Unsure where to turn to
 

Hi,


My name is Jack. I am 19 years old and I suffer from two conditions: bilateral femoroacetabular impingement and thoracic outlet syndrome. I have suffered from these conditions for a bout 2 years now. I used to be a martial artist, martial arts teacher, and competitive athlete. I transformed my life at 16 years old; I lost 30 pounds and fell in love with exercise. I will admit, after the first year of exercise I became overactive and weightlifted way too much. For the longest time, I thought I just overexerted myself and needed to rest up. I was horribly wrong.

It all started with a regular day in the gym. I was weight training, and I was doing shrugs with a relatively light weight for me (35lbs). Towards the end of the set, I shrugged up and felt a pinch right in the trap/neck area (almost where the two meet). I put the weights down and went home. Over the next two weeks, I had frozen neck. I could not move it side to side, up, down... anything. With more weeks of rest, I attempted to train again. I picked up the weights and attempted to do a dumbbell bench press. The pain in my neck was too much and I went home completely crushed.

Over more weeks of rest I was able to come back in and train, but only in certain ways. For one, I could not shoulder press. I felt the pain go from my neck into my shoulder. By this time it was a bilateral problem. I could not do regular pullups, or regular bench press. My grip always had to be neutral (palms facing toward my body). I was getting weaker and weaker, trying to hold on to whatever physicality I had left. I visited an orthopedic: overexercise, instructions to rest. I visited a chiropractor: adjustments did zero. I was hopeless.

One day, after trying all the stretches, all the foam rolling, anything I could find or think of, I stumbled upon a simple yoga stretch by Jill Miller on YouTube (scalene and platisma stretch). Oh my God. I did this one stretch and felt heat pour from my neck. Instantly my neck pain was gone, my rhomboid/shoulderblade pain was gone, nerve pain gone, everything. I was OVERJOYED. I worked out that day and all my strength was back. I could even do regular bench press. Then, I decided to try incline bench press. After a few reps, lo and behold the pinch came back. Same symptoms, same misery. I have done this same stretch again and again trying to replicate it. No luck.

I've seen a neurologist, three physical therapists, MRIs done, X rays done, blood tests done, EMGs done.... no answers. I am dealing with pain, weakness, and dysfunction that people my age would never imagine. I have symptoms of ulnar, radial, and median nerve entrapment. Even raising my arm slightly reproduces my symptoms. My body has begun succumbing to this condition and I now have a small SLAP tear in my shoulder. I am scared that more injuries will come along, and I will be doomed to watch my friends enjoy their life as I sit on the sidelines. I am currently seeing a cardiothoracic surgeon and his accompanying neurologist to get tests redone, as well as an angiogram done. What if I need surgery? I am both desperate for relief and scared ******** of something going more wrong than it already is.

NeuroTalk, have any of you had similar symptoms/causes? What were your outcomes? Advice for treatment? Stretches?

I am sorry that some of this information is extraneous... I try to keep this away from my family, especially my extended family. They cannot see the condition and therefore it is either all in my head or I am really okay and faking it for attention. Regardless, any help/wisdom would be appreciated.


Thanks in advance,

Jack

Jack,

I'm sorry you are experiencing this, and at such a young age. How long has this been going on? I know it will be very hard -- especially at your age and level of previous fitness -- but have you tried complete rest? Thoracic outlet syndrome is not like so many conditions where one can work through the pain. I've had TOS for nearly 13 years now and had unsuccessful surgery 10 years ago. Unfortunately, I've never been able to return to playing sports or working.

But, at your age, you have a better shot at a good outcome. You really need to listen to what your body is telling you. For whatever reason, it cannot take the intensity of the workouts. I would urge you to try to adopt a different mindset -- not one set on returning to the activities you used to do but, hopefully, finding different physical activities that your body can tolerate. The most difficult part of TOS, for me, is dealing with the reality of my body and my life as it is now, rather than how it once was.

Sorry to spend so much time on my soap box. I hope the symptoms will settle down with rest. Don't give up on finding some relief but you may need to make some adjustments in what you expect from yourself.

Good luck,
Kelly

No need to apologize Kelly. Thank you for the kind words. I have stopped exercise altogether for almost a year without any change in symptoms, unfortunately. The only thing that slightly alleviates my symptoms is keeping my shoulders shrugged up, then it seems to take some of my symptoms away -- or at least reduces the severity of them noticeably.

Did you do any specific stretches or exercises that gave you some relief?

" I've seen a neurologist, three physical therapists, MRIs done, X rays done, blood tests done, EMGs done.... no answers. I am dealing with pain, weakness, and dysfunction that people my age would never imagine. I have symptoms of ulnar, radial, and median nerve entrapment. Even raising my arm slightly reproduces my symptoms.
... I try to keep this away from my family, especially my extended family. They cannot see the condition and therefore it is either all in my head or I am really okay and faking it for attention. Regardless, any help/wisdom would be appreciated."



Hello Jack,
Not sure about wisdom but will take a shot. :wink:
I wonder have you or any of the medical folks mentioned TOS? TOS is not common and they don't usually know about this situation or look for it. You may need to see someone who has experience with TOS.

Have you looked through the resources, the sticky notes? There are a bunch of posts at the top of the forum. It needs to be cleared of some old bad links but there is a lot of great info.

Yes, I am familiar with the "barely move your arm and the nerves begin complaining" portion of your account. I have an entire choir screaming in my body from tip of fingers to face. It seems like when you try to shut one up the others get louder. :eek:

Being misunderstood by the medical field is also familiar. I have yet to talk to or read about a TOS patient that didn't have their sanity doubted. In a herd of horses we are zebras. Docs aren't used to seeing zebras...they see all the regular horse problems everyday so their mindset is horse. All day long, year after year they see horses. Then we show up and they don't know what is wrong so WE must be crazy. We just don't meet their expectations.

Family members are even less prepared for TOS. They are geared to appllying a little antibiotic cream and using a bandaid. The worst woud be a broken bone...but then you get a cast...it when it comes off, voila, you are all better. They just aren't prepared for such an unusual situation. That's why I think these forum places are so important, you can talk to other zebras.

I was injured last February but only recently diagnosed with neural TOS with possible vascular component. Its not fun. I have gone through a dozen wrong Dxs, multiple drs, unneeded procedures, OT/PT therapists, specialists and after almost a year I think we finally have the right dX.

You are so very young. Do you know if they have looked for a cervical rib? I cant tell you not to work out but I will give you the same advice I give my kids (your age) Honey if it hurts don't do it.

I have found that heat helps a lot, rice bags and hot bath/shower. Nerve pain is a royal thrill which is not effected by any meds I have found OTC. I do stretches many times a day. Check out *reputable* sources for stretches...Mayo clinic, John Hopkins etc. I also do a lot of yoga with modification to moves that hurt....back to the if it hurts advice. The ones that I do most often are wall/corner stretches and corpse yoga pose. I make sure to keep moving all I can to avoid freezing anything. Ask your dr for specific stretches he wants you to do. I was told no strengthening until I have range of motion without pain. Sure hope that happens one day.

I am sure others will pipe in that have much better advice and real wisdom.

Good luck Jack, please keep us updated.

Hey Jack,

I'm sorry to see you posting here as well. I posted here some days ago with similar symptoms. Although I'm 36yo, I can assure you our symptoms match and I too have undergone multiple testing, and continue yet to no avail.

Your statement is exactly like mine of experiencing all 3 nerve entrapment symptoms...with negative diagnostics. This started for me over a year ago, yet worse the past 4-5 months where I really started paying attention that "something" wasn't right, especially given my zero health problems. I have run ultra marathons, won age groups for the half marathon and 10k, hike, and ride long distance motorcycles. All of those have been put on hold for the past few months.

Just like yourself, I'm not sure what to do.

What doesn't work so far:
Hard aggressive stretching or hard massage
Holding my shoulders back because of poor posture (I mean really??)
Active release technique

What has helped (so far):
Chiro adjustments, yet brief
Passive stretching with foam roller and towel under back lying supine
Shoulder stretching
Most notable...lightly working out the rhomboids

I'm in the same boat man, I want my life back. I've found tons of depressing articles and posts where no one seems to get better. Apparently surgery is not the greatest either. Yet, I would expect positive outcomes from the right surgeon.

Sorry I don't have the magic 8 ball man, I too am still looking.

Shrugging shoulders up gives you a false relief...let me explain.
With TOS there is compression of the nerve, artery and vein at the side of your neck. Shrugging up or forward will pull off some of the compression but it shifts muscles into really bad positions that have potential for long term damage. Tense muscles don't flow freely and therefore cause more pain. Your alignment gets all crooked.
You should aim for shoulder down and back....as if you are trying to put your shoulder blades in your back pockets and keep your chin level with the floor.
That is the goal posture for TOS.
It will be uncomfortable for a while and the muscles will scream at you because they have been in a bad position and liked it. It wont take long to get them used to being back in place. TOS is all about posture. with good posture you should see a reduction in pain.

I have found this to be exactly true over the past few weeks. Thanks for the reassurance.

Thank you so much for the support. I have a great girlfriend and close family that are very supportive of me. From my surgeon's first look, he says I may have something similar: N+ a little V. TOS.

I am a fan of the hot showers and sometimes a heating pad if I'm feeling luxurious, haha. Thank you for the advice.

I think that's why we are all here. It's at least somewhat comforting knowing I'm not going at it alone. If I find anything significant I'll be sure to post here.

Also, who knows... maybe some light resistance on the rhomboids will help. Thanks!

Really? I was trying to be conscious of my posture by pushing my shoulders back/down and chest out, but I figured it was bad because it gave me a pinching sensation in my clavicle/scalene area. Should I fight this and see if it relieves any symptoms?

Lots of good info given already...
I was "middle aged" when I started to have multiple work related /repetitive motion injuries. (neck, shoulder, arms, hands, elbows..)
I had to navigate through the work comp system & delays... and stop working to see any real healing . It took about 2.5 yrs for me to get back to 85% of normal.
I figure 1 yr of that was wasted due to the wc & delays and PT early on while I was still working..that just did not work..

So usually a younger person with really good care team and focus on a ton of self care - this isn't something only a PT or CD or MD can do for you , you have to do a lot of the work on your own.. *As long as there isn't something surgical that need attention..*

As mentioned earlier explore all the sticky threads. Great info there. :D

Passive posture work & awareness & easy stretches, just to the point of resistance not beyond it.
http://neurotalk.psychcentral.com/album.php?albumid=422

Ah okay, I had tried the foam roller stretch before but perhaps if I stick with it it'll show some results. Thank you :)

slouching
 

It hurts I know....sorry Jack but the better your posture the less pain you will have in the long run. The muscles are fighting you right now when you stand properly. They will give up soon though if you are consistent. Its a matter of the muscles needing to be retrained and strengthened.

I began to slouch because it lessened the pain. Your body wants a position that doesn't hurt. But the slouching will cause more problems.

It hurts because the muscles have been in the wrong position for a while and were accustomed to that wrong posture. The pinching will serve as a reminder to keep straight. I promise it wont last forever. It took me a while before they finally gave in and now they fuss if I slouch. My Pt was kind enough to tape my trap as a reminder. I used the uncomfortable pinching as a reminder to not slouch.

Also the way you sleep has a big impact. Never on your stomach! Try not to lie on the bad side...like I could anyhow. On your back with support under your elbow/shoulder is ideal. That way there is no drag on your arm. The mere weight of your arm will pull things in your neck and make it hurt/worse.
Its no fun this TOS, but the more you know the less fear there is.

Good luck, we are here.

Bobby's posture
 

Good to hear it. Keep up the good posture. I see that you lie on your back with a towel under your spine....excellent. do your breathing exercises when you are down there. Also if you get brave turn thumbs up while there and then barely lift off ground...an inch or so and hold for a couple deep full breaths.

Also try childs pose in yoga. Breathing exercises are important. Pretend you are blowing bubbles. Or really get a bottle and blow bubbles. These may seem mambee bambee but they work on the area that is messed up. Shoulder shrugs and rolls are excellent to strengthen and correct your posture.

You were spot in when you said no aggressive stretches. That only makes it worse. Never go into the pain. This is not the injury to be all macho. You can touch the pain my PT says but don't go into. TOS is NOT a no pain no gain injury. You will pay dearly for pushing it.

Wow Bobby, Ultra marathons...I am impressed. I was never that hard core. I ran 2m every morning but now a briskly paced walk jars my arm too much. Folding laundry kicks my but these days. You must be so frustrated. I am sorry you have to go through this crud.

Good luck!

I tried doing this for about a year along with the rhomboid workouts, doorframe stretches etc. Things only got progressively worse.
Pushing shoulders back gives me numbness in fingers on both hands.

We each have such individual versions of this - we can suggest things and you'll have to try them to see what works best for you..

But some good basic tips -
don't force anything , stop before pain is increased, be aware of delayed pain,

** and if you start to feel better - don't go out and overdo activities... that will set you back...** been there done that...

did any of the providers try (or check for) top rib mobilisations?

You know, I heard about one but I haven't been trying any. Is there a specific mobilization you use that helps?

I had an advanced PT guy (taught PT also) do a rib mob on me the first time ( was a major fix for me at that time ribs had got lifted and stuck up, stayed up after the spasms were resolved), then another PT at the place I was having PT sessions at ( had to tell him about it) then my chiro did the rest of them as needed..when it happened to pop up again a few times..

I never did it for myself.. but I learned to tell when it was getting ready to pop up and could stop the activity before it got bad...

You absolutely need to message me, our lives sound so identical it is ridiculous, I lost 40 pounds at age 17 by going hard with weight training and now developed symptoms at 18 and still have them now at 20 years old. My family thinks im insane and the only person who will listen is my GF of 4 years. I too have a SLAP tear and labral cysts. Seriously send me a message so we can share some info.

Where are y'all located? I have PT and doc references here in So Cal.