My TOS conservative care journey
 

Someone asked me in a private message:
I ended up writing a novel and thought I might as well post it here in the public forum for everyone's benefit.

But first, rapid fire disclaimers: I am not a doctor or even a health practitioner. I am not cured. I don't know your specific issues. Your mileage may vary. You may have TOS plus something else that also has to be addressed. Different things work for different people. As a TOS person, you may actually need surgery and will have to determine that with your doctor. You will likely experience flare ups as part of exploring things. Easy does it.

Now then: :Clever:

Yes, I have posted about Egoscue. The book I used was "Pain Free At Your PC" and I chose Chp 9 which was the exercise set for power PC users (I develop software for a living).

I found it helpful for my postural problems and for neural type symptoms. I think I observed progress after about two weeks (it's been awhile, so it's hard to recall). I did my exercises in the morning before the day's demands could interfere. For me and many others, this is a way to guarantee that something always gets done: do it first and early.

Including a few other stretches and some reading, I spent 120 minutes every morning for weeks, whether it was Egoscue or other programs. More on that below.

However, it was not helpful enough for my circulation symptoms (ATOS) or my TMJD symptoms (which I didn't know I had at the time). But I did receive benefits and I'm glad I did it. I think it was necessary for me to improve my back and shoulders.

If I had to do it over again, I would try to go to an Egoscue clinic from the start so they could individually evaluate me, prescribe specific exercises and give corrections on how I did them. My experience with my chiro and PT is that the people who do this kind of work for a living will notice things about me that I am not aware of.

Regarding my ongoing problems, I eventually saw a good chiro (one who spends 30 mins with you and pays attention to detail, rather than one who cracks your back in 5 mins and is on to the next patient). I made good progress for a couple months, but then plateaued.

I then added a muscle relaxant (diazepam) and a good PT who does a lot of soft tissue work (Joyce W in Santa Monica). After a couple months of that, I improved so much that I started strength training, but as I gained muscle mass, especially around the chest and shoulders, my compression increased and I caused a flare up. Ug!

Part of this process is learning what you cannot do.

I also have problems with chronic muscle tension (greatly improved). See our threads on magnesium, meditation and caffeine if you do too.

My current routine is down to a 35 min stretch set and another 30 mins or so of postural exercises. Throw in more reading and the chiro and PT appts (one per week of one or the other) and I'm at about 10 - 15 hours a week, down from 15 - 30 when I was in really bad shape.

I also love this book:

"3 Minutes to a Pain Free Life" by Weisberg & Shink
http://www.amazon.com/Minutes-Pain-F...8124970&sr=8-1

While the title is overhyped, I found the info and the small stretch set to be quite useful and I do them every day. I noticed results on day 3. You might even start here first for the "bang for the buck" factor. Or rather "bang for the time invested".

There is also good book for women written by a female PT called "The Core Program" by Peggy Brill, which is only 15 mins a day. Despite being for women, I gave it a try as much of it was not specific to females. Personally I found the face down "belly breath" exercise to be interesting as it evened out the lateral range of my neck (even though nothing was mentioned about it having that benefit and I was not expecting it). I do that one every day. This is a great example of how exploring these different books and really trying their programs can yield unexpected improvements while teaching you more about what your specific body issues are.

Another good one is "It's not CTS" which specifically talks about TOS.

"Somatics" by Thomas Hanna was very interesting. I found that I had both the "red light" and "green light reflexes" (as he calls them) kicking in during the day, which is bad for posture and compression. With this awareness, I have reduced them.

I also found the "Posture, Get It Straight" DVD informative. For me, "lifting the sternum" was a key tip I was in need of.

One pattern you'll see above is that whenever I plateau, I reach out for other stuff. Make progress, plateau, try something new. Repeat.

Another pattern is drawing from multiple sources to pick up every tip and advantage I can get.

Due to that, I now use a word processing document to list all my stretches and exercises. I tweak it almost every week.

So for stretches/exercises, I currently recommend:
* Weisberg book (3 min/day)
* Brill book (15 mins/day)
* Egoscue book (many mins/day)
... in that order. The first two are quick to read and start their programs. You could do Weisberg in week 1. Add Brill for weeks 2 and 3. And add Egoscue on week 4.

I recommend finding a good postural specialist whether that's an Egoscue clinic, or a PT or chiro that likes to talk about posture and muscular balance upfront as something they emphasize in their practice.

I recommend both active treatment (doing things yourself) and passive treatment (chiro, PT, OMT, etc.). I don't think either is a substitute for the other when one has serious problems.

The two downsides to the above are (a) the time it takes to do all this is huge and (b) I have not achieved a total cure (and realize I may never). (a) is mitigated by the fact that as I get better, less time is required. Also there is some overlap between the books where you'll see the same exercise ("cat and cows" and "cobra" are popular).

Plus if you have serious symptoms and forgo surgery, you pretty much just have to suck it up anyway and put in that time and effort. :Viking:

The biggest upside is that my investments have yielded positive results.

I hope this information helps! :Dancing-Chilli:

Wow, great post Chroma!:hug: edit: oops, I accidentally added an angry smiley

GREAT POST!!!!!!!!
As always........... very informative.
I'm definitely paying the price for not doing enough stretching :(.
I returned from physio today to be told that my thoracic spine is VERY stiff and causing a knock on effect with my shoulderblades etc.
I just looked at her with an agreeing nod and wanted to kick myself for not keeping up with my post op stretching routine.
I'm very sore and have a deep bruised feeling right in the middle of my back now so its time for a nice relaxing hot bath.
Thanks for all the fab tips Chroma........ EXCELLENT!!!!
I just need to do them.

You're all welcome. @SD38 what stretches do you (or your PT) like for your thoracic spine?

I forgot to mention that I have found break reminder software to be a valuable tool.

you dont know of a stretch for around the clavicle do you? i get pain there but im wondering if i should just leave it alone, probably

Re: clavicle pain, two things that have worked for me:

-- cold pack on for 15 mins, off for 15 mins, on for 15 mins

-- gently rolling a lacrosse or tennis ball underneath the clavicle from the sternum out several times. real gently; a dab will do

Thanks. Sounds good. I'm a big fan of ice

Chroma, thank you so much for taking the time to post your wellness plan. I have printed a copy and have reserved two of the books at the library. I am so miserable I don't know where to start. I have hope from your post because I know a person who actually has TOS will understand how frustrating it is to constantly take one step forward and three backward with the wrong stretches and/or strengthening exercises (given to me by well meaning PTs).

I don't know why, but if I give little weights a try, I am set back every single time. I need some guidance as to where to begin. The past few PTs I have seen take it as far as they know to do, but it seems without an at-home program, I loose almost all of the benefit in a very short time.

Also, does magnesium really help? And what about caffeine? I drink about four cups of coffee per day but my doctor(s) have never said it would make a difference. Does it?

Well to be honest I'm only just starting with PT and my therapist has recommended that I do mainly neck/shoulderblade stretches to begin with.... due to post op tightness/sensitivity in that region. They are very simple at the moment and I am to do them daily until I see her again in 2 weeks time-by then I hope to have a full program in place to work on, it should include some strengthening exercises for my scapula regions because apparently I'm over working the front...traps, shoulders, etc and not fully engaging my upper/behind back?????
In all the stretches take as little as 5 mins to complete! But I have to be consistant with it.... every morning , I even give it a go before bed too!
The 1st stretch is simply to look face on and bend my neck to the sides-ear to shoulder, then next move twist and place chin to shoulder, holding each position for 5 secs a piece, repeat x3 on each side. Also arm raised above the head and then bent 45 degrees towards the opposite side and then to stretch out from the shoulderblade upwards only NOT to engage the lower spine/waist region, again x3 each side for a 5 sec hold per move. The last stretch is to place both hands palms facing forward against the wall ( as if doing a standing push up ) then to pull your shoulderblades forward ( Really stretch the scapula......at a comfortable rate- DON'T overstretch!) then lean into the wall and push out again, like a push up but placing more emphasis on the stretch of the scapula as you come back up from the dip.
HOPE THAT MAKES SENSE? :winky:
At the moment I'm abit tender from the moves but I know that I need to get it all moving. I think that little and often is needed to help the body from seizing up. I find that the less I move the worse I feel! As long as you move/exercise, whatever is achieveable ......as much as you can, is best.
You know the saying...... use it or lose it!!!!!!
I really do believe that....... It's strange but I honestly do feel worse when I stop being active/rest:rolleyes:
Best wishes guys?gals xxxxxxx