That being said...I offer something that applies to ME.

If you are in a lot of pain, your tight muslces generally become tighter becuase you are tense and always trying to protect yourself. This is also a very bad cycle. If you hurt so much that you cannot withstand PT or stretching, you will not make progress. It is important to be able to relieve that pain and relax your muscles. The medication or combination of emds that provides releif for each patient is different...which must be considered.

I believe a good course of physical therapy, chiropractic, and body work such as Hellerwork or Alexander or Feldenkrais, combined with pain relief is the better way to go.

When you move to the point of being able to tolerate some exercise, add it. BUT, not everyone is at that point, AND exercise must be approached with extreme caution because it is very easy to hurt yourself once your nervous system is all worked up. Advice from trainers is to be avoided unless they are very familiar with TOS.....best to get advice for a highly qualified PT, and start VERY SLOW.