I was offline for the past 8 weeks due to neck surgery. I'm now the proud owner of a prosthetic disc. The surgery went very smoothly and seems to have resolved the compression at the C7 nerve root, so now I can do training without feeling much worse afterwards.

8 weeks off training has definitely made the TOS symptoms worse, but after a week back training the serratus, things are much better. However it's difficult to say definitively what is a TOS symptom and what is directly resulting from nerve root compression.

I'm convinced that (in my case) the serratus is the main culprit. Another simple diagnosis:

• Stand shirtless in front of a mirror with arms to the side, fingers pointing upwards (ie elbows bent) and palms to the mirror.
• Raise and straighten the arms, keeping palms towards the mirror.
• Look closely at the space just above the top of the trapezius between the neck and shoulder. As I raise my arms, the shoulder on bad side (that suffered nerve root compression) collapses and the shoulder moves towards the neck. This is corrected by pushing the shoulder outwards using the serratus. This is very hard work on my affected side.

I found this to be a great exercise to strengthen the serrratus: raise the arms slowly and count to 4 without allowing the shoulder to collapse. If you have a good side, try and make the bad side look like the good side. If raising the arms gives pain, do it very minimally at first. As it gets easier, add hand weights.

Other serratus exercises:

1) Hold hands in front of you, palm upwards (thumbs outward), elbows at 90 deg.
Hold a thera band in tension between the two hands.
Raise the arms slowly, keeping elbows at 90 deg, all the time trying to push the elbows outwards (causing the serratus to push the shoulders forwards).

2)Wrap a thera band around your your upper back, across your upper arms and held by the hands about 30cm in front.
Push the shoulders outward then forward against the thera band.

Note that strengthening the serratus is not about compression. It's the exact opposite. The serratus pulls the shoulders outward and upward, lifting the clavicle off the ribs and taking the weight off the upper trapezius.

Can you describe the exercise in detail as @smaug did above for his exercise?

Thanks.

@smaug what do you think a good frequency for these exercises is? Meaning:
- Every day
- Every other day
- 3 X week
- 2 X week
- etc.

What does your PT recommend?

For initial activation exercises (not strength building) I have been recommended at least 3 times a day with each session < 10 mins. These exercises also help relieve pain during the day by getting muscles moving that are not being used properly.

Once I get on to using weights and the exercises are more strength building (after a couple of weeks) I reduce to once a day then every second day. It is vital that the progression to these exercises only happens after the activation is correct. Many times I have been guilty of being too eager to get the muscle strengthened and jump straight to this step causing incorrect movement and more pain.