Happy 2013! Jkl626, when you reach a plateau, no matter how comfortable it is, is when you need to search for another road.
My local therapist, the first one I went to for myofascial release had said that the "Road to good health is not straight." That's what made me think of coming to Anaheim. Incorporate whatever helps you on the way and add whatever else you may need. What does Art say, is he recommending surgery? In my case the Stanford surgeon had sent me to Peter for couple weeks to see if he could help me. Peter is the one who had suggested a scalenectomy since I just couldn't do his breathing exercises without going into excruciating pain. Peter had worked with a lot of surgeons who removed ribs but didn't feel it was necessary if one could practice his protocol as it helps lower the first rib over time with his home exercise program.I am so glad I listened to him. Has Art been indicating anything or that you take any direction? jkl, I would suggest if you can come and learn it from Steve at Hayward, that would be your best option, and then follow the program at home. I beleive you have some family in the Bay Area.

Jkl, what are you trying to achieve with a nerve block? Just curious?? of course good luck with whatever you decide to do.

Thank You Stos that is good advice and in the New Year I am planning to do that. Art does not recommend surgery. He thinks I am better, I think he wants to release me soon, i have been going for 8 months! He wants to release people when they are 80%, -and I am better maybe 60-70 % but just not enough for me-I have been having alot of pec minor and underarm pain and numbness and of course it changes every day so on days when the pain is bad it doesnt feel any better. I havent seen him for 3 weeks ( I saw James right after xmas) but I see him tomorrow and also get a massage.

i had Trigger pt injections yesterday and feel much better today-I have to note this time how long it lasts. My purpose in finding out about the nerve block is that Dr Jordan had recommended it to me at one time, and I havent seen him in a long time so I need to go back to him and tell him my progress and see what he recommends.. If it does what the Trigger points do but last longer then I might do it. He does radio frequency so that the block lasts longer-he says up to 6 months. The fact that the Trps help tho make me think it is more of a muscle issue than nerve so I am not sure.Dr J reccomends surgery if I want to go back to my regular work and I do. I will lose my health insurance if I dont. but I am not considering the surgery at this point.

Maybe I will plan a trip up there to see Steve.Do you think I can go ahead and order the kit anyway? I was going to try it on my own first. I have done some on my own already. Do the breathing exercises really lower the rib? Do you actually do it several times a day?

I am also looking for a pt and masseuse and maybe a new acupuncturist closer to home, Art has a colleague he studied with who is on the CMFT list and now that my insurance has kicked in again I will be trying some new therapies. I will keep you posted.

jkl626,

My therapist here thinks the diaphragmatic breathing is key to helping us not chest breathe even when we are sitting or standing, consciously all the time. Chest breathing is what causes our chest and muscle tightness and causes the ribs to rise and the first rib in turn to rise. ( Peter's philosophy) If Art does not think you need surgery then you probably don't. They are good at figuring that. As I mentioned before in my post don't order the whole kit. Order only the core stuff.
Infact you can order just the DVD and the booklet, if they sell piece by piece. You can buy the manual blood pressure cuff from a pharmacy and you already have the pinky ball on the stick from Art right? Buy a wide quilting ruler that is about 5 " by 24" put it on a table so it over hangs and use that to secure the meter. Follow directions from his DVD and booklet. Put a heavy book on the ruler so it does not slide.
First just learn the breathing, both the abdominal and the chintuck with the cuff. Don't rush this. It takes time to get it down. For me I can't do without Peter's core program nor can I do without Art's exercises. The combination with mobilizing from my PT here in Palo Alto works great. My surgeon and also Peter once told me for us TOS patients, if you feel 80 or 90% better then that's our normal, we just have to accept it as our normal. we can never be a 100 % and it's ok if we are ok with it.
My therapist is teaching me to notice my breathing when I am sitting and trying to make me consciously do diaphgramatic breathing. Very important to use the sitting pose that Art has taught us with the weight on the feet and siting a little forward with breast bone over the pelvis bone while doing this breathing. As she feels my diaphragm doesn't stay supple and soft and doesn't move smoothly and is causing some of my stiff rib problems. She is working on my diaphragm too since couple visits.
To answer your question Peter had me begin with the breathing exercises twice a day. After a whole year, I now do it once a day. Good luck

Thanks, I wonder why i dont get notifications from this thread. I have been doing the first few breathing exercises but not that consistently and have been trying to be more concious of my breath during the day.but I definately think the DVD will help. Is the booklet the same as the xeroxes I have? I am going to take your advice and order it this week.

The Trigger pt injections helped me right away and then I saw Art and Ken yesterday. They really beat me up-I think it is too much for one day as I flared afterwards, but today I feel better. Art was actually using his knee to try to get my ribs to move. He keeps saying I am almost there-but its hard to see it. I def have to work on my posture more. I am going to have to ask him to go over the posture stuff with me again. Its hard when you are short to always have your feet on the floor! He also says I really have to dig in to get the back of my subscapularis, which is causing alot of the problems.

Thanks for all your advice!

Jkl, sit in front of the mirror on a bench or stool that helps you sit in the pose Art has taught us with feet firmly on the floor and weight on the feet. If I recall that is the very first thing Art teaches everyone. The simplest things we are taught are sometimes of the most significance! Except it is hard for us to give it importance, which is such a folly.(Me too)!
My therapist here taught me how to stand the first time I saw her. Again breast bone over pelvic bone. Art can go over it again with you. Good idea to have him work with your posture again.

Then notice when you breathe with your diaphragm your abdomen should be moving and your upper chest should barely move. My therapist put me in front of the mirror on wed and showed me how important the posture is as you almost can't avoid chest breathing if you are not in the correct posture. It takes time but slowly over time it should help us get into the habit of breathing like that all the time. I am still working on it. Marc bought a wedge from " relax the back " to help him sit in the correct posture in the car I think.

To answer, your QS. I think the xeroxes you have are okay to start with, you don't need the booklet for the core part of the program. I guess, but I would order the DVD and start soon. You must have the DVD to do it all correctly.

Peter's protocol has a rib mobilizing section with a pinky ball where you mobilize your back ribs, that should help you move your ribs in the subscapularis area. Also remember, I mentioned mobilizing that 3rd -4th maybe 5th rib in the front where it attaches to the front of the rib cage slightly left or right of your breast bone with a yamuna ball while standing against a wall?( Given by my therapist here in Palo Alto). Mobilize that first in the front as the foam roller can't get in there, then mobilize the back ribs using Peter's method with the pinky ball. (I still do Art's foam roller exercises and all others. Don't stop those.)

jkl626, please copy all this info and paste it into a document you can refer to later, as I will be out of the country the whole month of feb and won't be visiting the forum. Iris is working on some of he Edgelow stuff you could PM her if you need any help in Feb.

I actually ordered a book that Edgelow has a chapter in and it has those rib mobilization exercises in. I brought it to Art and he says he doesnt like them? go figure, but I will give them a shot. I have a Yamuna ball , 2 actually 1 black one and 1 small purple one that is harder. I started to use it laying down because the roll is too soft for me now. I will try it on the wall too. I am going to order the dvd and booklet today!
It sounds like the PT you found there is really good and willing to work with other peoples protocols. I'm sure I will talk to you before you leave.

I have a question - I take it that Peter Edgelow is retired and that the web site no longer exists - what I don't understand is if he and his protocol are important factors in TOS healing, why is it so hard to find any info on it or trained physical therapist. Why is it not easily available?