My TOS

My TOS  : 

Almost 5 years ago I lifted some heavy wardrobe doors, 20 mins after doing so when stretching my right arm horizontally to my right hand side I felt an excruciating pain near my right scapula (shoulderblade).2 days later when lifting something on my right side, once again I had pain near my r scapula this progressed to stiff neck ,tingling sensations in r arm and the inabiity to lift heavy things in front of my body.Many differing diagnoses later, after 14 months and my condition made worse by many therapies, I was now suffering many new symptoms including cyanosis in r hand, muscle spasms in thoracic spine, pain and altered sensations in many dermatones in r arm, dropping things,fingers curling up,headaches, sleeping problems,all the tos symptoms .A functional capacity evaluation (computer monitored strength test) showed that I had an unstable r shoulder girdle, I was in the 5 percentile for strength,whilst holding things out in front of my body (my job was very physical and mostly above shoulder height and I am 6'3" and 200 pounds).3 1/2 years after the initial injury I was diagnosed with serratus anterior weakness due to partial long thoracic nerve palsy.Significantly this partial palsy was not picked up when I was asked to put my extended arms against a wall and put some body weight against the wall,my scapula would only react in its unstable manner if I tried to hold a heavy weight at arms length in front of me. It seems that this partial palsy occured due to having the middle scalene muscle in spasm in my neck (wry neck), the nerve actually pierces this muscle. To cut a long story short,when I use my r arm the muscle (serratus anterior) that helps to stabilise my scapula doesnt work very well, compensatory muscles (rhomboids ,trapezius) try to stabize the scapula, they tire much more easily, this is when my arm feels heavy.I have much pain around my scapula and in my upper back .A musculoskeletal doctor told that these muscles were causing my thoracic spine to be hypomobile this is called T4 SYNDROME,if one researches T4 SYNDROME one will see the similarities between TOS and T4 syndromes.Less sympathetic doctors will call T4 syndrome MYOFASCIAL PAIN OF THE ERECTOR SPINAE MUSCLES.I dont know how many TOS sufferers are in the same situation as I am but you will find some information on the web suggesting that unstable shoulder girdles will cause TOS.Unstable shoulder girdles will affect one's posture,physiotherapists can try and improve TOS sufferer's posture until the cow's come home but if the wrong muscles are being used to stabilise the scapula this will lead to overuse problems. I am able to control the TOS symptoms by various means .By far the greatest exercise that I was shown was "laying on a chi ball".A chi ball is a 4" diameter, half inflated rubber ball that one places on the floor and positions between one's shoulder blades. Laying on this ball and relaxing my shoulder blades to the floor allowed me take my pain levels from consistently 8/10 down to 0.It is supposedly a thoracic mobilisation exercise, but I know that if I am compromising nerves in my shoulder girdle causing TOS,T4 and LTN palsy, then when I am laying on this chi ball I am doing the opposite. I lay on the ball often during the day.Often I would not be able to get to sleep at night or would wake up on my back with a stiff neck and headache.I slept on the floor each night for over a year as I found the incidence of the head ache and wry neck to be less.But now I tape a polystyrene half a cylinder approx 4" long and 1"in radius between my shoulder blades when sleeping and try and sleep on my back as much as possible.It performs the same function as the chi ball.For 2 years I taped (strapped) my r shoulder back as this significantly reduced the altered sensations down my arm.But continuous taping caused problems with my skin.I now get very good results with an elastic brace which hooks on to my belt at my lower back, symmetrically travels up my back with the strap going over the rhomboids either side the spine ,over the top the shoulders, under the armpits,around one's back again moving to one's waiste ,crosses over the other strap ,continues around to the front and fixes to the other strap with velcro.the more you can pull your shoulders down the better.It sounds like a lot of trouble and non-TOS sufferers would not understand.The elastic I use is 2" wide.There are a few different places within the thoracic outlet that the brachial plexus can be compromised I believe that in my situation it is behind the pectoralis minor, as the more I use my arm the greater the imbalance of muscles in the shoulder girdle, the muscles at the back become weaker the more the pectoralis minor takes control the more it compromises the brachial plexus. I understand what you are going through.I hope I am of some help to someone.The insult is when they question the TOS sufferer's sanity and integrity.

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kana nathan chiro.