TOS is Confusing
 

How often is it that you feel pain is coming from one place and later realize it's coming from another?

I'd like to hear others experiences.

For me it's always a question of if it is coming from my pec minor, my scalenes, and then I have back pain as well but that isn't so bad! The arm pain I experience is always a question of where it is coming from. I never think my elbow or wrist..

I also got a negative NCV and EMG. I talk to a orthopaedic surgeon on Monday to talk about what my MRI showed.. if anything.

Anyways, this syndrome is confusing and as mentally exhausting as it is painful. Plus getting anyone to listen to you and not treat you like a crazy person is so frustrating. I'd love to hear from folks that can relate..

I'm also going to make another post shortly!

Those tests usually only show if there is an actual nerve issue.

Look into delayed pain & referred pain (goes back to trigger points)

MDs & surgeons mainly want a clear cut issue showing on testing, (something they can show for proof of ongoing treatment or RX, surgery) and often they are not too much help unless they studied beyond the norm and learned about soft tissue and whole body healing..

It is good to have that testing to rule out possible medical/surgical issues..

soft tissue, internal scar tissue & trigger points can impinge and cause just as much pain & symptoms and actual direct impingement.
Expert PT, DC, body work & lots of self care is a good thing to seek out.
If you need a MD referral.. find who or a few you want to try and ask for referral to them.. If they don't work out ask for a change to another place.
Going to a PT, DC or other place and asking questions is a good way to gauge them.. often The PT might come out and talk with you if they aren't busy..

Many professionals don't care for us to ask or know more than they might know..so some times we have to word what we know into a simple question..

Hi Jo,

I appreciate you always replying. When you say that an EMG and NCV are negative that means there is no nerve involvement? Or no nerve is being pinched at the moment during that test? Either I have a nerve involved or I have a killer trigger point in my scalenes that I can't get to.. my pt that normally dry needles me is on vacation so I won't be getting needled anytime soon. Her assistant did some first rib mobilisation on me which was actually not gentle but not very hard either. She pressed down on the first rib and held my arm and sort of moved the arm upward while pushing the rib downward. She also adjusted my collar bone a bit as well.

Needling the tight muscles like pec minor and scalenes (she did those only once because they can be hard to do) but they do bring quite a bit of relief. I am looking into a chiropractor here that can maybe get some things back in place and can give me a few pointers as well.

I'll be keeping you everyone up to date as time goes by..

Sure do wish there were more people around :( I guess this is kind of an old medium.

First rib mobilisation
 

I thought I would add here that first rib mobilisation has been something I have been doing to myself for the past 4 or 5 days now.

I will link folks to the video I followed so that others can see the technique used.

Athletic Thoracic Outlet (TOS) | Feat. Kelly Starrett | Ep. 257 | MobilityWOD - YouTube

In this video he used a PVC pipe and a towel. For me I use a broomstick, and I cut a + into a tennis ball and stuck in on the broomstick. What I like to do BEFORE doing the first rib mobilisation is either take a hot shower to loosen up the muscle fibers or use moist heat on the neck and trap area to loosen up the fibers as well. Then follow the directions in the video. What I can say is that it is uncomfortable to do. Are you going to feel 100% better instantly? No. But you might find that if you do this regularly you might retrain that rib to work properly.

Some folks here have been dealing with TOS for years. You aren't going to fix it in 5 minutes, the first rib may not even be your problem, it could be pec minor, and a host of other issues. It is good to loosen up every possible area of compression before as well as mobilise the first rib. I try to do this twice a day right now to keep my rib moving normally. One in the morning and once at night.

I have kind of realised that when my first rib originally got stuck in the upward position, it caused some weird pain in my armpit. To avoid that pain I started shrugging my shoulders up because relaxing them felt tight and uncomfortable. By shrugging for hours all day every day my traps, my pec minor, started to compensate for shoulder movements. This, in my opinion causes the degradation of proper scapular movement. From here you also get tight, shortened scalenes (hypertonic) because the rib is constantly elevated. Now you're in a world of trouble.

So, start getting to work loosening up those soft tissues. I recommend a good PT, massage therapist or chiro, to loosen you up. Some of them may be able to do the first rib mobilisation for you as well!