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Back In The Water


In April of 2018, during my Junior year in high school, I was diagnosed with thoracic outlet syndrome (TOS). I had been swimming since the age of five, and suddenly swimming was taken away. This film and website are my way of giving back to the community. As I have lived through the veno-occlusive form of TOS, I have discovered a lack of information on how to manage this long-term and how an athlete should approach TOS. I hope that this website can be a place where others grow, learn, and share about TOS. Since my diagnosis, I have heard about many athletes and others whose careers and lives have been changed dramatically due to TOS. TOS is a condition that is still being studied, and the long-term effects are still unclear. I want the information I have learned to be shared and used as a source of encouragement. As you read this, feel free to interact.

Thank you for visiting, and please share this resource with others who might benefit.

Jake Marcum

Watch the film

34 min, Medical Documentary, Sports Therapy

Cast Members

Jake Marcum

As a high-school senior,  Jake swam to a National Juniors Title in the 200 backstroke at the NCSA Junior National Championships in Orlando, followed soon after by U.S. Olympic Trials in Omaha. What it took to get him there was nothing short of a miracle after battling with thoracic outlet syndrome.

Sonya Marcum

Jake’s mother, and biggest fan, shares the role of parent and nutritionist through Jake’s recovery, as he fought to rehab his body and get back into the pool.

James L. Marcum M.D.

Father and cardiologist. Dr. Marcum knew the medical complexities of Thoracic Outlet Syndrome. A wholistic approach utilizing the best in rehab, optimal nutrition, and emotional support would be needed for Jake swim again competitively and heal from this syndrome.

Mark Fugate M.D.

Board certified vascular surgeon with the Chattanooga Heart Institute. Dr. Fugate is a surgical expert in Thoracic Outlet Syndrome.

Coach Timothy Bass

As one of Jake’s trainers at McCallie school, and now a trainer at Brigham Young University, he was the first to identify a problem. Coach Bass rushed Jake to obtain needed medical help. In the following months he provided skilled, intense rehabilitation and emotional support.

Coach Stan Corcoran

McCallie Aquatics Coach, and the one responsible for teaching Jake to swim, Coach Stan pushes Jake to work harder while helping him realize the gains may come back slower than desired.

Coach Ray Looze

Head swimming and diving coach at Indiana University. Having just signed Jake to swim at Indiana, would he be willing and  able to hold Jake’s spot at Indiana after learning of Jake’s serious medical condition?

Learn more about Thoracic Outlet Syndrome


In this follow-up interview, Jake shares what happened after the conclusion of filming “Back In the Water” and tells us how he’s been dealing with the condition since.

Jake and Meg discuss similarities and differences of her experience with arterial thoracic outlet syndrome.

From TOS Diagnosis to swimming once again at a top-level. Jake Marcum shares his story.

Join James Marcum, MD, a national thought leader on vascular health and nutrition as he discusses how nutrition may impact Thoracic Outlet Syndrome.

Frequently Asked Questions


Where can I find up to date information on the diagnostic and acute treatment of thoracic outlet syndrome?
What is Thoracic Outlet Syndrome (TOS)?

TOS occurs when the space between the collarbone and first rib is narrowed or compromised. The structures that pass through this area, including the vein, artery, and nerves, are compressed and symptoms can develop.

What symptoms are commonly associated with TOS?

This can vary and depends on the anatomical structures that are compressed.

  • If the vein swells with fluid, pain and a bluish discoloration are common.
  • If the artery swells, pain, numbness, a white discoloration, or weakness may be experienced.
  • If the nerves are affected, weakness, pain, numbness, tingling, problems feeling temperatures, and poor coordination are common.
What causes the TOS?

This can vary and depends on the anatomical structures that are compressed.

  • Injury
  • Repetitive activities
  • Anatomical defects
  • Anatomical defects and hypertrophied muscles
  • Pregnancy
What are the treatments?

This depends on the cause.

  • Mild cases may respond to physical therapy, including scalene stretches, pectoralis minor stretching, trapezius muscle strengthening, exercises used to help the shoulder muscles open up this area.
  • Compression of the artery and vein usually needs surgery.
  • Analgesics
Can athletes compete at high levels with the TOS?


Is the TOS common?

More common than most realize.

Questions & Comments

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