some things that worked for me w/primarily Neurogenic TOS follow. please note that my TOS is chronic. this applies to chronic vs. acute stages as this would not have been an option when i was in acute stage or very flared. (And now that I have the vascular component my job is to watch for swelling and stop before it swells too much. To avoid vigorous walking--but slow and gingerly I can manage.)

This is diff than what Peter Edgelow taught me to do to treat my newly diax TOS primarily Neurogenic TOS yrs ago. He said to AVOID flare, to NOT exercise to the point of flare. Learn to recognize in your body that pre-flare point and stop when you reach it. To stop at only 2 minutes if that's what it takes to keep out of flare. To attempt to train to walk for 20 mins, several times a day. btw-cold fingers are a sign to watch for.


0. wear really cushy tennis shoes; watch so you hit the ground softly. especially if you also have cervical neck issues as i do. Take your walk on softer surfaces if you can. (i am most comfortable walking on spongy surfaces-the playground material made of old tires is something i seek out if there is one on my route.)

1. Place a strap (like a yoga strap) through the loop of the dog's leash. belt the srtap around the waist so the dog pulls on the hips and not the arm/shoulder/upper body.

2. pre-medicate if nec. but aim for anti inflamatories or other vs. pain meds so that you can be as aware as possible of your body on the walk.

3. ice if nec or do your breath work upon returning home. Or lie down and do some Sharon Butler stretches.

4. DO NOT let the arms hang down freely--or if you can, do so for short periods of time.
ideas--- wear a fanny pack or strap around the waist or have high pockets your arms can be placed in. Your arms rest on the purse area or hands can be tucked into the strap in a variety of locations.

*Whats' best for me is this-tie a knot in a long narrow scarf. place the scarf around my upper arms. Place the TOS arm/arms inside the scarf in front of the body. it sort of looks like a prayer position with arms resting against the scarf. This takes the stretch off of the arms and unweights them. then when i can, i take an arm out for bits of time.

5. watch and see if you get flared initially and then maybe are able to walk off that flare. what happens to me often is this. A flare occurs initially after a few minutes of walking--first in neck, then moves up the neck to head /ear /jaw and down the neck to arm, hand and also moves out to shoulder blade and upper back. Sometimes I can walk several minutes creating an initial flare and then the initial flare subsides and I am comfortable. I watch to see if I am creating a lasting flare or if it's one I can work through and am able to keep walking longer. The trick for me is to be able to walk off that initial flare and then walk as much as I can but not so that I will create a larger, lasting flare.

6. Here's one more idea but it wont help you walk your dog. Walk in the water. Go to a pool that has lanes where they have an open lane for walking. Wear shoes, ones made for aerobic activity in the water. You may find that you can walk, forwards and backwards, perhaps even skip or jog! The arms can be loose or tucked into the body if that's what you need. I wear a synthetic bicycle T-shirt that keeps me warm and stays relatively dry. I tuck my arms into the shirt by rolling the bottom fabric around my fists.

7. If that's too hard on the TOS try walking in water suspended. Wear flotation around the ankles and do walking and jogging motions suspended in warm water up to the neck or chin. This takes all the weight off the spine. It feels great to me. I've seen several TOSers in the warm pool and some have gotten better.

Of course my biggest advice is pay attention to one's body. It will lead you to what works for you.