Well, I'm crossing my fingers that I'm having some unrelated pain today.

I pulled a low back muscle in the gym and it's causing me to have all kinds of screwed up posture. I've also been adding new movements in the gym and may have over did it.

The pain is in the upper trap neck area. Same side as the recent bout with TOS.

There is a faint pain in the forearm area. This would be troublesome since it's exactly where I had pain before. Then again, it could be just my brain acting up and activating this pain pathway that was quite active before.

Going to relax, do some tissue work on the area, and take some anti inflammatories to see if it's just a muscle pull.

If not, I will be terribly, terribly disappointed and upset.

KY

Much to my chagrin, this is without a doubt a TOS flare up.

Unreal. Shocked.

4 weeks of deep tissue and posterior work goes poof.

It's really surprising to me. During my first TOS episode on the right side, once this thing was kicked it was kicked for good. Not so much on my left side the 2nd time around.

As I did all this tissue work I could see the results day by day until the point where there was zero symptoms. It's amazing to me it's back in the blink of an eye.

Something tripped me up. And I'm sure it's me. Everything was going great. Was slowly getting more active in the gym. What I think did it was being a bit too aggressive the last couple weeks and acting "normal." For example, I added some overhead press work. And I think the tweaking of my back just was the last straw.

It's not as debilitating as it was in December. I actually got plenty of sleep last night. This was impossible before. Still, it's not pleasant. The burning forearm pain has returned. Nothing in the fingers. Crossing fingers I can nip this in the bud quickly before I lose strength again.

Really don't think the scalenes are the culprit. Botox didn't do anything. I think it's the dreaded pec minor. I've been rehabbing the left shoulder and working my way up in terms of pressing. Maybe it just got tight. Still, this seems a bit absurd.

I'm starting to wonder if my pec minor is just prone to tightness.

Will be talking to Dr. Donahue this week. Maybe a botox injection in pec minor makes sense.

Going to just layoff this week, do a lot of stretching, and do double duty on pec minor again and see if this starts to recede.

KY

Everyone has a threshold of how much "compression" they can take on the nerve structures on various locations before symptoms arise. But once the symptoms come and you are in a "stirred up" state, things that usually wouldnt trigger symptoms and pain, can and will. You can a load of tightness and triggers points and what not and still no symptoms, but once you pass the point and symptoms arise, all those trigger points will start irratating trhe situation along with movement and ect. There never is a easy fix with this it seems, it takes time and very frustrating.

Frustrating indeed.

I'm back to sleeping on my back and hoping for the best. Broken sleep, but it's better than no sleep.

I'm starting to wonder if my case is "positional" vs. "static." Reason: When a pull my shoulder blades back, the symptoms recede and when I let them naturally roll forward the symptoms re-emerge.

I've done TONS of rhomboid work to pull that shoulder back. I don't think there's much more I can do there. Those muscles are strong. This has to be be pec minor related where the pec minor is winning the "tug of war."

I had dropped the frequency of my pec minor tissue work to more of a "maintenance mode" situation. David Leaf indicated that was the right course of action. I have a feeling that this along with me upping my game in the gym to get the left shoulder/chest strong once again may have tightened the pec minor up again.

Waiting for a call back from Dr. Donahue. Going to bring up pec minor botox. Maybe this is something that I'll need on a regular basis.

KY

The trick is to be able to use the arms, without engaging the neck muscles, you can master that , TOS will go away. Cant be done alone you may need assistance from a PT to help re train that movement pattern, but for people like us that would be the cause id say.

I think you and your kinesiologist are spot on. Posture and muscle imbalances definitely aggravate TOS symptoms and can be corrected non-surgically if addressed in time. In addition, rib dysfunction (not just cervical and/or first ribs) can develop and must also be addressed with mobilization. Finding the right practitioners with the necessary skills is often a huge challenge as well. If these things are not corrected early enough (my case), extensive scar tissue can develop making the exercising and rib mobilization fruitless. I only started seeing results after having my 1st ribs removed and scarring cleaned up.

Thanks for sharing your experiences.

I've forgotten about this completely. Not stressing the neck muscles.

On my fourth day of lying low. Been doing deep tissue for pec minor, subclavious, and rhomboids multiple times per day. Probably 5-6 times per day. Not seeing a hell of a lot of progress, but I'd imagine its too early.

Last time, it took about a week to see results and then the drop off in pain was significant after that.

Driving was next to impossible yesterday. Thank god I can work at home. We'll see if this starts to fade a bit over the weekend.

KY

Talked with Dr. Donahue this afternoon. Told him the story:

* Got better doing deep tissue and posterior exercises.
* Botox didn't seem to do anything.
* Symptoms all but disappeared.
* Went too hard for rehab.
* Symptoms re-emerged.

His advice was very similar to my wife's: Cut back on resistance training and get back to what I did originally for deep tissue work. Re-evaluate in a couple weeks.

He didn't think it makes sense to do any re-scanning, but did think that understanding how well pec minor tissue work seemed to do, that a pec minor botox shot could be a next step if things don't improve.

KY

Learn to use the Lower traps more then the upper, its about really learning how a "relaxed" neck feels so when you lift weights, you activate the correct muscles with out putting so much tension on ur scalenes/neck. We have very good soft tissue and rehab specialist here that taught me this stuff, neuromuscular re training, i recommend you look into it.