Several articles, especially PT-focused ones, mention core muscle strength as being critical for TOSers, and recently a post specifically mentioned the abs and how if they were weakened then I believe faulty posture would follow. Dr Annest told me several times post-op that I needed to strengthen my core muscles, which I take to mean my abs, sides (lats?), upper and lower back, and maybe glutes (butt). Please let me know if I am leaving something out.

The problem is, I don't know HOW I am supposed to go about strengthening these muscles, as ANY strenghtening work flares me badly, and by that I mean puts me in bed for two days to sleep through the pain as best I can.
My RSD makes it difficult to be touched, or to touch some items, depending on texture; I always perceive metal as cold and burning. And I can't put any pressure or weight on my hands, especially the right one. Swim therapy was good while the ins. co. paid for it, but that was more aerobic than strengthening, except perhaps for my legs.

My point of this post however is this: if weak abdominals are so key in the onset of the poor posture which often is seen in TOS, then NO WONDER this condition strikes predominantly females in their mid-30's to mid-50's, barring those born with it. Women who have given birth, especially more than once or by c-section, are likely to have weak abdominals, and to have less time to work out or take part in sports to keep in shape than males as they age. Even those who don't have children have the constant forward and downward pull of their breasts, which can make a more comfortable forward slump an unconscious habit. This is why weight becomes such an issue, I think.

Now add a c-rib, abnormal scalene attachments, repetitive, non-ergonomic job conditions or a traumatic accident to the brachial plexus/neck area--

This isn't scientific in any way but seems pretty obvious once looked at logically. The men affected by TOS who currently post or have previously posted on this or other versions of our TOS board have usually related their TOS to their work - either overhead or heavy lifting, often both.

Of course, several predisposing factors apply to either gender - slight build, short (therefore have to reach above head frequently), long neck, repetitive tasks, heavy keyboarding/mousing, static positions/head forward - I know there's more but can't think - past bedtime I guess!

Any thoughts, comments, additional factors? Let's kick this around a bit!

beth

gentle core work-
For me the big inflatable exercise ball seems to work and be do able.

I just sit/balance on it and move hips side to side , back and forth- side bends /stretch .
I tried bouncing on it but feels like it is kind of jamming my spine a bit so i don't do that anymore.
But that is on the DVD of exercises that came with the ball, there is a lot more that I hadn't even thought of but some are just using the ball with lift and stretching.

Oh there is one where you lay on floor and grip ball between feet and use core /legs to lift ball then do side to side with it.

I use it for stretching by laying over it on my stomach and my back and rolling it slowly to and fro.

since it is a round ball the core is used to help stabilize you anytime you are on it.

also don't forget isometrics - focus on just tightening muscles and hold 6 sec release and repeat - way better for us than trying crunches or sit ups!

gluts: do bridges, but not high enough that it hurts your neck. ONce you get ok with two legs, you can do them one legged

abs: leg lefts on foam roll
Lay on foam roll with arms crossed over chest and legs bent, feet flat on the floor. Activate ab muscles, pushing small of back against the foam roll, and lift one leg at a time for a few seconds. The 'balancing' will work your abs. If you can't keep the abs activated/back against the roll you ware trying too hard, do an easier version or less reps.

If this is too hard, put a hand out on the floor to help you balance (it is the act of balancing that exercises your abs) or start by just raising your heels and keeping a toe on the floor.

As it gets easier, you can stick the leg straight out in front of you or make circles in the air. Since you are stable on the foam roll, it is very gentle on neck and back.

Obliques: lay on floor with legs up in air, bent, toes sort of pointing at a 45 degree angle into the air. If more comfortable place a small (like rolled up washcloth or hand towel) under your butt to raise it. Engage your ab and other core muscles. Lower one leg out to the side towards the floor, keeping the leg bent. Go as low as you can go while keeping good balance. bring it back to center, lower the other leg.

This one feels really easy when I do it but I am always sore the next day. Once again, easy on the head and neck because they are flat on the floor.

good luck, and you are ABSOLUTELY RIGHT...core muscles are the key to posture.

Johanna

Today I found a rehabilitative Pilates instructor who works with injuries. Thought I might try him to see if he can help my core. I'll let you know how it goes.

my physiotherapist told me that it was important that one had core stability.
she said that it has been noticed that people with back problems also have transversus abdominis (TA) muscles which have relaxed. efforts made to retrain these muscles but were to no avail. my opinion is that if chest breathing is a symptom of TOS and TOS sufferers need to lose weight if they are to improve their condition. then quite possibly the relaxing of the abdominals will decrease the pressure on the diaphragm and therefore the impact of chest breathing will be less.
if i am chest breathing (which is bad) and I have a large meal(which is bad) and then try and pull my stomach in, the consequences of the chest breathing are worsened. i maintain that the relaxation of the abdominals is a consequence not a cause of TOS. since i have been taking medication to control my chest breathing, pressure on my diaphragm does not have a significant affect as it it did previously. my view is out of step with most others.

Having had two babies, one by c-section, in my 20's and 30's, I know my abs aren't nearly as strong as they used to be - despite working out deperately to get that flat stomach back after baby #1 (the c-section). Once muscles have been stretched that far or especially if they've been cut, they are never quite the same, even with regular exercise. If you don't get regular exercise,and add in the effects of time, gravity, possibly gaining and losing that same 10 or 20 lbs over and over, it's no wonder by mid 30's to mid 40's women's abs may be weaker than desired.

I think firmer abs would tend to support the upper torso more and promote better posture, maybe take some strain off the pecs. Also, it seems as though better breathing would be established as you more naturally breathe from your abdomen when your posture is correct. And by providing better support for the structures and organs of the thoracic cavity from below, firm abs along with strong side and back muscles might help reduce some brachial plexus distress due to weight and gravitational pull on the chest.

Anyway, it's definitely worth a try to see if I can cope working on building these muscles, the injured ones are a no-go for sure!