My experience with Edgelow protocol
 

Just wanted to post an update on my progress with Edgelow's exercises so far.

I started the exercises two months and saw some major improvements since then. While I cannot yet tell if these improvements will last, I am feeling much better than I did at any time in the last year.
I started feeling better within a couple of days and continue getting a little better each day.
The major improvement is in the pain level: it is down from disabling non-stop pain to occasional annoying discomfort. I went off all medications and was also able to resume some of the things I had to give up earlier. I can now do a little bit of driving, shopping, cooking, hiking, running, even some weight lifting (trying to be very careful with this though).
Cannot go back to work full time yet (working from home for a few hours a day since August).

As you may know, the Edgelow protocol is mostly built around breathing, rib mobilization and some gentle stretching.

My routine each day is:
breathing exercise 4 x 20min
walking 3 x 30 min
relaxation 2 x 40min
stretching (most major muscle groups except arms and pecs which flare me up) 4 x 10 min
plus some trigger point massage and hot showers.

All this adds up to about 5 hours a day. This may sound like a lot, but this leaves me with 10 hours of (mostly) pain free time. Much better than being in pain all day.

Now the hard part is keeping myself motivated. Pain is a very good motivator.
With less pain I need to convince myself to keep going. :D

Will keep you updated on the further progress.

It has been foour months since I started Edgelow and an update is due.

I am doing the exercises diligently every day and continue to improve slowly.
At this point I am down to 3.5 hours of exercise a day (with 5 hours a day I barely had time to eat).
This gives me time to return to some of my old hobbies and I can also read books and work on
the computer a few hours a day. I am also now working in the office two times per week.

For cardio workout I resumed running regularly and am training for a 5K race (don't think I can manage more than 5K).
Arm and upper back strength has improved a lot. Last summer I could barely lift 5lbs. Now I can curl 20lb dumbbels no problem.
Still cannot tolerate arm and pec minor stretches very well, but at least I can do very gentle stretches which
don't flare me up anymore.

As far as the pain goes, I am mostly pain free as long as I don't skip the breathing exercises and
don't spend too much time on the computer, but I have a permanent achy discomfort in my shoulders and arms.
The sore places move around a lot (neck, elbows, wrists, upper back, chest and so on) which I find much easier
to tolerate than non-stop pain in the same place.
If I overdo things or forget to do the breathing, the discomfort quickly goes from annoying to painful.
I then have to take it easy for a couple of days.

The progress seems to be slowing down. Don't know if I am approaching the plateau.
I was hoping to be back to full-time in the office by April, but I clearly will need a lot more time to recover.

Had a bit of a flare-up last week: did too much computer typing at work. Was in pain for several days. I think I am over it now.

Ran the 5K race yesterday. Came 8th (out of 500 or so). Not too bad, but not anywhere near my personal best time.
Today I am feeling good, but my left hand is numb. I suppose this means I need to take a break from running. Sigh.

An update after eight months.
I am doing OK, continue to improve slowly.
All symptoms in arms (pain and numbness) went away, but still have a lot of achiness in neck and shoulders.
I think neck pain is mostly myofascial and exercises don't seem to do much for it.
Shoulders are diifferent. When I have pain (usually when I overdo it on the computer), it is more intense and disabling. I also have muscle atrophy in the trapezius which I suppose means nerve damage (although not all Drs agree - they can't agree on anything).
Anyway, I still do Edgelow's breathing exercises 3-4 times daily. I think other exercises of his are less helpful so I am gradually replacing them with strengthening exercises (crunches, prone cobras, bridges, weights etc).
I found strengthening to only helpful when the pain is gone. They were only making pain worse when I was in bad pain.

Even though I am feeling much better, I am clearly not ready to go back to work in the office full time :(
I usually only show up once a week or so for half a day.

Will keep you updated on the progress.

Is your pain in both shoulders or just one?
Also, do you have any coexisting neck issues eg disc bulges etc.

I am trying Edgelows protocol but hitting a brick wall in that I seem to be activating my scalenes and not the deep neck flexors. Frustrating.

My pain is bi-lateral. Right is worse than the left.
I had neck pains and associated headaches for 10-15 years though there is nothing in the neck that shows on tests. No stenosis or herniated disc.
I suppose that all my symptoms can be explained by muscle spasms somewhere in the neck. Depending on which muscles spasm, I get pain in different places.

At this point most of my pain in the shoulders and arms is gone (unless I do too much computer work). However, occipital pain is not. Edgelow does not seem to help with that. Various neck stretches are helping a bit.

I don't think I have a problem with scalenes substituting for the deep neck flexors. My scalene problems are mostly from improper breathing. Training myself to breathe properly unloaded the scalenes and helped the nerves start healing.

Thank you. So the breathing exercises stopped the shoulder pain as well? Can you detail which stretches or shoulder exercises you did, or was it the breathing alone? Seems a ton of time commitment, many hours a day!!

In my case, I think my left side deep neck flexors are all messed up, and right are weak. Left worse than right. So right side scalenes are overactive. It seems to be some sort of paradoxical CNS response post whiplash to protect the left side. That right side spasm or the whiplash shut off my shoulder muscles as well. Its a pain to work through all this, and the subtle arts, ie breathing, isolated muscle activation seem to be beyond me.

Yes, I was mostly doing just breathing and relaxation exercises and that helped with the shoulder pain plus the neck flexor strengthening with a pressure cuff.
I also stopped almost all computer work.
For stretches I was only doing neck stretches. Basically tilting my head in all possible directions wherever it felt tight (for many hours a day).
Did not do any shoulder exercises because I could not tolerate any.
I think shoulder pain was due to accessory nerve and/or brachial plexus compression. I now have little pain, but some atrophy in the trapezius.

Now that the pain is diminished, I am working on building strength (doing back flys, prone cobras, rubber bands etc). The strength is getting better though there is not much change in the athrophy.
I also do pec and arm stretches now (foam roll, doorframe stretches and the like).

Does Edgelow have the potential to completely cure people?

I don't think it claims that it is a cure.
I see it a way to control bad flare-ups and as a start of a progression to other exercises which will actually correct the underlying problems (like bad posture or scapular instability).

Okay. Thanks so much

Hiker, I like this idea of posting regular progress updates, it is very useful! I am going to try and do something similar myself.

Btw, I followed the Edgelow protocol and some modification of it with Steve for quite a while last year. Good to hear a story similar to mine. Thanks to Steve (he's the most honest, straightforward PT I've met so far!), I was able to get rid of my immediate nagging pain and felt significantly better.

After a while, though, I felt that the full solution was in a more comprehensive posture correction, so I started to see the Egoscue folks. For example, I noticed that apart from problems with my right arm, shoulder, scapula, I also had pain in my right hip, right knee and foot. I was not and am not yet sure if these are cause or effect but it felt like addressing all of them together might yield more progress.

All the best and let me know if you have any questions.

Have you figured out the solution to your leg/foot problem yet?
A few months ago I noticed some on and off numbness in my feet and then some on and off pain in the hip area (on both sides).
There are some L5-S1 disk/vertebrae issues showing on my MRI which may be a direct cause of this, but I suppose the root of all problems is in the overall faulty posture.
Most exercises for the lower spine I tried seem to make the problem worse so I'm not sure how to proceed.

I am progressing to more strenuous workouts for the upper body and these work very well. I regained much of the arm and shoulder strength I lost and stopped dropping things. Scapular stabilization still needs a lot more work though.
I am curious what Egoscue exercises you find helpful.

Who's Steve and would you have any contact information for him? Is he based out of California.

Hiker, did the Edgelow exercises address the upper trap/back pain spasms you mentioned (correct me if I am wrong) which you said were an issue earlier?

PS: Thanks a ton for the regular updates you provide. They offer a lot of hope for all those of us hitting walls in trying to figure out how to address this TOS stuff.

Yes, I think Edgelow exercises helped with the trap issues (bad pain above the shoulder blade). I think the nerves were being compressed in the neck and neck relaxation exercises reduced the compression.

PS Steve Talajkowski is the PT in California who is based in the old Peter Edgelow's office in Hayward.

@Hiker, I have a similar theory - the problem is the overall structure/posture instead of a clinical fix in the neck/shoulder area. The clinical fixes in the local area of the pain do provide relief but each time I go back to doing significant work at the computer or sit for a long time, the symptoms reappear. There's a bunch of people (Egoscue, Esther Gokhale, others) who point out problems in the spine arch (http://www.healthandlovepage.com/wp-...-Back-Pain.jpg) as a possible root cause. I am still not 100% convinced about the cause and effect cycle here (did shoulder issues cause back pain or did consistent lower back issues cause shoulder instability?) but my current theory is that everything needs to be addressed.

In my case, I could see that despite doing shoulder opening exercises, the weight of my body was more on the front face than on my heels, butt etc. After I started doing the exercises that the Egoscue folks recommended, I can clearly see the distribution shifting to the back, albeit slowly and steadily. With this change, I seem to be able to slouch less and maintain an open shoulder pose for longer. However, I need at least 3 more months before I conclude that this is a successful direction (after 3 months of doing their exercises so far).

If you want to try to address your lower back and see if it helps, I have some suggestions.

1. Try to do something like http://www.oregonexercisetherapy.com/blog/static-back for 15 mins with good diaphragm breathing and check if you feel straighter/better right after.

2. Do the (relatively simple) exercises in Egoscue "Pain Free at your PC" chapter "For those in pain" and see if you feel better/straighter right afterwards. This is what I started with, which convinced me to pay a visit to their clinic.

3. Egoscue has a clinic in SF, Esther Gokhale has one in Palo Alto. There are many others who do overall posture correction, but these are the ones I know enough about. I believe both offer an initial consultation for just evaluating and suggesting exercises to start with.

4. Han Yoga in the Bay Area offers a low intensity therapeutic yoga class that might help. Pain in my hands/shoulder did not allow me to do this a few months ago but I can manage to do this regularly now.

Let me know if you need any more details, all the best.

Thanks for the pointers Dufus!
I tried exercises from Gokhale's book and did not like them much. I think she is making assumptions about what's wrong with the posture which may or may not be correct.
Most her exercises seem to be aimed at fixing posterior pelvis tilt, but mine is overly tilted anteriorly leading to a kyphotic-lordotic posture.
I'll definitely check out the Egoscue book.

Yoga is also an interesing idea. Like you, I was unable to do any Yoga due to arm/shoulder pain, but I think I should be able to do some of it now.

Hiker, it could be cause and effect mixed up. From what (little) I know, a forward head ends up often causing a kyphotic lordotic posture as a balance mechanism. I have a KL posture with FH too and efforts to fix it went nowhere because I ended up developing a disc issue in my lower back. What help it are lower back extensions. So..

Ideal posture is a slight anterior tilt (not full on) per all the PTs and a decent lordosis with some kyphosis (flat thoracic spine means the scapula wing).

Gokhales book - I completely agree with you, are for the general population much and may not apply across the board. I did like her stretch lying stuff though. I wasn't quite able to implement it, but I do take care now not to flex my spine when sleeping.

We all seem to have picked up our own specific issues along the way.

Right, I am not really sure about cause and effect here :)
According to some books I read, tight hip flexors can lead to the forward head posture. But it could be the other way.
Makes sense to try and address the faulty posture on multiple fronts.

I am familiar with the Edgelow protocol but haven't found it that helpful. Maybe I'm missing something. The only exercise that I find helpful is the one where, you are lying on the floor with knees bent, and doing abdominal breathing in rhythm with pelvic rocking. When I rock forward, flatten back completely against floor and exhale, I get some relief. But that is it! All the other exercises seem to be small variants to the basic abdominal breathing.

Hiker, what particular exercises are you finding helpful?

SummerRain,

That has been my experience as well. Abdominal breathing is helpful... then you have to get off the floor and live your life. Unfortunately, I haven't found any residual relief once I get off the floor.

Take care,
Kelly

SummerRain,
yes, most exercises are variations of the abdominal breathing.
I found the basic one you described most helpful.
When I was in bad pain last year, this was the only exercise I could tolerate. I would just lie down on the floor and do it all day.

After a couple of weeks I noticed that 20 minutes of breathing provided an hour or so of relief and that I can make it through the day by doing it every hour.

The other exercises I found helpful was the longus colli strengthening and the foam roll. Breathing on a ball - not so much.

I think in my case TOS symptoms are secondary to RSI. My overworked neck muscles were constantly spasming causing pain due to nerve compression and trigger points. Doing Edgelow's exercises alllowed the muscles to relax and take pressure off the nerves.

I don't think they helped much with trigger points as I still have a lot of myofascial pain in the neck.

I've done some of the Edgelow stuff but after 35 years with TOS breathing isn't going to break up tight muscle fascia. Joint mobility exercises, self-massage, and vacuum cupping have really helped me but I've been doing this stuff for over 5 years. Results come slowly and they can be painful!

What are your symptoms? A posterior pelvic tilt appears to be what you are doing.

Edgelow's program is 1 year long. I am now at 10 months. Don't think I will be back to normal at one year, but I definitely made significant improvments.

I am feeling good on most days as long as I don't touch the computer. I can now work for 30-60 minutes before the neck pain slowly creeps in (big improvement compared with a few seconds 10 months ago).

All symptoms in my arms are moslty resolved. I can do push ups, chin ups, dumb bell curls etc without flaring up. Though I think proper scapular stabilization is more important than arm strength so this is what I am focusing on.
I resumed regular running and hiking. Went for a bike ride the other day for the first time in over a year - feeling no ill effects. Swimming is the next thing on my list.
Driving is less of a problem now - I can drive pain free for an hour or so.

I am now on the last exercise from Edgelow's DVD, neck stretch with wedges (don't have the wedges, I simply do it lying on the foam roll). There is some minor pain in the clavicle area when I do these stretches. It will probably take a couple months for it to resolve.
I am gradually adding more exercises on top of Edgelow. Mostly core exercises for the upper back and abdominals.

Still not able to work full time in the office. I am now working in the office two days and at home three days a week. My neck/shoulders feel achy after a day in the office so I have to stay at home the next two days.
The biggest problem area for me now is the neck. Any activity that involves a static pose and looking down (reading, typing, writing/drawing, cooking etc) causes neck pain. Have not yet found a remedy other than avoiding these things.
Another problem is the atrophy/weakness in the upper traps. Not seeing a lot of improvement there. I added some strength exercises for the upper traps a couple months ago. The traps feel a bit stronger, but no visible change and lack of endurance is a problem. Hopefully the affected nerves will recover and allow me to build strength.

Can you tell me a bit more about how you did the neck strengthening exercises with the cuff, any tips for the method, how many times, duration etc? I think they are crucial for me as I developed TOS via sudden trauma, though I was predisposed to it.

You use a pressure biofeedback device like this one:
http://www.amazon.com/gp/product/B01...f_rd_i=desktop

No need to buy the expensive gadget. One can simply take apart the old blood pressure cuff (the old-style with the pump and dial, not digital).

Here is the exercise (longus colli strengthening):

1. Lie on your back with knees bent
2. Place the pressure cuff under your neck and attach the meter where you can see it without moving your head. Inflate to 20 mmHg
3. Tuck the chin slightly to increase pressure to 22 mmHg
Make sure not to use scalenes or SCM muscles (feel them with your hand).
Hold for 5 seconds, relax for 5 seconds. Do 30 reps twice a day.
4. If this is easy, increase to a 10 second hold and then progress
to 30 or 40 mmHg.

This exercise is not hard to do. The idea is to learn to engage the right muscle for neck flexion and relax the scalenes.
I am not sure how fast one should progress and what target pressure is the best. I was adding 2mm pressure every few days. After a while I stopped using the meter, just inflated to the pressure that felt right.

I did this exercise for 3-4 months and found it helpful. Don't think my longus colli was actually weak. I was just using a bunch of other muscles along with it.

Thank you Hiker!

So does the arm/nerve pain come back when you work on the computer or only the shoulder pain? Its such an irritating thing, this TOS. And I still can't figure out why its the computer posture as you say, looking down, which is the biggest bother.

Hi Akash,

The current pain I have starts in the neck after 20-30 minutes of computer work. It then spreads to traps, clavicle and shoulder. This is when I stop.
I am guessing if ignore the pain and continue working, the pain will eventually spread down the arms.

Often times, I also get neck/shoulder pain at night. Static posture causing lack of circulation? Don't know.

Where did you get the DVD of exercises at? I have looked online but cannot find a Edgelow Protocol DVD.

I found no place to order it online.
You need to call Medical Dynamics at (800)945-0302.
I think they sell the DVD for $60. They also have a bunch of other stuff which you can get elsewhere (foam roll, exercise ball, pressure cuff, pinky-ball-on-a-stick etc).

I started this thread a year ago and it is time to draw some conclusions.
In the last few months I continued improving slowly, but steadily.
I have graduated from the Edgelow program to other exercises.
Most of my current exercises are based on Pilates, but I also do all kinds of stretches: neck, arms, pecs, hamstrings and so on as well as walking or running three times a day.
I continue working full time. Currently I work three days a week in the office and two days from home. Hopefully I'll be able to work in the office full time soon (remains to be seen).

I still have some aches and pains in the neck and traps (and some minor one and off back and knee pains), but nothing compared to how bad they were last year. I was seriously considering going on disability then as I could not work on the computer for more than a couple of minutes.
Today I worked on the computer for 8 hours (with small breaks) and am feeling OK.
I resumed doing most of my hobby activities. Though I have to limit reading and doing anything time-consuming on the comuter.

I think Edgelow's exercises were a very important first step in the recovery.
Nothing else I tried helped me get out of the cycle.

Like many of you, I have seen more than 20 doctors, therapists and chiropractors most of which were not helpful.
I never got a definitive diagnosis. Some suggested that I have nTOS, others dismissed that. I may never find it out, but hopefully I will continue getting better.

Hiker, can you post a rough timeline of the key exercises which you did and the daily schedule? Did you do the more "advanced" Edgelow exercises with the foam roller, triangular wedge etc? My issue is the breathing with spinal motion aggravates my lower back as its twisted up (in part due to the compensations that came with having a wry neck and TOS so long).

Also, i seem to lack focus in doing the belly breathing for more than a while as it seems to give little to no benefit.

Walking for long periods becomes an exercise in muscular tension for me. My different muscles at war with each other.

Its my pec minor which is a huge problem I think, did yours relax thanks to the breathing?

Also, Edgelows, hand to the chin exercise is very hard for me to grasp or do (I seem to apply either too much force or too little). I presume (from your past replies) that it was the breathing exercises that did you the most good.

I dont have the triangular wedge either. It was too big to get so i left it. In hindsight I think it was silly because it seems to teach proper rolling of the neck.

Here is a rough timeline.

Initially I could only do diaphragmatic breathing (with air pillow and without) and walking for 5-10 minutes so I started with that.
I gradually added other things. The very important rule is to never do any exercise that increases pain as this makes the injury worse.
Edgelow's idea which I found working for me is that diaphragmatic breathing relaxes the muscles and reduces pain. If it don't feel the reduction in pain
after 5-10 minutes then maybe it doesn't work for you. But if it does reduce the pain and if you do it all day every day, then you let the injury heal.
But you must not lie down all day. This is why walking is important.
I did the exercises as many times a day as I could. As I could not do anything else, finding free time wasn't an issue.
I also did relaxation exercises. Basically lying on my back in a dark room twice a day for 40 minutes or listening to relaxation music
and trying to relax all the muscles.

I also did do some chin tucks occasionally, but not every hour as per Edgelow. Also for the first few months I did longus colli strengthening.
But I suppose this was not a big issue for me so later I only did it occasionally and eventually dropped it.

In a couple of months I added rib mobilization with a pinkie ball on a stick. I am not sure these were very useful.
I walked at least 3 times every day and gradually increased time to 20-40 minutes per walk using pain level as a guide: if the shoulders start to hurt, I walked too far.

Month 4: I added ball exercises (diaphragmatic breathing on a ball). I only did these once a twice a day for a few minutes: these seemed less useful that breathing on the back.

Month 5: I added spine mobilization with a small foam roll. At first these were OK, but after a few weeks I started having numbness in my feet. As I found out later, I had L5 vertebrae fracture and herniated discs and mobilization was apparently aggravating the nerve roots.
I stopped doing the foam roll mobilizations, but still have some on and off feet numbness 6 months later. Getting better though.

Month 6: I was able to add big foamroll stretches. 5 minutes 3-4 times a day.
These are good as they stretch all the chest muscles. Could not do them before due to increased pain.

Month 8: Added doorframe pec minor stretches. Had to be careful with these as they cause hand numbness if I stretch too much.
These were quite painful initially so I only did them for 10-20 seconds a few times a day. Gradually increased to 60 seconds at a time multiple times per day.
Also did some ball exercises. Only did these once a day for 3-5 minutes. The more useful of this is the one where you lie with your back on the ball and
feet on the ground.

Month 10: added neck stretches on a foam roll. I don't have the wedges so I did not use them. These were also quite painful so I only went to the
point of pain, not past it (this is what the wedges are meant for). Gradually these became less painful and are almost pain free now.

At month 12 I was continuing diaphragmatic breathing, foamroll chest/neck stretches and some ball exercises as well as walking.
Later I replaced diaphragmatic breathing with abdominal crunches and added a bunch of other pilates-type exercises.

Thank You Hiker! all good info. I am finally going to buy the dvd and do the protocol for the new year even though I do many of the foam roller and ball exercises already. Also going to get a mini trampoline.

I too am back to work with a day of bad flare ups every other week or so-I don't work on the computer much though which definitely flares me up.

2 things that may have contributed to my being able to work-ozone shots and a chiro who understands TOS and did activator technique. i only saw him 5 times though because I got flared up after every session. Also TIME . I didn't work for almost 4 years.

Happy New Year Everyone!

Has the Egoscue helped?
I also have pain in hips and both shoulders too. It is very pricey to go to their facility.

Hiker, you are a gem. I am awed by your discipline and methodical way in which you did all this. The amount of willpower you have must be amazing. Were you an athlete perchance?

Did the L5 issue resolve, do you think it was worsening your neck pain and shoulder pain. Any exercises that helped there? I think I have a herniated disc on the left side thanks to a stupid mobilization by an arrogant PT who was into manual therapy. As a result, I have developed twisting in the lower back too.

Another thing, I learnt abdominal crunches are pretty bad for folks with kyphotic posture as they strengthen the rectus abdominis that basically pulls down on the rib cage and hunches one over. Another exercise most folks benefit from (supposedly) is the heel slide. Basically lie on your back, and making sure hips dont move, back is flat against the floor/ but by not pressing it - just shouldn't move or arch too much, keep moving one leg out heel against floor (sliding). While other leg is just braced (ie triangle shape). Then other foot. Basically gentle exercise for lower stomach muscles.
https://www.youtube.com/watch?v=_jvUnWbBPXc

Hope it helps.

No, I am not an athletic kind.
The L5 issue is gradually improving. I suspect I had the disc/vertebra issue since childhood as I had episodes of lower back pain on and off for 30 years. I think both lower back and neck issues are connected to the poor posture, but probably are independent from each other. I tried different back exercises, but none had any obvious benefit. I learned by trial and error which exercises trigger the foot numbness and avoided doing these for a while. I am now able to do some of these again.

I am a bit concerned about abdominal crunches too. I make sure I always complement these with upper back strengthening to counteract any effect they may have on the posture. I am also doing various leg slides like you suggested (and also with one leg raised) though I find them too light of an exercise.

For upper back strengthening are you doing the arm raised on an exercise ball or rows? I see those as the most commonly recommended.

I suspect a lot of my issues are from kyphotic posture and weak neck muscles.