If you don’t think that I’ve lost the plot and you want to improve your condition, here are some things to do and some things not to do.
As you all know I believe that the majority of TOS conditions are caused by scapular instability. This isn’t the common view. I believe that the long thoracic nerve, (LTN) which innervates the serratus anterior is partially compromised. This compromise is varying. In my situation some doctors discounted LTN palsy by asking me to lean against a wall and try and press my weight away from the wall and they would look for a winging scapula if they did not see the winging scapula they assumed the nerve was OK. After the third doctor asked me to do this and my scapula did not wing out. I said to him ”watch this”, I picked up a pair of weights in my hands and held them out in front of my body at shoulder level. My right scapula moved upwards and away. He later performed nerve conduction tests which showed that I had partial LTN palsy. I am a medical layman but I don’t understand the logic that the other doctors were using, that is, if my scapula did not wing then the LTN must be ok. My understanding is that there are three roots for the nerve and many twigs, what if one of the roots or some of the twigs were compromised what did they expect to happen?

THINGS WHICH COMPROMISE THE LONG THORACIC NERVE (if it is already partially compromised)
1. chest breathing and deep breathing
2. increasing the pressure on your diaphragm (eating too much, being overweight, bending down to the ground to pick something up)
3. stabilizing one’s scapula ( the higher and the further from ones body the greater the scapula stability required)
4. stabilizing ones scapula for long periods of time( driving, using the keyboard, reading the new paper)
5. laying on the scapula( on your back, on your affected side eg sleeping, sitting in a high back chair)
6. having your arm supported and therefore lifting the shoulder(resting the arm on the door with the window wound down whilst driving).
7. tilting ones head back and towards the affected scapula.
8. rotating the scapula in a way that makes it grate and scrape on the rib cage
9. manipulations by treating health professionals
10. combinations of all of the above (which is daily living)

THINGS WHICH WILL ASSIST TO LESSEN THE AMOUNT OF COMPROMISING OF THE LONG THORACIC NERVE
1. abdominal breathing through retraining or asthma drugs
2. decrease pressure on diaphragm (lose weight, don’t sit down after meals, use devices to pick things up
3. limit the use of the affected arm.
4. use strapping tape and/ or a brace to hold shoulder girdle steady
5. don’t sleep. (only joking, don’t sleep on affected side, use support between scapula to lessen pressure when on back)
6. don’t adopt postures which prop shoulder up
7. gentle neck stretches forwards and diagonally away from the affected side improve scapula stability
8. never rotate scapula or make it grate or click.
9. avoid medical treatment in the area that is between ones neck and the scapula on the affected side
10. don’t expect to have normal life ( you have a disability which will not allow you to do so many of the things you used to)


regards towelhorse