i recommend working on gravity, like that :

http://www.globalbackcare.com/articl...t-on-chair.jpg
http://www.surftilyoudrop.com/images/inversiontable.gif

Hi boytos
thanks for your suggestions, simple BUT effective!
I will give them a go ( GENTLY )....... post op 3 weeks: (first rib resection/excision and very tight around incision area and SCM).
From SD38

Maybe start out with yoga style "corpse pose" on floor or bed first, then move up to a rolled towel to see how you do with it, then move up to foam roll or large ball.
Don't want you moving ahead to soon- maybe run it by your Dr or PT person to get an OK.

images of various corpse poses -
http://www.google.com/search?tbm=isc...655l2.7.2l11l0

Trigger point therapy by a licensed massage therapist who is skilled in neuromuscular therapy (trigger point therapy). Read the "sticky note" explanation of trigger points on the main page.

The brachial plexus (BP) is often compressed by the scalenes in the lateral neck (three on each side, and each can have 2-3 active trigger points). Farther down the line, the BP can be compressed by the pectoralis minor, which attaches to the coracoid process of the scapula (located beneath the clavicle). Next trouble spot for the BP is deep in the armpit, where it passes beneath the coracobrachialis, which also attaches to the coracoid process of scapula. In the posterior elbow region nerves are close to the surface and easily damaged there, but for the same reason unlikely to be compressed down here. But further down, as the nerves and blood vessels move into the hand, the retinaculum of the hand can compress the heck out of one or more tendons, blood vessels and the median nerve-- the infamous carpal tunnel. Carpal tunnel syndrome is often confused with TOS compression of the entire brachial plexus. As a rule, if the pain/tingling is felt in the thumb and first two fingers, it's probably cPS; felt in the others, it's probably TOS compression higher up.

MT for TrPs is slightly painful. If you visited the sticky notes I directed you to, you know that a TrP can cause the entire muscle to become hypertense, which limits circulation through it, which causes ischemia which causes sensory nerves to light up. But by definition an active TrP can send its pain to another muscle-- i.e., a scalene TrP can send pain into the fingertips or-- oddly!-- into the infraspinatus or other muscle that either attaches or is very close to the scapula. TrP work is slightly painful, but releasing the several TrPs in the muscles that can compress the BP will take just a few minutes, and the pain relief will be evident before you leave the MT's office.

PT can be effective treatment for TOS. But in my personal opinion, MT is quicker, more likely to bring relief, and it is certainly less costly. Medical doctors' standard treatment of trigger points is an injection that calms the trp temporarily along with a cortisone shot into the affected joint. The opinion of at least one clinical study is that cortisone has an adverse affect on tendons, ligaments and muscle tissue itself. (google "cortisone--is it really good").

Do read the sticky note: it is first rate explanation of trigger points.

Where did they stick the "needle" to determine the BP compression in the second test. I am going back to the Neuro to ask for a second test and if I am going to go through that discomfort again, I want to be way more thorough about where we're testing on my body.

How are your symptoms progressing or improving?
When you do the Adson's test do you get reduced or absent pulse? Have you found anything that helps?

The guy didn't use needles, he used those sticky pads. He started testing me for Carpal tunnel and radial tunnel but all those where negative - then he placed the electrodes on my chest near the BP - and he concluded that that is where the compression is - bilateral.

If you like, i can probably upload the charts from the test.
As far as i can tell, a positive nerve conduction test is very rare in this condition.

Symptoms are atm progressing i think, its hard to say - but its not improving, i just need to find the right amount of stretches and excercises.

Regarding the Adson test, my pulse went completely away. Tiger Balm and positive thinking helps at the moment

@Chroma: I need another appointment with my rheuma, awaiting a MRI scan of my BP - then i'll probably get the verdict, whether its surgery or PT.

According to the test the compression is at chest? That's a trigger point in the pec minor-- easy to fix. Pec minor originates on ribs 3, 4 and 5 and inserts on the coracoid process of the scapula. The active TrP will likely be high on the pec minor, between the 3rd rib and the coracoid, but you should also release the lower TrP, right about the fourth rib--but they can arise anywhere in the belly of the muscle.

If you haven't submitted to the surgery, you, yourself, with a fingertip can dig beneath the pec major and search the pec minor till you locate the tender spots-- then press on it and hold the compression for about 10 seconds, let up a little then press again to see if it is still tender; repeat the pressure but with a bit more pressure this time. When the trigger point releases you will feel a wave of relief as the tenderness goes away. Surgery will still be available option if working the trigger points doesn't help.

In SOME cases the extreme stretching employed by SOME PTs can make exacerbate the problem. And exercise after the TOS is cured.

Thanks for your post GaryA - am planning on scanning the report and putting it up here, as it could be beneficial for someone going through a nerve conduction test.

I have been told by multiple physical therapists and chiropractors that my pectoralis minor is really tight, I am currently looking into trigger points, and I will definitely look into your tip.

I agree that, the extreme stretching used by some physical therapists really aggravate my condition.

" Tiger Balm and positive thinking helps....."

OH YEAH!!!!!!! That's my little jar of wonder too. Good old Tiger Balm, far more effective than all the drug( ibuprofen and other NSAIDS ) induced muscle rubs I've tried in the past.

Best of luck with pain management. SD38