Sixers at Knicks: 3 storylines to watch and how to stream the game

Sixers at Knicks: 3 storylines to watch and how to stream the game

The 27-16 Sixers begin a three-game road trip Saturday night against the 11-31 New York Knicks.

Here are the essentials:

When: 7:30 ET with Sixers Pregame Live at 7 p.m.
Where: Madison Square Garden 
Broadcast: NBC Sports Philadelphia Plus
Live stream: NBCSportsPhiladelphia.com and the NBC Sports MyTeams app

And here are three storylines to watch: 

Campaigning for Simmons 

Despite posting 20 points, 11 rebounds and seven assists in addition to playing smothering second-half defense, Ben Simmons might have been a bit overshadowed Friday night by Furkan Korkmaz’s career-high 24 points.

Brett Brown didn’t want that to happen.

How can we not recognize Ben Simmons' defense? After the first timeout in the third period, are you serious? He was just the adult in the room defensively. He's a physical presence by a lot when you watch him play defense. I thought he changed the game. How can he not be a First Team, All-League defensive player? I don't know.

A great chance to win on the road

The Sixers are 20-2 at Wells Fargo Center and 7-14 on the road. Simmons doesn’t know why there’s such a disparity. 

“If I knew the answer I’d probably fix it on the road,” he said Friday.

A game against the Knicks presents the Sixers with a strong opportunity to win away from home for the first time since Dec. 23. The Knicks are 6-14 at Madison Square Garden.

“At the end of the day, it comes down to playing defense, locking in from the first to the fourth quarter, and keeping that mentality and not letting up,” Simmons said. “Just staying locked in to that team game and playing defense.”

The Sixers beat the Knicks in New York on Nov. 29 without Al Horford, Josh Richardson and Kyle O’Quinn, coming back from a 16-point second-quarter deficit. All three of those players should be available tonight, while Joel Embiid is set to miss his sixth straight game after having surgery last Friday for a torn ligament in the ring finger on his left hand. Knicks rookie RJ Barrett is out with a sprained right ankle. 

Not so fast … 

We all expected the Sixers to play at a quicker pace in the absence of Embiid. So far, though, that hasn’t been the case.

The team’s 95.8 pace since the Boston game last Thursday is 29th in the NBA. 

They have, however, taken better care of the ball since Embiid’s injury, turning it over only 11 times per game, tied for best in the league. 

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Furkan Korkmaz sparks sudden blaze, then leaps over logic

Furkan Korkmaz sparks sudden blaze, then leaps over logic

There came a point Friday night during Furkan Korkmaz’s career-best 24-point performance when everyone at Wells Fargo Center seemed to collectively shrug and say, “Sure. Why not?”

Korkmaz had already flashed his trademark skill, hitting four three-pointers in under two minutes during a sudden blaze at the end of the third quarter.

With a little less than seven minutes to go in the Sixers’ 100-89 win, he stared down Bulls center Cristiano Felicio. The 22-year-old then crossed Felicio over, blew past him, dunked and let out an exultant scream. 

“At that time of the game, I was really feeling it,” Korkmaz said. “I got that confidence. When I saw the open lane, I just took off. I was also not expecting that, but I just dunked it. That was a good moment.”

Korkmaz wasn’t done, though. He missed a well-earned heat check on the Sixers’ next possession, but dropped in a floater shortly after. And, just to confirm that it was indeed his night, he took a charge on Bulls star Zach LaVine. 

Which play did he enjoy more?

“It’s a tough question, but I think I would say the dunk,” Korkmaz said honestly.

This isn’t the first time Korkmaz has changed a game this season with his shotmaking. He had nine key fourth-quarter points Wednesday vs. Brooklyn, blew up the Bucks’ zone in the third quarter on Christmas and made the game-winning three on Nov. 2 in Portland.

The Sixers declined Korkmaz’s third-year option last year, then let him sit on the free-agent market until July 25. Though they billed him as a young, promising player, their actions suggested Korkmaz was not a prominent part of their plans. He appeared to be on the fringe of the rotation.

Brett Brown hasn’t passed up many chances to laud Korkmaz, and he had a great opportunity Friday.

It’s really quite a — to say it's incredible would be too dramatic — but it's a heck of a story, isn't it? Just where he was and where he is. For us to see him — and he's young, can't forget his birth certificate — for us to see him come in and do JJ [Redick]-like stuff and have that type of a bomber, that was different. … We ran probably, I don't know, five plays in a row going to him. 

“I had flashbacks of JJ. We jumped into JJ's package and he changed the game. He gave us a spark and whether it was a three ball — I don't remember JJ dunking like that … but the long shot and just like bam, bam, bam — quick points, buckets — fueled our defense.

While Korkmaz deserves credit for translating his hypothetical value as a shooter into real contributions this year — he’s made 71 threes, tied with Tobias Harris for most on the team, and converted 39 percent — he will probably not maintain Friday's euphoric high. 

He’s devoted time and energy to improving his defense, but the question of whether he’ll be able to hold his own in the playoffs remains open and valid. If he’s not sinking shots, his impact tends to not be positive. Any moves the Sixers make before the Feb. 6 trade deadline could shift his role, too.

But, for the time being, he is playing with an apparently limitless self-belief.

“As a player you just need to get that confidence,” he said. “When you start to feel good on the court and also your teammates see that, your coaching staff sees that — I think today everybody saw that I was feeling it — and I knew that I had to shoot those looks. I just take the open shots, that’s all I do.”

Brown is clearly relishing in Korkmaz’s success.

“He's quality people,” Brown said. “He's a genuine person and you're proud of that, too. Good things happen to good people ... He's put in the time and to his credit, he came in and changed the landscape of an NBA game. And he did it quite emphatically. It wasn't like it was swept under the carpet. He did it where ESPN and all of us and his teammates, probably more importantly, felt his success.”

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