hello Mighty slug,

I use one of those inflatable exercise balls to lay over 26 inch size - I also have a Styrofoam cylinder 6" diameter and 30" length approx. {a rolled up towel or 2 will work also}

nearly anything that is comfortable to lean on and over will work.

small firm balls will work for triggerpoint therapy. more info in our sticky -useful sites - above the posting list.

lay with that the length of your spine and let the shoulders drop down and also the chest will release and stretch.

do small movements with arms out at various angles for gentle stretches there too.

If pain is high start flat on floor with the small arm positions and movements.

diaphragmatic breathing is very good to use at this time also.

thanks for your info mighty slug. the chi ball that you asked about is only 5inches in diameter it is made of the same plastic that those exercise balls are made of. it is able to be inflated, deflated by removing a small stopper which looks like a golf tee and blowing it up to your suit your requirements. here it costs about 15 australian dollars. i worked out that just over half inflated was the best size, then at the local $2 shop they were selling childrens small soccer and basketballs (from china) just the same size complete with a small pump. so i bought a couple of those, pumped them up to just over half full and now i use those. my point about the relief that i get from laying on the chi ball is. I think that the chiros and PTs have misinterpreted the reason that some people get an improvement in symptoms. i dont think it is because the pec minor is stretched or the thoracic spine is mobilized. I think that there are a significant number of other people like myself who have scapula instability and when they lay on the ball they allow the nerve to be decompromised which improves scapular stability. when i returned to light duties (making security products) i would make my shoulder worse and very uncomfortable. i would attend a pt (we call them physio) session and lay on the ball 5 or 10 mins and notice the difference. then i would do some exercises, for instance a theratube arm exercise and lose the scapular stability.
using the chi ball decompressed the nerve, having to stabilize the scapula compressed the nerve.

one of the things that i couldn't understand with this condition was whereas if i had hurt my lower back or knee or some other part of my body is if i rested it would eventually get better but with this condition rest usually made it worse. i had told my doctor that i was having a terrible time sleeping so he prescribed some sleeping tablets. they would cause me sleep through the night but my symptoms would be worse. it reminded me of when my first child was born, he was a spilling all the time and vomitting. he would keep my wife and i up all night. we hadnt had a decent nights sleep for 12 weeks. we took him to the paediatrician and he prescribed a sedative for him. i was not happy giving a small baby a sedative but you assume that the experts know what they are doing. we gave him the sedative and he gave us some peace for a while but he was not happy when he woke up. we had a visit from a CAFHS nurse to see how we were going with our new baby. we told her the problem. she said try some antacid medicine (mylanta) he slept like a baby. we had been giving him sedation so the acid could eat away at his oesophagus.

i think it is similar with TOS when you are sleeping you are making your problem worse. you are compromising nerves. this is why sleeping is so difficult. the things which make this condition persist and worsen are
1. laying on your shoulders and ribs
2. using your affected arm (stabilizing the scapula)
3. chest breathing

it is pretty difficult not to do all of these things

thats why just resting doesn't make you better

within the next couple of days i shall take some pictures of the things that have made my condition significantly better.

i am interested if anyone has had a problem where they have
a)bent to the ground to pick something up
b)sneezed
and had the weirdest and scary sensation in their thoracic spine which feels as though their spine has opened up? when i was at my worst it happened at least ten times, once when the pt had her hand exactly where the clunk happened, i read of another TOS sufferer who described it. i will find the link for it tomorrow best wishes

sometimes I get the very strange sensation of the T/C or upper T spine feeling like it is pulling apart.

like reaching out over the couch to pull or push the large slider window open or closed. gotta get some silicone for this year so it will slide easy.

the leaning over to pull weeds of pick heavy objects from floor can at times cause this too.

One of my Dx's was cervico-thoracic spine strain with arm pain- this was from a physiatrist - his adv PT guy that actually did the full evaluation - {dr did not do it}- PT did find TOS sx - but dr did not change his Dx after the eval.

I think I do have both after doing kitchen remodeling project last summer, the spine strain seemed to appear again- lots of lifting, bending, carrying.

Thank you Jo55 - the technique you describe sounds very similar to one I do at Yoga - basically lying on two yoga blocks lengthwise along head and spine with arms and scapula hanging over. I told my Yoga teacher your advice and she nodded enthusiastically - she said I need two sandbags on my shoulders to weigh them down.....have you tried this.

Towelhorse...I will try to help but please forgive me if my understanding of all these neurotalk is a little beyond me...and gets a bit scrambled up.

You say your point is - rather than nerves are being outstretched by laying on chi balls, relief is obtained because the nerve is decompressed which improves scapular instability.

This would concur with a piece I've found from a text book years ago and kept copies of.....I will try to scan at library and put on site but don't hold out too much hope as I'm not too good at these type of things....anyhow

The first thing would seem to identify the root cause of the instability it seems instability of scapular is caused by glenohumeral instability or rotorcuff instability.

I quote the following

"the tests are performed with the patient in suprine lying and involve passive movement into the 'apprehension test' position of 90degree abduction and 90deg of lateral rotation. In this position a gentle anteriorly directly pressure is applied to the head of the humerus. If the patient experiences marked apprehension with or without pain, then this is indicative of gross glenohumeral instability, as in the case of recurrent dislocations. Pain without apprehension could indicate either a primary impingement or mild anterior instability with secondary impingement.

Differentiation between anterior instability with secondary impingement from primary impingement is possible by performing the 'relocation test'. This simply entails positioning the patient in the above apprehension testing position and then placing a posteriorly directed force to the humeral head.

Patients with primary impingement experience no change in their pain level, while those with anterior instability and secondary impingement experience a lessening of their pain. This results from the posteriorly moving humeral head relieving the impinging pressure on the underside of the rotator cuff against the posterosuperior genoid rim".

It may be that you are both correct (not that I want to defend their point)
Sounds to me that pain is caused because of the rotator cuff pressing onto the genoid rim(?) and the chi ball perhaps changes the position of the humeral head which perhaps stretches the nerves and at the same time decompresses the nerve which pull apart the rotator cuff and genoid rim.
Or am I talking out my....

Its difficult to try to reason these things out when you don't have a clear picture of the parts e.g. what is a genoid rim, and I think you also need to see a visual demonstration of how things things move and function in relation to each other.

I hope that little piece may have helped
It's so frustrating when people don't understand what you're trying to get at...I hope I haven't missed the point......If I have don't try harder to explain....I've gone down that road.....it means that I just don't and perhaps can't comprehend because of a lack of full knowledge on the subject. Perhaps someone outthere can supply the knowledge you need.

Take Care
I'd think about another occupation though if even light works are causing you a problem.....can you go on the sick? A job isn't worth ruining your health for....I learnt the hard way. i know its difficult wife & child to support.....

Travel with Love

The Slug

hello every one,
apart from the frustration of having the condition one of the incredibly frustrating things was the blank looks one receives from treating professionals when you tell them of your symptoms.
for instance when my problem was at its worst if i tried to set a time on the microwave oven, if i pressed one of the buttons i would end up pressing it twice. if i tired to use a clutch pencil with a small lead in it i continually broke the lead. i couldnt write my signature properly. i couldnt pickup a sliced loaf bread without dropping it or crushing it. when i told the health professionals they would just look at me with a blank look on their faces. it is almost unbelievable that we dont have the expertise to understand why this is happening.

i tried to make up a flow chart of my theory of why i have the problem in publisher then converted it to word and then add it as an attachment but "the computer said no " those of you who watch little britain will no what i mean. so the i printed it and then scanned it but it think that it is going to be too small but i will have a go.

if you look at the boxes you will see that all i am doing is rearranging the order of how things occur. i am not intruducing anything new apart from suggesting that the scalenus medius ( one of the scalene muscles) is compromising the Long Thoracic Nerve (which will weaken the serratus anterior) rather than the scalene muscles compromising the brachial plexus.
i am only a pleb but i feel so strongly about this that i choose to stick my neck out.

here are some indicators of my varying scapular instability. if you try these be careful.
i can not put my affected arm behind my back and move it upwards without causing a lot of pain and worsening my scapular stability.
i can not put my affected arm behind my back with my palm facing away from my back and push my hand away from my back without causing a lot of pain and worsening my scapular stability enormously. ( an occ physician asked me to do this. the consequences were excruciating pain immediate loss of scapular stability, muscles in my shoulder twitching uncontrollably, he said that he had never seen a myofascial pain reaction like that before.
i can not hold things straight out in front of my body for very long without causing loss of scapular stability.
laying on my back without a support between my shoulders
if someone manipulates across a tight band along the levator scapula on the affected area.
maybe if the medical people treated TOS as a shoulder injury they might get better results see you later towelhorse

Attached Thumbnails

 

I'll try to save that image and see if I can resize it for reposting.
{ no -it gets too blurry}

Most of us have found that each of us has very different cause/effect when it come to TOS.
Specific PT, treatment, or other things might work for me but may not work for others.

It would be interesting if other feel they have more of the scapular instability like you have.

Hello everyone,
Ive spoken about varying scapular stability and also varying symptoms down my arm due to the varying pec minor tightness. I would now like to speak about other symptoms such as cold hand, cyanosis and changed breathing patterns.
The first time cyanosis was noticed in my affected hand was when my wife and I were at a meeting with a new rehabilitation consultant. The previous rehab con. had been dismissed by the case manager due to her improper conduct. A meeting had been convened to meet the new rehab consultant and also so I could express my disappointment with the Occupational Physician and his rehab strategies.
The Occ Phys had told me that despite the fact that the MRI indicating that the disc bulge was on my left side and it was my right arm was the affected side he still felt that my problem was nerve root irritation. His treatment consisted of a truncal stability program and neural stretches. The weight lifting in the gym caused muscles to become tighter and hand tingling to get worse. My complaints that my condition was worsening were met with “no pain , no gain”. The PT had written notes which I had delivered to the OCC PHYS which stated that I had scapular instability. The Occ Phys said my shoulder was fine. He instructed the pt to show me 3 neural stretches. These caused a massive flare up of all the symptoms.
At the meeting with the new rehab con. Where I was to tell her that I was getting worse, my wife (who is a nurse) said “look at your hand”. My right hand was blue /red, significantly different in colour to my left hand. The treatment that I had been receiving (for nerve root irritation) had worsened my condition. Not only did my hand become blue/red but at other times it would it would become significantly colder than my other hand. I often showed other people how much different the temperature of my hands might become. Before I was able to remove myself from the control of this Occ Phys he sent me back to my workplace . At the workplace I was required to use a machine which necessitated the use of my right arm above my head. Something happened in my upper back when I did this. I reported this occurring and I was given different duties. The strange thing was that when I sat down 10 mins later my hand turned cold. I have noticed that the over whelming majority of cold and cyanosis symptoms happen when I sit down. It would seem greater pressure on my diaphragm combined with chest breathing exacerbates these symptoms.
I have noticed that breathing patterns vary also. There is much information regarding TOS, T4 syndrome and chest breathing. I have noticed that when i lay down to sleep at night time that breathing becomes harder. I have mentioned previously that I use a brace to hold my shoulders down and back because this stops much of the muscle spasms which occur in my upper back. On a few occasions when I have removed the brace in the evening, it has been obvious that the chest breathing has started. I have also mentioned previously that investigations into high blood pressure had uncovered the fact that I have a hyper inflated chest cavity. An xray prior to my TOS problem did not indicate this problem. I have only had a breathing problem since getting TOS . Pulmicort has made my breathing easier. Sleeping is much easier when you are not chest breathing. It seems strange to me that even if TOS sufferers don’t have an extra rib they may have a section of rib removed (please correct me if I am wrong about this).
I believe that chest breathing is a significant contributing factor to TOS.
three PTs tried unsuccessfuly to retrain me to stop chest breathing, the medication has improved my significantly. the PTs tried the only way they knew how, if high blood pressure hadnt uncovered the chest problem, the chest problem would not have been addressed. got to go. see you later, towelhorse.

thanks for the update towelhorse. any chance you can show us that brace you devised. i'm very curious but couldn't understand your prev. explanation very well.

"I have mentioned previously that I use a brace to hold my shoulders down and back because this stops much of the muscle spasms which occur in my upper back. "

I don't recall if you've tried the actual Edgelow breathing method exercises; you might find his video interesting. it shows breathing in both lying down and seated positions.

Oh I was looking for Sharon Butlers "tape trick" the other day.

Basically you have someone help you get into proper shoulder alignment and they place a large strip of medical type tape from upper back over the shoulder to the chest.
approx where the bra strap would be.

then throughout the day if you start to roll or slouch the shoulders the tape will tug and remind you to stay/get into correct alignment.

If you are in high pain or quite out of alignment start with tape in a better than your usual ,but less than the perfect alignment - and work your way up to the best.

1. I use a 6" in diameter and 3 foot long foam roller. You can get them online or in a "relax the back" store. It is great for all sorts of things (acupressure and the like). I lie on it lengthwise under my spine. Head is at one end, butt on the other. Legs bent...lower spine as flat as you can get (work that core) into the foam roller. Thus upper arms are draped over the foam roller. Yes, add weights to shoulder to open chest more and push shoulders back further. Try to engage RHOMBOIDS and MID-Traps to create this pull naturally. Remember to keep your neck straight do NOT pull it forward...head must touch foam roller.

2. I Yoga...I use a rolled up blanket...same principle.