Hi Everyone!

Just when I thought I had a handle on what was happening (TOS) and why (posture, shortened muscles, trigger points etc), a new PT has turned it on its head!
For the past 4 months I've been focusing on stretching (scalenes, pecs, scm, upper traps) and releasing (soft tissue work). In my mind, my rounded shoulders and forward-head posture had created chronically shortened scaleni, which then irritating the plexus, elevated the 1st rib, and caused further spasm due to neural inflammation, round and round. I've had dry needling, myofascial release and mobilisation, and I've been self-massaging and stretching as much as poss.

Things haven't really been improving so I sought out a new PT, basically wanting more of the above (thinking what I was having/doing wasn't enough). Anyway, I saw him today (after getting his assurance he was experienced in treating TOS), and HE TURNED IT ALL UPSIDE DOWN.

He thinks my traps are OVER-stretched and weak (scalenes same). Basically what he described was 'droopy shoulder syndrome', which is a sub-set of TOS, caused by TRACTION of the brachial plexus, rather than strict compression. Of course, this also causes the 1st rib to rise, so also causing compression. When I elevate my shoulders the awful tight pulling pain down my arms immediately stops, and though it feels unnatural to me, I look a lot more 'normal'. He pointed out I'm also hypermobile (which I knew), and therefore although I'm addicted to stretching, I MUST NOT STRETCH, I must strenthen my upper traps (I thought I had to switch them off) and correct posture.

As you can image this all feels very wrong. Can I accept this PT's view that my scalenes are not the problem, and that I should not stretch, only strengthen? I've read so much on this forum about the dangers of PT regimes that get you building strength straight away, but I wonder if the difference with me is this peculiar 'droopy shoulder' diagnosis, and therefore if the usual rules don't apply?

I've just spent $99 on Sharon Butler's protocol - which is all about stretching and sticky fascia - so am now totally confused. Stretch or strengthen??

All opinions greatly received! Thanks x