[chroma]

When I searched Amazon for "thoracic outlet", this book came up and I ordered it. But I had a lot of things I was reading and didn't get to it right away. I sort of forgot why I had ordered it as the title kept making me think it was going to be all about the arm from the elbow down. It's not.

They mention thoracic outlet syndrome almost immediately and even pec minor syndrome. There was a lot of great info in the book including ergonomics, self massage, postural exercises and proper nerve glide instructions. Also, a variety of patient histories showing that different things worked for different people.

The authors are a PT who treats RSI, TOS, etc. and a software engineer who suffered from such problems.

I just finished reading it, so I'm not ready to comment on how the advice all pans out. But I found it well written, honest and well informed. And they correctly point out that recovery takes months or more.

I already knew much of the material from other reading sources, but still picked up some tips. I imagine folks here would have a similar experience. I recommend it for any TOS sufferer.

You can check out reviews at Amazon:
http://www.amazon.com/Its-Carpal-Tun...7000468&sr=8-1

[mspennyloafer]

i have read this book and while it was great, the nerve glides in it shouldve put me in the hospital (i didn't go bc no ins). i actually wouldn't advise for anyone who suspects they have tos to do the exercises, nerve glides or strengthening without seeing a PT and even then 90 percent of the time the pts are untrustworthy!!

[mspennyloafer]

http://www.howibeatrsi.com/2011/03/how-james-beat-rsi/

i found this just now and im reading it, always curious to see how people recover

[mspennyloafer]

interesting he talks about pilates. that's basically what im going to do in pt, the idea of using your WHOLE body. he emphasizes the swan which i think is actually in the ITS NOT CARPAL TUNNEL syndrome book. but i still think u need a pt to monitor all of this. do not go to one of those offices where pts see 10 patietns at once.

[chroma]

Originally Posted by mspennyloafer

i have read this book and while it was great, the nerve glides in it shouldve put me in the hospital (i didn't go bc no ins). i actually wouldn't advise for anyone who suspects they have tos to do the exercises, nerve glides or strengthening without seeing a PT and even then 90 percent of the time the pts are untrustworthy!!

I found the following comments from a brief paper on nerve gliding to be interesting:

"When attempting to glide a nerve, it is important to put one side on slack before pulling in the opposite direction (Fig. 1)."

"Simultaneous neck bending and scapular elevation is usually painful in patients with TOS. Painful exercises should be avoided initially because they may aggravate the patient’s symptoms, and they will be introduced as soon as feasible."

http://intraspec.ca/PIIS0749071203000908.pdf

They claim that if one side is not on slack you are stretching the nerve rather than gliding it.

What's your impression, mspennyloafer? Were you doing a stretch instead? Did you bend the neck and elevate the scapula at the same time?

Btw I'm not disagreeing with your advice. Even the book says on page xii to see a medical practitioner.

[chroma]

Also, the following study is interesting in that it found tendon glides to be more effective than nerve glides. Alas, this is for CTS, so it's not clear (at least to me) that it would apply to TOS as well, or what the tendon glides for TOS would be.

The comparative effectiveness of tendon and nerve gliding exercises in patients with carpal tunnel syndrome: a randomized trial

Conclusion: The combination of tendon gliding exercises with conventional treatments may be more effective than that of nerve gliding exercises with conventional treatments.

http://www.ncbi.nlm.nih.gov/pubmed/21430512

[chroma]

Originally Posted by mspennyloafer

http://www.howibeatrsi.com/2011/03/how-james-beat-rsi/

i found this just now and im reading it, always curious to see how people recover

Overall an interesting read. Two things that I think he got wrong:

1) He mentioned being sore every day for eight months from doing the same exercise every day (for a postural muscle). You're supposed to wait 48 - 72 hours for the muscle to heal before breaking it down again (for strength training that is). When the muscle is sore then it is still building strength (e.g., healing).

2) He mentioned several times that his pain would come back and then he would fix it again with the [postural] exercises. I think he'd do better with a maintenance schedule so he doesn't revert in the first place.

But otherwise, I found the page interesting to see the specifics of what someone went through. His recovery was congruent with the "It's Not CTS" book.

In a nutshell, he had trigger points and he had postural muscle weakness. When he fixed both he went from having RSI pain within seconds of using the computer to working 8 hour days with only minor complaints.

He went from having to quit his job because he literally could not work, to working full time.

Now that's a happy ending! :-)

[mspennyloafer]

Originally Posted by chroma

I found the following comments from a brief paper on nerve gliding to be interesting:

"When attempting to glide a nerve, it is important to put one side on slack before pulling in the opposite direction (Fig. 1)."

"Simultaneous neck bending and scapular elevation is usually painful in patients with TOS. Painful exercises should be avoided initially because they may aggravate the patient’s symptoms, and they will be introduced as soon as feasible."

http://intraspec.ca/PIIS0749071203000908.pdf

They claim that if one side is not on slack you are stretching the nerve rather than gliding it.

What's your impression, mspennyloafer? Were you doing a stretch instead? Did you bend the neck and elevate the scapula at the same time?

Btw I'm not disagreeing with your advice. Even the book says on page xii to see a medical practitioner.

i actually had this same article saved to my computer awhile back

i absolutely believe i stretched my nerves instead of gliding them. are you saying (or am i just projecting what i think lol) that because my shoulder are chronically elevated i cannot effectively do a nerve glide..i.e. the slacking part?

i can barely look at these drawings bc it gives me anxiety LOL but i know this is why my hands are numb. my rheum thinks i have like small fibre neuropathy or some crap i think. i believe all the docs are wrong


my pt has done this thing called the UPPER LIMB NEURAL TENSION TEST on me 1000x and i've gotten better at it but she's never turned my head. i am going to ask her if eventually she's going to start turning my head, after i am stronger.

[mspennyloafer]

i agree im not saying he's THE CURE but he cured it doing stuff which i believe will work. in maintenance of course

[mspennyloafer]

Originally Posted by chroma

Also, the following study is interesting in that it found tendon glides to be more effective than nerve glides. Alas, this is for CTS, so it's not clear (at least to me) that it would apply to TOS as well, or what the tendon glides for TOS would be.

The comparative effectiveness of tendon and nerve gliding exercises in patients with carpal tunnel syndrome: a randomized trial

Conclusion: The combination of tendon gliding exercises with conventional treatments may be more effective than that of nerve gliding exercises with conventional treatments.

http://www.ncbi.nlm.nih.gov/pubmed/21430512

imo tendon glides are a totally different ballpark..more for like your wrists and forearms. i can do tendon glides just fine but cannot nerve glides