hand bike, therabands, overhead exercises (shudder)

Just hearing those words make me hurt

I had an excellent phys therapist tell me that as long as I was having pain I should not do any strengthening ( she meant off pain meds too)

Her reasoning was that you will not sense pain in the usual way and could cause injury and not know it.


This info was given to a Braintalk member Debra by Dr Sanders

Jo: maybe this could be made a sticky?This question is asked and I'm not always around to post Dr Sanders info
_______________________________________

"The initial treatment of TOS is certain types {or modalities} of physical therapy {PT}. Over the last few years, we have learned that a few modalities of PT are effective, while MANY OTHER modalities are ineffective or can make the symptoms WORSE. The recommendations below are based on the experience of OVER 1000 patients who have received therapy for TOS.
RECOMMENDED MODALITIES:

1.) Neck stretching exercises. Holding each stretch a minimum of 15-20 seconds, using your hands to help hold the head in the stretched position, and NOT trying to stretch through severe pain. If a stretch HURTS, reduce that range of stretch. Do NO MORE than 3 repetitions at one sitting; do this 2-4 times a day or more.

The 2 positions that are useful for TOS are:
1) Neck rotation and
2) Head tilting.

2.) Posture correction. Proper posture for people with TOS includes:
1) Head back,
2) Chin down and,
3) Shoulders relaxed in a neutral position, NOT STRETCHED BACK SO THAT THE SHOULDER BLADES APPROACH EACH OTHER, This position should be maintained as much of the time as possible when standing an sitting.

3.) Abdominal breathing: Practice this lying flat on your back on the floor.

4.) Nerve glides.

5.) Feldenkrais method. This is a total body approach of slow gentle movements of arms and spine with an emphasis on learning what motions bring on symptoms in your body and developing ways to avoid these motions. There is a national registry of Feldenkrais practitioners across the United States and practitioners in your area can be found on the Internet by looking up: www.feldenkrais.com

MODALITIES THAT OFTEN DON'T WORK AND CAN MAKE SYMPTOMS WORSE:
1. Strengthening exercises
2. Theraband use
3. Resistance exercises with machines
4. Neck traction
5. Exercises with weights
6. The concept of "No pain - No Gain"

The above are guidelines that have been effective in TOS patients. They will work for many people, but not everyone. Additional modalities of PT are indicated for other conditions that accompany TOS, such as fibromyalgia, shoulder tendinitis, cervical spine strain, and others.

Therapy must be individualized and it is best carried out with the guidance of a physical therapist plus additional training in the Feldenkrais method, usually with a different therapist.

Much more information about TOS can be found in the book, "Thoracic Outlet Syndrome - A Common Sequela of Neck Injuries", by Dr. Richard Sanders. The book describes the causes, symptoms, methods of diagnosis, treatment, results and complications of treatment, and other aspects of TOS.

__________________________________________________ _________________