I've been able to do either the elliptical or the Cybex Arc Trainer without much problem. I start out without holding on, my arms are either just down by my side or gently resting on my hips. Then I vary my arm position, either by holding the arm handles or by having them on my hips. When they are holding the arm handles, they are simply just holding, I don't pump them to get an upper body workout. I do it mainly to get some motion in my arms. If the arm part bothers you, don't do it, just keep your arms down or on your hips, or wherever they are comfortable.

Also, I wear a heart rate monitor and keep my heart rate at such a rate where I am able to control my breathing and not incorporate any chest breathing and my scalenes. I have to stay around 140 bpm. I'm 40 and like to work out harder than this but I'll take it if this is all I can get right now.

I'm also able to do leg exercises without much problem, just be aware of posture, breath holding, etc...

Good luck.