So we get these spastically tight muscles such as the scalenes and the pec minor. We get PT for that and botox shots and surgery to remove or sever the muscle.

But why are the muscles spastically tight? How did we get like this?

pec minor is totally shoulder hypermobility for me

reaching movements are bad, i avoid reaching forward..and overhead obv is bad
squising the shoulder forward in my sleep is bad

http://www.youtube.com/watch?v=Hu-FeatPgaU

(^might not apply to some people but fits me perfectly)

Thanks for the video. Looks interesting; I'll check it out.

Re: reaching, lots of people do lots of reaching, but don't have chronically tight muscles or TOS.

yeah sorry i meant with me reaching is bad because my shoulder is grossly hypermobile, my shoulders are downwardly rotated and floppy

here's a pic of how downward rotation messes up the bp

http://img534.imageshack.us/img534/5818/clav.png

I see. My worst side is my left and it started with a downward tilted clavicle. Although I no longer have that issue, I still have TOS and chronic muscle tension.

yeah i know what you mean
i was against pec minor blocks but we'll see.

hypertrophied muscles are the worst

I also have extreme muscle tightness. Mostly in my traps and pec region. Sometimes warm baths help them.

But I am kinda like you guys, what caused the extreme tightness to begin with. My shoulder is winging, droopy, and curved forward. When I talked to Dr. Thompson, my understanding was, that it is still not a confirmed thing was to whether the droopy shoulder and curvature caused the TOS, or whether TOS caused the droopy shoulder.

My physical therapist said that she has seen this a lot in mothers that breastfeed from being slumped over while breastfeeding.

Hopefully with more time, and studies that can get to the bottom of what causes it.

These muscles become tight and shortened for a variety of reasons.

Everyone has different underlying genetics, structural make up, biomechanics and so on. These can be quite good to begin with or they can be particularly defective for a variety of reasons. We then do a variety of unhelpful things to our bodies over our lifetimes which affect what we were born with. Typically, people will have poor posture - all that endless hunching and slumping creates shortening and tightness in these muscles. Then there are normally significant muscular imbalances in the pairs of muscles which should theoretically be evenly balanced to work efficiently. All our slumping and rounding means that the opposing muscles which should be pulling our shoulders back and our scapulae down and in are then weaker. This in turn makes it even harder to fight the pull of the short, tight, strong muscles that are responsible for rounding the shoulders forward and pulling the rib cage up.

When you add repetitive activity such as sports, work and just general day to day moving, this tends to exacerbate both underlying structural or genetic issues and the postural issues. It becomes a chronic, self perpetuating problem. The longer this imbalance goes on, the harder it becomes to fix. Stretching, trigger point release, exercises and physio can sometimes only do so much with muscles that have been shaped wrongly over years or decades. Sometimes surgical intervention then becomes desirable or necessary to try and undo the secondary consequences like the pressure on nerves or blood vessels causing pain, loss of function and so on.

Does that help explain a bit?

Sort of. I already understood things on that level.

But it doesn't explain why some people who have poor posture and biomechanics don't have TOS while others do. It doesn't explain why I get severe muscle spasms in my left neck, ribs and back, but not the right. These sides are not so uneven any more, at least not when looking in the mirror.

Sorry if I was insulting your intelligence with things you already knew. I just took your question at face value and assumed you were asking why muscle tightness occurred.

The answer to your question is that medical science doesn't know why some people end up with conditions like TOS and others don't. I have extremely tight shortened muscles with all the risk factors plus I am a manual wheelchair user so should be a prime candidate for TOS but I don't have it. I do however, have a rare incurable neurological condition, the cause and mechanism of which is even more of a mystery to medical science than TOS. The inability to determine why some people get a disease or medical condition and others don't is a universal problem throughout the whole of medicine.

If medical science actually knew what causes some people to develop illnesses, diseases and conditions and others not to, then it would know how to cure them. With a fairly small number of exceptions, it doesn't. All medicine can do for the vast majority of conditions is treat symptoms.

I don't think looking in the mirror is necessarily a very reliable way of assessing the detailed features of underlying structure, positioning and health of internal soft tissue and bone. You may look less uneven than you used to but there is clearly still a difference between your right and left side and still an underlying problem which you would be unlikely to see for yourself by looking in a mirror. Add to that the fact that nobody has a symmetrical body even if it 'looks' much the same on both sides. Sometimes tiny defects or differences make all the difference.