Lower abs only should help reduce engaging the neck. Put a hand on the neck and focus on relaxing the scalene muscles to get started.

Per Dr. Donahue, Mass General has a unique CT-Scan machine that provides more or less a 3D view of the thoracic area. He believes it's the best diagnostic tool around for TOS diagnosis.

An update on my situation...

I met with someone who is an "Applied Kinesiologist" last week. A fellow by the name of David Leaf in Plymouth, MA. My regular chiropractor thought he'd be a good person to check out. As I understand it, applied kinesiology tests muscles for strength and weakness to diagnose any illiness. I was skeptical for sure, but what the heck.

I told David, who may have the worst bedside manner I've ever run into, about my TOS situation and he immediately said, "Why do you have TOS now and didn't have it 20 years ago? TOS is hogwash. It's all about posture." He then went on to poke and prod me and I must say what I experienced was impressive.

I told him that I had lost 2/3 of my tricep strength. He tested my strength sitting as I normally would. Yup. No strength. He then pushed my shoulder in a certain direction, tested it again, and I had full strength. He did the same thing with all my posterior muscles and compared the strength on my impaired side (left) to the right. Everything was weak on the left. But again, he would position me in certain ways and out of nowhere strength would appear.

I was shocked.

He then went on to tell me that my left side of my body was having a "tug of war" and the anterior muscles...my pec minor and subclavious more specifically...were winning. Basically, the pec minor is so tight it's pulling my entire shoulder forward and inward creating less space in the thoracic area. The muscle below the collarbone was also tight. These are two key areas of nerve compression. So not only is there less space, but these muscles are also impinging on the nerves. Double whammy.

I tell you all this because I think everyone should examine to what degree this may be happening to you. It may be an issue.

David then went on to print out some pages of deep tissue massage and exercises I should do daily. Among them:

* Pec minor massage with a raquet ball against the wall.
* Subclavious massage against the wall.
* Serratus Anterior massage.
* Infraspinatus massage.
* Scapular squeezes.
* Wall push up isolation exercises.

I've been beating the hell out of my pec minor and sub collarbone since and I must say I think it's working. As I do this I can feel bolts of electricity down my arm. The nerves may be getting some breathing room. If this is the case the next step is strengthening the posterior muscles to pull back the shoulder more.

Anyways, there may be something to this applied kinesiology. I know everyone may not be in the same boat as me, but the above may be worth a shot.

Botox shot approved.

Getting it done Monday.

Let's hope it works like it did on the right side.

Not going to just hang my hopes on this though. Have to continue anterior stretching and posterior activation.

Last few days I've seen a change in symptoms. I'm not sure if this has coincided with all of the deep tissue massage I've been doing on pec minor and subclavious along with the posterior strengthening of the rhomboids and lats. Curious if anyone has experienced this or if this is common.

Anyway, previous to the last few days I had intense throbbing in my forearm and hand. I also had great difficulty tilting my head back without serious pain. All of this prevented me from sleeping at all.

Now, the above pain has diminished significantly. And sleep has returned.

Even better: I drove over 6 hours back and forth over the last 48 hours. Not more than a week ago, driving 10 minutes produced intense pain. Not only that, I skied for two consecutive days. And I'm not a bunny slope skier. No pain. I find this pretty incredible considering that about 10 days ago I was desperately trying to find a comfortable position on the floor that didn't produce pain.

Now I think I should take this as good news. That said, I've experienced pump fakes before and next thing you know you're back in the same boat.

However, my previous pain has been replaced with some tingling and a bit of numbness in my index finger. I can't imagine this is good.

So I've swapped good for some bad here.

I have no idea if this means I've made some progress or if actually things have worsened. So confused.

One other thin

KY

Received the botox injection yesterday at Mass General via Dr. Donahue.

Anterior scalene only.

Very quick. 2nd time I've done this. First time on the right, this time on the right.

A little sore, but that's about it.

We'll see if I see any drastic changes over the next few days.

Why only anterior scalene?

I haven't gone through with botox shots yet, but my doc ordered anterior scalene, medial scalene and pec minor (all left-side only) -- for the botox?

Why does Donahue only do 1 scalene muscle??

I recall Dr. Donahue saying something to the effect that the medial scalenes are very difficult to access b/c of nerves in the area.

Botox injections
 

I have had Botox by Dr. Donahue multiple times and he usually does anterior scalene and pec minor of the affected side, unless like me where there is no longer a anterior scalene related to a 1st rib resection and scalenectomy.
The last set of injections that I had were for both sides as my left side (operative side) and now my right (initially no symptom side), have Been increasingly flared and unbearable and I had an awful time with these injections.
I am scheduled for a cervical fusion for a non-union at C6-7, with an iliac crest graft, this is all related to a work related injury in 2009 and it just keeps getting more and more involved.
Good luck and I hope these injections give thou some additional relief.

Warm regard,
NMC

Hi NMC,

Did Dr. Donahue perform the TOS surgery (first rib resection and scalenectomy)? How are you doing as a result of the surgery? I'm a patient of Dr. Donahue and he recommends surgery for bilateral NTOS, but I haven't yet decided on what to do.