My thoughts run on (and on) along the so-obvious to me male-female disproportion. It appears that MOST (not trying to fit everyone into the same square peg-hole here, honest!) guys with TOS tend to come by it via work - either overhead mechanic, heavy lifting, house painting type labor or logging mega hours in front of a computer, and sometimes bodybuilding. They still must have a pre-disposition for TOS. However, many of the men may stand a better chance of recovery because they have stronger upper back and chest muscles than a lot of us women.

While there are certainly a number of couch potatoes, many guys continue to shoot hoops, play baseball, football, some type of sports with friends, whether they work out or not. They are also more often the ones who work on the car and mow the grass, do the heavy work, not that wmen don't or can't, but lots of single guys do it for themselves, and in a couple, it is still often the guy who does the car and lawn, etc. type work. All of this keeps the muscles strong. Men also tend (not all, but many), to deal with one thing at a time; when they're at work, they think about work, when they're at home, they relax. They deal with problems straight-on and then forget about them.

We women, however, often try to please everyone, and put everyone's else's needs first. Finding time to work out regularly is a struggle; taking an afternoon to spend with our girlfriends is a guilty luxury (and we can think of better ways to spend it than running around after a ball!) But womens' back, chest and arm muscles are weaker than mens' to begin with, and without regular exercise additional strength is lost. And gravity also takes a toll - the more endowed you are, the higher the price you pay. But I really think FOR ME, and maybe many of us, childbirth caused havoc with those oh-so-important core muscles that are the foundation for the rest. My first daughter was born by c-section, so the abdominals were cut. At 29, I worked like mad to get back a flat stomach. But 4 1/2 years later child #2, born the regular route, undid all that exercise, and with 2 small children and very little sleep I had neither time nor energy to care about the Battle of the Bulge.

Instead I took on all the needs of two little people, tried to meet and anticipate all their needs, take care of our home, catch a few quiet minutes with my husband when we could find it, chaired a parent support group, held garage sales. Drove to and from preschool, Dr appts, ballet and Girl Scouts. And worried about everything under the sun - every bump, sniffle or fever, shyness, school bullies, sleepovers, when to go back to work. Then going back to teaching, even part-time, added even more to my to-do list and things to worry about.

And I'm far from alone. Women are good at taking care of everyone else first, leaving no time at all for taking care of themselves! We multi-task like there's gonna be a prize for it! And we worry, worry, worry that we haven't done something or did something wrong or something in the future "might" happen! Again, this doesn't apply to all women, but if you have kids I bet it sounds familiar, am I right?

So, you have weakened core muscles (which allows everything to slump or slide downward), chest and upper back muscles (maybe causing the shoulder girdle to round or pull forward?), plus a whole lot of stress, some admittedly self-induced, and never enough sleep, PLUS a predisposition for TOS.

It makes perfect sense to me why more females than males have TOS. I know the above doesn't apply to all TOSer women, obviously some are college-age or younger, some don't have children, or their children were grown when TOS hit. And some were/are physically fit, and/or very laid back personalities. But some may care for their parents instead of children, or be just as stressed in other ways. I am only saying childbirth takes a huge toll on a woman physically, which can have consequences later, and motherhood along with marriage and working can also take a toll, especially for us intense types.

I was 41, with kids 11 and 7 at time of injury. And I'm learning to take one day at a time, not to worry about tomorrow, and to let go of the trivial and unimportant things in life. Good lessons to learn, but man is the teacher ever harsh!