hello everyone ,
I have attached some pictures of some of the things which have given me assistance to improve my condition. When I was at my worst I was laying down or resting for 18 hours a day suffering all the symptoms of TOS. Currently I am working 3 days a week at one place, I day at another, attending college I night and usually college I day. Previously evenings were terrible (as though I was recovering from an auto accident) now as long as I don’t do any thing dumb, they are really good.
I don’t know what order in which the pictures will appear.

Picture 1 chi ball, deflatable to suit the user, you can see the stopper. The size is critical it must fit between your scapula. I use it to take pressure off of the nerve that goes under the scapula. not for pec minor stretches or chest wall stretches. Any similar sized partly inflated ball will suffice.

Picture 2 foam cylinder, I use this 1) all the time if I am sitting in a lounge chair, between my scapula so as to ensure that I do not push the affected scapula against the chest wall. 2) if I am laying on a soft mattress, once again it protects the scapula. 3) when in a car seat

Picture 3 ERGO Chair, sitting in this chair places less pressure on my diaphragm which in turn allows a cycle of breathing which places less pressure on the nerve which runs under my scapula. I take this to both my places of work and it gives me greater capacity to sit and use my arms out front of my body, for instance working on a computer. Since I have been using the pulmicort and my breathing pattern has changed I have a greater tolerance for a normal office chair, but I use the ERGO chair if it is available.

Picture 4 laptop table. Sitting at a desk and using a computer was impossible for more than 20 mins or so. Muscles would wind up in my upper back and arm symptoms would happen. 2 and a half years I was starting an OHS course where I needed to use a computer. I borrowed my brothers laptop (notebook) and found that I was able to use it in various positions. The table can be adjusted so that I can lay on my bed with a chi ball between my shoulders and operate the laptop comfortably.

Picture 5 singlet (vest) with a hard foam block sewn on, to wear when sleeping in bed. You may be able to see where it was originally taped on. The size and shape of the block would need to be adjusted to suit the user. The critical factor is, that it must protect the scapula from being pressed against the rib cage when asleep. I wake up with 95% less neck and head aches when I use this. Significantly when my wife bought a new lambswool underlay for our bed. I woke up with the neck ache, I had to increase the thickness of the block to ensure that the block was not being completely absorbed by the soft underlay and therefore not being effective.

Picture 6 and 7, hook of shoulder brace. Previously a professionally made shoulder brace had been supplied which made a small improvement to the muscle spasms in my upper back. I worked out that the critical factor was how much pressure down, not how much pressure back. The part of the professional brace which travelled from my lower back to my upper back was not made of elastic material therefore could not exert constant tension as I bent forwards and backwards. As soon as I made and used the style of brace displayed there was a reduction in upper back spasms. I wear the brace all the time apart from sleeping and showering. I have a few braces. The one displayed is 50mm or 2 inches wide. I tried making one from 3 inch wide elastic. It would not fit on top of my shoulder or alongside my scapula as it needs to. The hook with the black webbing attached was removed from a small pouch and then sewn to the elastic. The hook allows easy removal from a belt worn in trousers rather than feeding the elastic around the belt each time. I wear the elastic under my shirt. So that I can wear a shirt tucked into my pants I now wear a pair of short pants under my pants. The short pants have a horizontal strap at the back. The hook fits onto this strap.

Picture 8 (me wearing the black t shirt) the elastic strap is hooked onto my belt, the two legs travel upwards with a leg positioned either side of my neck. The two legs are stretched under each armpit, the elastic once again travels around to my back and then to the front where the two ends are fixed together using Velcro (hook and loop). The tension fore and aft can be adjusted by stretching more or less of the elastic from the back to the front and vice versa at the top where it travels past ones neck. The effectiveness of this brace is very much dependent on 3 things.
1) The width of the elastic
2) The tension of the elastic
3) The band must travel upwards close to the spine and not be on the scapula at all. I find myself often adjusting the top of strap closer to my neck and away from my scapula.

Picture 9 taping the point of the shoulder back. Modesty precluded this 50 year old man from modelling in this picture. I thank son of towelhorse for volunteering.
As you can see it is not the same as the tape trick. I believe I have described in an earlier post the circumstances in which a pt first used the tape on my shoulder.
The tape is 11/2 inches wide. It is strapping tape that sports people use. It does not stretch. In the picture I have shown the other tape which I had to use under the strapping tape to protect my skin from the strapping tapes effect on my skin.
I am to the point now where I have only used the tape for five days in the last 15 months. These5 days were due to a medical professionals intervention which caused a negative effect on my scapular stability.
The intention of the tape is not for one to be able to detect movement of the shoulder blade upwards (although as the day progresses one can feel more and less tension on the tape) the aim of the tape is to stop ones shoulder from moving too far forwards. When my shoulder was held back with tape, the symptoms in my hand were only approximately 5% of what I had without the tape. I believe this to be because when one moves the shoulder forwards the serratus anterior is supposed to be controlling the scapula with the pec minor. If the serratus anterior is weak then the pec minor has greater influence than it would normally have and therefore it compromises the nerves under it. Anyway that’s my theory and until someone can come up with a better one I am sticking to it.
I would normally wear the tape for up to 5 days. Please be careful of dermatitis.

My improvement has been slow but steady. Just as there were many factors which contributed to acquiring TOS there have many conditions and circumstances which have not allowed my body to get better. It has been as though there is a threshold through which one must pass before the body can heal. Wrong diagnosis, wrong treatment, reaction to medication, need to use ones arm, secondary conditions, family pressures have all made it very difficult. If my information can help anyone, it is wonderful.

I just remembered something. A treating PT had said that my lower trapezius was weak on my affected side. This she said, was why my scapula was moving upwards. Where as many lower trapezius exercises had been unsuccessful in retraining my scapula to stay down, within 1 day of taping my shoulder I was able to use my right arm without my scapula going up. But when I used my arm with my scapula down there was a clicking, grating sensation under my scapula. this was not good. ( I believe this to be snapping scapula syndrome)
It became quite obvious that my scapula was not moving up because the lower trapezius was weak but because using the lower trap. caused pain under the scapula.

Hence, why the brace pulling my shoulder down works. The brace pulling down my shoulder means the lower trap isn’t causing the problem I have just described.
Picture 10 pulmicort there is something very strange happening in the diagnoses of TOS. Many persons treating TOS suggest that to get better the TOS sufferer must learn to breathe abdominally as their chest breathing pattern is causing problems. But when you look for at the list of symptoms of TOS sufferers it doesn’t list chest breathing as a symptom. So they are suggesting treatment for something which they don’t list as a symptom. The breathing problem is a major contributing factor in the TOS problem. Mine has been solved with the pulmicort. Much time was spent by PTs trying to re-educate me on how to breathe properly. I have spoken before on how I don’t get as tired, the bed feels like a different bed, the gastro oesophageal reflux is a fraction of what it had become since getting TOS, my chest is not hyperinflated and I am not hurting the nerve under my scapula as easily as I could prior to taking the pulmicort. Good luck and goodnight. towelhorse

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