Steven Talajkowski, PT, MPT, OCS, Cert MDT

I have been a physical therapist for 25 years, after graduating from UC-San Francisco / San Francisco State University in 1993 with a Masters Degree in Physical Therapy. I am a McKenzie certified therapist (Cert MDT) and APTA Orthopedic specialist (OCS). I authored the ‘Thoracic Outlet Syndrome’ chapter in the book Physical Therapy Treatment of Common Orthopedic Conditions, which was published in 2016.

In 1998 I began providing professional services at Physiotherapy Associates in Hayward, California. Peter Edgelow became my mentor and started my education in treating people with TOS.  Peter was already a well-known physical therapist at the time. Peter had developed the ENVEST (Edgelow Neurovascular Entrapment Self Treatment) program for treating patients with TOS.  Many authorities widely recognize this program as a highly-effective conservative method of treating TOS. Peter has lectured throughout the country on the ENVEST Program.

As I learned from Peter, I treated more patients with TOS and gained invaluable experience in TOS.  When Peter retired several years ago, I took over his TOS program. I have been fortunate to maintain the privilege of the many relationships Peter has developed with other TOS providers. I have also been fortunate to have met and treated a large number of people with TOS. Every patient I treat is another chance for me to help others by sharing my knowledge and the knowledge that Peter developed over his many years of practice. It is also an opportunity to advance my skills, experience and understanding of how to effectively treat TOS. I learn something with every patient I work with. The experience has truly and positively changed and shaped my life professionally and personally.

Sergio Azzolino, DC, DACNB

I am the director of Azzolino Chiropractic Neurology & Integrative Wellness. My practice is a fully integrated multidisciplinary practice of chiropractic neurologists, medical doctors, and naturopathic physicians. Our team specializes in the diagnosis, treatment and rehabilitation of complex health issues.

I hold board certification in Chiropractic Neurology through the American Chiropractic Neurology Board, and board certification in Pain Management. I am a Fellow of the American College of Functional Neurology.

Blending my background in biomechanics, nutrition, sports medicine, functional medicine and neuroimmunology, we provide a comprehensive and unique approach to patient care.  We serve patients from around the world. We treat and guide numerous professional athletes and performers in their quest to maximize function and recovery from injuries.

I have been teaching the diagnosis and treatment of Thoracic Outlet Syndrome for over 20 years. I serve as an Assistant Professor of Clinical Neurology for the Carrick Institute for Graduate Studies. I also serve as a post-doctorate preceptor faculty at Logan University, Life University, and Palmer Chiropractic College West. In addition, I am a post-doctorate residency supervisor for National College of Natural Medicine and for Bastyr University.

I have served as a Qualified Medical Evaluator, and have extensive experience as an expert witness on industrial injury and personal injury cases. I am currently serving as the president of the American Chiropractic Neurology Board. I am the past president of the California Board of Chiropractic, as an appointee of Governor Jerry Brown.

As a 2017 graduate of Harvard Medical School’s Global Clinical Scholar Research Program, I have interest in researching the many underlying neurophysiological causes of Thoracic Outlet Syndrome.

G. James Avery, MD

I have been a cardiothoracic surgeon for almost 40 years. In addition, I have treated hundreds of patients with thoracic outlet syndrome over the past 20 years.

I graduated from Yale University in 1967, from Columbia University College of Physicians and Surgeons in 1971, served as Chief Resident in Surgery at Roosevelt Hospital in 1976, then as Chief Cardiothoracic Fellow at Presbyterian Hospital in NY City in 1978.

Since 1979, I have lived and practiced in San Francisco, and am currently serving as Surgical Director of Heart Transplantation at Sutter Pacific Medical Foundation. Over my career, I have published over two dozen journal articles.

It is a rare privilege to be able to save and extend my patient’s lives through heart transplantation. It is equally rewarding to be able to vastly improve the quality of my TOS patients’ daily lives. I have continued to refine and develop surgical techniques for the challenging TOS surgery, and take no small pride in our local active TOS community.

David Smolins, MD

I obtained my undergraduate education at The University of Texas at Austin with degrees in Psychology and Biological Sciences. I finished my Doctor of Medicine at the University of Texas at San Antonio and spent a year as an intern at The University of Chicago/Weiss Memorial Hospital. At the University of California, San Francisco, I completed my resident training in Anesthesiology, and followed at UCSF as well with Fellowship training in Pain Management. 

My fellowship training specialized in the multi-disciplinary management of acute and chronic pain. Over the last 10 years I have used these skills to treat patients in my practice with TOS.  An integrated approach is key, with the goal being not just pain reduction but functional improvement in one’s day to day life.  There are a number of tools at our disposal, and often multiple modalities are necessary to achieve success. 

In addition, my experience includes responsibilities as an Assistant Clinical Professor in the Department of Anesthesia and Perioperative Care at UCSF/Veteran Affairs Medical Center and as an Anesthesiologist for Kaiser San Francisco. I have practiced Pain Management with Remedy Medical Group since 2007 and founded the San Francisco office in 2009. I am double Board Certified in Anesthesiology and Pain Management.

Tracy Newkirk, MD

I am a board-certified neurologist, practicing in Marin County since 1974. I was born in Texas. However, I spent 30 years in Michigan preparing for California living and for an ever more fascinating career in the field of Neurology. My preparation included undergraduate work at Kalamazoo College, from which I have great memories of small, personal classes. Eventually, I attended medical school and residency in Neurology at the University of Michigan in Ann Arbor. Following residency, I performed a one-year rotating internship at Kaiser Foundation Hospital in San Francisco.

My good fortune continued with a staff position at Letterman General Hospital on the Presidio in San Francisco. During this time, I felt the constant dark cloud of potential reassignment to Viet Nam. I also experienced an invigorating assignment to Fort Ord where I learned to shoot rifles on the beach. This good luck created a two-year academic period, including teaching residents, research on blood-brain barrier and managing EEG and clinic responsibilities.

After training, I began my practice in Marin County, north of San Francisco in 1974. My first venture outside a routine neurological practice came in the mid-1970s. I organized and directed a chronic pain management and functional restoration program at Kentfield Medical Hospital. During that time, I managed referrals from railroad and Jones Act cases involving dock workers. In the 1980s, the entire staff of this program joined me in a private clinic in nearby San Rafael. This new METS clinic (Medical and Ergonomic Therapeutic Services) served many patients chronic orthopedic pain problems. In time, our focus shifted to patients with upper extremity pain syndromes.

In due time, I realized that upper extremity industrial injuries were out-numbering low back injuries. With a nod to Occam and his razor (Willian of Ockham, 1240 A.D.), I realized that common medical wisdom (or possibly dogma) was not adequately serving these patients. I discovered that carpal tunnel, cubital tunnel, and radial tunnel syndromes, repetitive strain and overuse syndromes all had a common denominator. Whereas each syndrome might exist as a diagnosable, objective injury in any given individual, most patients had various combinations of the same symptoms. Many of these diagnoses were determined not by the unique symptoms, but by the type of specialist consulted. Overall, I learned that typing at poorly designed work stations, industrial injuries, and seat-belt injuries appeared in many patients. These injured patients usually demonstrated some or all of the following symptoms: headache; facial dysesthesias; bilateral neck and shoulder pain; numbness, tingling and weakness that often crossed the ulnar/median division in the hands; intermittent tingling in the feet; non-radicular back pain; pelvic floor dyssynergia. Nearly everyone had bilateral but highly asymmetrical symptoms and shared disabilities that tended to become more symmetrical over time.

In my current practice, I search for and correct the common causes of these connected disorders. Detailed, inclusive clinical findings correlated with MRI/MRA/MRV studies of the superior thoracic aperture have yielded highly useful insights that contribute regularly to the sustainable reductions of disabilities related directly and indirectly to neurovascular compression in the superior thoracic aperture. My philosophy allows me to find great satisfaction and success diagnosing and treating patients with TOS.

Scott Werden, MD

I am the founder and medical director of Vanguard Specialty Imaging. I invented the NeoVista MRI examination for patients with TOS, and have been granted two patents for this work.

I trained at SUNY Stony Brook, Duke University, Boston University, Mallinckrodt Institute of Radiology, and Johns Hopkins. After training, I achieved board certification in both internal medicine and diagnostic radiology. Since 1998, I have practiced radiology in the San Francisco Bay area.

I saw my first TOS patient in 2003, and quickly became intrigued with learning more about the disease and helping TOS patients. Since then, I have studied over 2000 TOS patients with my unique MRI examination.

I speak on TOS at national meetings, and in community and university Grand Rounds. I served as a board member for the country’s largest TOS Patient Advocacy Group.  I participated on the steering committee of a national multi-center grant application to the National Institutes of Health. I authored the chapter on MRI of TOS for the state of the art textbook on TOS.

I devote much of my clinical practice and energy to TOS. I greatly enjoy outreach with TOS patients and their providers. I am an active and perpetual student of TOS. I teach myself, and then reach out to expand awareness and knowledge of the disease to patients and physicians. I founded the NeoVista® Multi-specialty Group, and the Thoracic Outlet Society, a group dedicated to the study of TOS.

TOS is my passion. I deeply enjoy expanding TOS knowledge, helping patients, raising awareness, and providing doctors the best TOS diagnostic and treatment tools. Each and every patient success brings me tremendous professional and personal satisfaction.