[BKRich]

I first wrote the title as TOS vs keeping fit, but plumped for a more positive tone

The first purpose of this thread is to ask for any experiences and opinions regarding exercise whilst suffering from TOS. I don't mean exercise specifically to treat the TOS such as nerve glides and stretches, but any general exercise like cardio, resistance work or yoga.

What have you tried?
What can you do?
What do you avoid?

The second purpose is for me to share my experience, in case it might be of help to any others. I'll start that off in the second post. I intend to share some images, so will need to increase my post count ** first. For some background, I'll also link to my introduction post in the introduction thread as soon as I can do that.

[Jomar]

My symptoms are fairly mild now and I never had symptoms severe enough to require rx'd meds, except for a few nights during the worst time.
I did eat way too much Advil/Motrin when trying to continue at work..

I've used treadmill, elliptical, exercise bike with no problems, I don't hold on to the support bars continuously, but the elliptical does have the arm movement support/handles- it is a smooth movement and it works out OK for me, more so than static hold positions.

I tried Curves a few times but having to change to the next machine so quickly was a pain as well as the equipment could be padded better and smoother operating.
I wouldn't recommend it as most is resistance or magnet driven, and the one size fits all approach.

I can do most any normal activity, but I do avoid having my arms up overhead & a lot of looking up (some c spine bone spurs)
I also avoid hand writing LOL the fine finger coordination is shot..

I just got some yoga DVDs from the library so I plan to see if there are any that work for me.

[BKRich]

Cycling

Prior to receiving a diagnosis of vascular and neurogenic TOS, but for a couple of months after experiencing the first symptoms (unknown at the time) I was spending 60 minutes a day cycling on a hardtail (no suspension) hybrid (part road bike, part mountain bike) bike.

I've had a few tentative trial sessions back on the bike since my dx, but do develop pain symptoms during. It is difficult to know whether these are due to TOS or are just normal pain following a long period of inactivity.

I am seriously considering whether acquiring a recumbent bike will be not only a short-term solution, but also be better for the long-term avoidance of issues which can be provoked by riding on upright bikes (low back, upper back, elbows, wrists, neck)

Treadmill, Cross-Trainer, Stepper
Any position where my head and neck are unsupported for periods of 45m+ currently provokes pain in the neck/shoulder region, so extended periods on almost any type of cardio equipment (treadmill, x-trainer, stepper) are not practical.

Before I became aware of the unsupported head and neck trigger, I did spend quite a lot of time on a treadmill. Sometimes whilst running, I would notice numbness developing in the 4th and 5th digits of both hands (ulnar nerve symptoms)

I've also spent time on a x-trainer, but this requires considerable shoulder movement in addition to flexion at the elbow, which provokes both neck/shoulder and ulnar nerve symptoms.

Currently offering hope are recumbent stationary bikes. I've been able to spend up to 60 minutes on one of these, with the help of a dedicated head and neck support to supplement the backrest of the bike itself. This is one of the things that I wish to share a picture of, and will soon.

Versa-Climber
This is another thing I was using almost every day, for about 20-30 minutes a day prior to stopping as a preventative measure against aggravating TOS. Exercising on a Versa Climber involves repetitive overhead movements. I'm concerned that my increased use might have contributed to development of TOS, but my phyiso is skeptical about this possibility.

[kellysf]

I walk or ride a stationary bike when I'm feeling up to it. Even on a good day, walking more than 40 minutes can cause very severe problems, including migraine. So I do exercise in small chunks. There are many days when I'm not up to anything so I don't push it.

I tried yoga in the very beginning of TOS. I liked it but there was too much arm forward activity that caused flares. I did some resistance band work in PT after surgery -- a very bad idea I learned only afterward. Cardio is hard because there is too much neck and shoulder movement.

I think the TOX maxim holds true -- if it hurts or causes increased pain later, don't do it.

[tied]

swimminng and yoga are good. be sure to modify them. there are always good modifications the instructor can suggest. i also park far away and use stairs a lot. shopping in a big box saves $ and gives exercise too. when standing in line do tree balance. balance is important in healing. i am very stiff so stretching is essential.

[BKRich]

Weight-lifting
This seems an obvious one to avoid, but . . . .

Prior to TOS, I performed 3 full body weights sessions per week, using the Hypertrophy Specific Training (HST) method and free-weights (bench, squat, deadlift etc). When I began to cease activities as a precautionary measure against worsening symptoms but prior to diagnosis, weight lifting was the last thing I stopped. This was partly because it is the thing I wanted to keep the most, but mostly because with one outlying exception, this never appeared to have any impact on my symptoms.

Advice against resistance exercise for TOS-sufferers seems to be consistent. However, after a 2 month break I have started resistance exercise again, but limit this to my lower body and core region. I do wall squats, leg extensions, leg curls, seated calf raises, back extensions and bicycle crunches. I can detect no negative outcomes during or after such sessions.

Yoga
I'm happy to see a few others already mention yoga. I'm currently practicing yoga each day now. It has somewhat filled the gap created by the cessation of cardio and weight-lifting. As a complete beginner, I do have to be selective about which poses I perform and which I avoid. For example, eagle pose, which involves interweaving your arms and bending elbows, is out because it does irritate my ulnar nerve related complaints.
Of course, corpse pose is always very welcome

[BKRich]

Originally Posted by Jo*mar

I've used treadmill, elliptical, exercise bike with no problems, I don't hold on to the support bars continuously, but the elliptical does have the arm movement support/handles- it is a smooth movement and it works out OK for me, more so than static hold positions.

I tried Curves a few times but having to change to the next machine so quickly was a pain as well as the equipment could be padded better and smoother operating.
I wouldn't recommend it as most is resistance or magnet driven, and the one size fits all approach.

I just got some yoga DVDs from the library so I plan to see if there are any that work for me.

Jo, if you are interested I can recommend some Yoga DVD’s. I recently began yoga practice as a complete beginner, and have done so based on instructional DVD’s rather than taking a class. I’ve found some extremely useful, and others less so. If you are a complete beginner like me, the ones I like may suit you too.

Regarding use of an elliptical, I want to ask – are you free of double-crush symptoms affecting for example the ulnar nerve?

Originally Posted by kellysf

I walk or ride a stationary bike when I'm feeling up to it. Even on a good day, walking more than 40 minutes can cause very severe problems, including migraine. So I do exercise in small chunks. There are many days when I'm not up to anything so I don't push it.

I think the TOX maxim holds true -- if it hurts or causes increased pain later, don't do it.

Kelly, your problem with walking may be similar to mine. My symptoms onset somewhere between 40-90 minutes of walking, and begin with a crawling sensation in the posterior cervical region that acts like an early warning system for the pain that follows if I don’t lie down or rest my upper back/neck/head against something.

I am interested in the small chunks of exercise approach. I have considered this. I am concerned that although I wouldn’t experience pain during that short period, I may nevertheless be aggravating the underlying condition. May I ask for your take on this?

Originally Posted by tied

swimminng and yoga are good. be sure to modify them. there are always good modifications the instructor can suggest. i also park far away and use stairs a lot. shopping in a big box saves $ and gives exercise too. when standing in line do tree balance. balance is important in healing. i am very stiff so stretching is essential.

My GP (who I think would not object if I said possesses a poorer understanding of TOS than I do) has suggested swimming. What about the overhead shoulder movements involved though? Do you use some strokes and not others?

Yoga’s Tree pose is something that I found hilarious at first because I was akin to a spinning top, constantly either twisting or falling over. I enjoy it now, and even try doing it with my eyes closed.

[Jomar]

Yes, post the ones you like, it's hard to find good one sometimes.

I had ulnar problems for about 2 months , it didn't appear until about the 10 month mark of my RSI/TOS/?? injury.
I was having PT at the time so they gave me the ulnar compression wrap w/little air pillows. Plus addressed those sx with therapies too.
Luckily it faded away, but the elbow sensitivity/soreness really messed up my sleep for awhile.

[kellysf]

BKRich,

I often have a delayed pain response to physical exercise. This happened to me repeatedly during PT. It would aggravate my pain a few hours later. I found this is actually quite common. It makes it very difficult to identify which activity aggravates ones pain, though.

I walk my dog quite often. I do a loop that takes 35-40 minutes. This seems to be my tolerance limit. I went on a trip last summer where the primary activity was walking and site seeing. Within one day I had horrible pain and migraine. This lasted on and off (mostly on) for 3 weeks. It was the worst 3 week period in my life. The only thing I did that could have spiked my pain was walking; I wasn't using the computer, driving, cooking, etc.

It's definitely a trial and error system to figure out what you can tolerate. I don't really think in terms of exercise anymore. I just try to keep moving.

Good luck,
Kelly

[Concoulor3]

I have been a fitness instructor for approximately 20 years. Yoga instructor for 6 and TOS sufferer for 25 years. However, I suppose I am a bit different in that I have a large cervical rib, my tos has developed over time, but without yoga, I can't imagine where I would be right now, probably chopped-up before necessary.

I would recommend yoga to everyone; however, very few yoga instructors understand TOS let alone know what it is. I happen to have a degree in kinesiology, and with my symptoms, really know how and what is right. For example, in Eagle, you would want to crisscross your forearms in an x across your chest and place your palms on opposite shoulders. But, there are very few poses that area unavailable, in fact, with the right modifications, I can't think of any pose that is unavailable.

For everyday fitness, I practice power yoga, a little less intense would be a vinyasa style. For flare-ups, I will do bikram, aka hot yoga. Specifically, I love the Bikram shalambasana or locust pose. I do it a bit differently, at the point when they call to lift both legs, I left my legs and my chest (by millimeters) this is an awesome nerve glide when your body is at it's most flexible!

The most important thing to remember is you do not have to do exactly what the instructor tells you to do. Modifications and props are an integral part of yoga. There are not rules (although bikram can feel that way and you must have a strong constitution to ignore them a bit). You do not have to extend arms and twist arms or straighten your arms, its all optional. Bringing your hands together at heart level is very meditative and an honorable position. It's also important to keep space through the collarbone by rolling your shoulders down and away. But bend your elbows whenever you want/need. Tell the instructor beforehand, that there are arm positions which may not be available to you. Any instructor worth taking a class from, should have no problem with that, and should then offer alternative options during class. Also, holding your head in any sort of craned-neck position is not necessary. Soften your neck whenever necessary. In fact Forrest yoga bases a lot of her stuff on total neck release.

Hope that gives you some food for thought. **Contact via PM or email ** if you have more questions as I am not on this forum very often.