I'll start out with some stories of how my many sessions w/ various places & PTs went.

1st injury 1999 - w/my own PCP Dr -
severe RSI bilateral - both wrists hands & fingers pretty much stopped working for awhile. Could drive on fairly straight roads but lots or turns & parking was a problem. was off work immediately (wc) due to no fine finger use/dexterity.
I vaguely remember the PT used heat/ultrasound/massage/ for the most part and then I iced and did a lot of resting at home.

I think I was off work for 4 mos. then back on modified work in other parts of the company for another 7 mos. til I felt I was ready (I asked to return to my assy job = more $$ and the modified jobs were pretty boring (LOL) I was at about 75% of my old normal , but I did nearly fully recover from that first episode of RSI. Or maybe I should ssay I thought I did
Plus they asked for my input on ergo changes and inventing some new equipment to make the work less stressful on our hands/arms.

Ooops getting off track sorry..

"shoulder strain" 2001 & another in 2002/03 -
no time off work , some modified duties & job restrictions.
went to PT during work hrs as it was only 3 miles away - MCO - managed care organization.
basic cookie cutter PT - heat, ultrasound, then go thru some basic posture exercises and strengthening the shoulder girdle.
It patched me up to go back to full duties.

2 months later = It ALL started coming back- but moving around, hands, arms. wrists, shoulders, neck, upperback pain - So my new PCP ( I went to my own Dr this time, but my 1999 dr had moved away ) had trouble pin pointing the problem/s.

But I did get decent PT - except for the first place she sent me to - it was a rookie PT guy still using a book to help him
Had more issues come up so back to Dr , but my regular one was out so got an older Dr that was more savvy about RSI - he got me to a hand therapy specialist -but they were still stuck with having to stay in the limits of my wc claim original injury for hand /wrist tx only
These PTs did much more focused PT on what I needed for my arms & hands- but they could not do anything for my neck or upper back.

About this same time frame is when I started seeing info about TOS during my web searches - and I started seeing the pattern, but still stuck in the wc system and a PCP that didn't really know much more than the very basics of TOS.
She did one of the blood flow tests on 1 arm - both sides had sx, and she never said what results she got from the one she did.

I did get another referral to an even bigger & better PT place.
So something good did come out of it.


I'll write more later about the actual PT sessions.
Did a lot of yard work yesterday...


PCP also later referred me to a physiatrist later on which was another good thing. At a spine health & rehab place.

But something about how we did it messed up my wc claim status.
For a referral at the time wc only lets you go out to another dr 1 time- I went 2x's!! so they "said" I changed Drs and deposed the physiatrist instead of the dr I saw regularly for 1.5 years..for the injury!!
live and learn... I guess..
My atty was not the best as I figured out later.. he should have asked me who my main dr was before allowing a depo of the wrong one.

I felt these were pretty good sessions.
Basically they did a brief assessment every time and made adjustments as needed, didn't push hand bike or stretchy bands until my pain & sx were low.

fist appt was also the evaluation appt. where they do an in depth questionnaire about sx, pain levels, what helps for you & what makes it worse.
The the hands on evaluation to locate the trouble spots & rule in/out any spine issues.

heat pack 15 min
ultrasound 10-15 min
massage 10-15 min
assess for sx/pain
then if acceptable move on to some basic stretches - adjust as needed to tolerance
send a home plan to follow until next appt.

nest appt session
assessment of sx & pain levels
same as above if acceptable
If any increases in pain/sx then back track /ease off on stretches or any exercises that might have caused increased pain.

repeat all until pain & sx are down to a 2-3
they also used some biofeedback machine to find out what muscles are relaxing & contracting properly or not- some of mine were not relaxing completely - showed a baseline tension all the time.
so they showed me specific things to work on for that
and made sure i was doing them properly before sending me home to do on my own.

Had me try a fluido machine one time - just sitting with the arms extended into that dumb machine was not a good thing.. but that was when we were still focused on the RSI arms injury.
Didn't do anything good for me at all and made my neck & shoulders more sore.

i bashed on stretching but its bc i was stretching the wrong areas i think, right now im getting TENS done to my t-spine and doing this weird "stretch" for my cervical spine or t spine??? its very very minor bc i have a lotta neural tension

those biofeedback machines sound neat

my physical therapy consists of Just Mobilization of all the structures involved, e.g. first rib, spinal vertebra, pec minor ect.

And its the same every time, no machines or ultrasound or anything. Just manual adjustments.

I want to update that my chiro did some nimmo for my severe spasms (mix of soft/deep tissue/trigger point etc), and top rib mobilizations, as well as adjustments and upper cervical adjusting (c1 c2).

The usual treatment went like this -
attached the IF stim pads to my shoulder/upper back on each side and also lower back each side and turned it on
then used ultra sound on my c spine and upper back
some times if specific pain areas he would use the soft/cold /low level laser - like on my wrist, elbow, shoulder and low back when it needed (I will buy one of those when prices come down, it is great and tx time is quick)

then adjustments if needed
went 2x a week for about 2 months, then weekly, then monthly for maintenance when symptoms were under control.

Hi Jo,
I did well with maintenance after years of WC by using the Physiatrist. Managing meds, and pain management trigger point and epidurals.
As restricting the TOS is, my lumbar sacroiliac is more painful. It restricts my ability to walk, stand, get up. But, the treatments med wise control the TOS pain.

My huge weigh gain since 1999 is horrific on the back, but thyroid, cortisol and other hormone problems battle against losing it.

Saddens me to look at my old self. I am starting some PT on the traps to control a large of my migraines. Mainly range of motion, massage, heat ultra sound. If it were not so far away I would do water aqua therapy.

Be well,
Di

My low back is getting to be problematic too, I finally went & got an x ray just to see what if anything was going on..

I think it was L4/5 was misaligned and my tail bone is at a sharper angle than normal. I thin I have quit e a bit of instability in that L4/5 area, sometimes I can feel it slipping or thumping around..

Has pinchy, fatigued and achy times..

might be time after the holidays to get a tune up w/chiro