I got very involved helping my Dad with our genealogy several years ago, found our Abel forefather, presumed German, was actually an Abell from England via 1650 Maryland! Most all of my lines trace back to England, Scotland or Ireland except my paternal Grandmother's, which is German. But my hypermobility and connective tissue disorder come from my Mother's father's side - arms and legs longer than proportionate, loose in small and large joints, smooth skin, easy bruising, visible veins on chest, feet, back of hands, small jaw, large teeth, high arch to roof of mouth. With all these anomalies, what's an extra scalene?

Not great farming in Scotland and Ireland. The clans raised cattle in Scotland, and in Ireland I think each family grew what they needed to live on, til the British came in and put sheep on their fields. Then it was sheepherding and potatoes. So what accounts for the long limbs? Hmm, wonder if any of my illustrious ancestors ever fell afoul of the Inquisition? Maybe some forefather was put on the rack for "misplacing" a lamb? "I swear, guv'nor, I've no idee where the wee little lad could have run off too. What's that? Nay, that's not fresh grease stains on me shirt, me good-for-nothin' missus hasna done the washin for weeks, ya see."

I'll bet that's it! Hey, at least it's a theory - the learned medical establishment hasn't come up with any for me so far, so this is better than none. I like it, and I'm sticking with it - at least till I come up with an even better one!

beth

Hmmm....maybe something to do with Druids....yeah, that's got possibilities....

yep i'm 1/2 german, mom is 100% and she and i both have her dad's tall german frame with long neck. from rochester new york too!

Hi all,

The ancestry hypothesis sounds really interesting, though, I think it's highly unlikely. I'm Japanese. As far as I know, there's no German in my family, but I've had TOS for over 8 years. I don't know the specific prevalence but I'm sure there are a lot of non-German-descent TOSers in other Asian countries as well as here (in Japan).

Search PubMed for TOS. You'll see the researches regarding TOS have been conducted in various countries (I found the study conducted in "Ethiopia") .
http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
This means that TOS has affected many people regardless of ethnicity.

Yasuko

Thanks for the link Yasuko,
I did some other searches too while at Pubmed and posted the results on a separate thread.
*******************************************
The PT mentioned this the subject to me and that was what got me wondering about it.
But I'm sure she was thinking in general that certain body types, build or structures {due to genetics, ancestry, hereditary etc} might be more predisposed to certain injuries because of the structure.

I still haven't nailed down anything concrete on the subject in my searches- probably somewhere in some genetic anatomy scientific type studies - my brain/eyes glaze over trying read those things.LOL Or just not getting the right search terms combination.
Oh well it's sunny outside.

just the person i was hoping to hear from, thank you so much for posting on this thread! i was hoping you would take the bait!

and i want you to know that i agree with what you said. i don't think TOS is solely attributable to genetics. besides which, national borders are entirely arbitrary, aren't they, so if you think about it, in order to really nail it down, i suppose one would want to pay the $100 and submit their DNA into that national geographic study, go back a few 10,000 years or so and REALLY see from whence ye came (i.e., as in which primitive tribe along the euphrates).

as far as the norman english v. the german blood coursing through my own body (and doing a lousy job, at that!), the irony is not lost on this child that it is an historical ACCIDENT that we are not posting all of this speculation here today in the FRENCH language!

great britain was ruled by the normans, after all, for over 200 years! do you know how rare it is for the dominant tongue NOT to become the mother tongue in that situation? instead, we ended up somehow keeping the GERMANIC grammatical structure (emphasis on the germanic, not an accident, either, pay attention) but at least 70% of our vocabulary is ROMANTIC. not lovey dovey, kidz...ripped off from the normans! frogs, that would be.

(i'm an equal-opportunity offender and in case anybody reading this doesn't "get" my humor by now, picture my tongue firmly implanted in my cheek as i write this. i am not trying to insult anyone's ethnicity and i am really just kidding around. but i am bound and determined to make a point as well, if you all will just be so kind as to bear with me for a sec?....)

some linguists theorize that english must be a creole because of this phenomenon, as that is the "only" thing that explains it. of interest are the couplets that still exist, side by side, comprising words from each language - that of the oppressor (the normans) as well as of the subordinated people (the brits) - such as 'cease and desist" or 'vim and vigor' (there's a ton of 'em)... the 2 words mean EXACTLY the same thing if you look them up in the dictionary; they just have different historical roots!

(FYI, a creole is a pidgin language with @ least one native speaker, by 'de way, if anyone is interested... and a pidgin is generally defined as a trade language, i believe [no native speakers, very simplified, used for basic commerce, etc.]. gosh, it's been years since i thought about this stuff. i wonder if anyone but me finds it intriguing?)

so anyhow, yasuko, you would be absolutely correct, TOS does not discriminate, and even if it did, it would make no sense whatsoever to say that it did so based on a nationality. if so, then i'm fleeing to botswana.

but i still think we might be on to something. and i wonder if anyone is aware of any studies have been done - i don't want anyone to take this the wrong way, now! - but regarding the relationship between the development and/or the severity of TOS injury, on the one hand (i know there's a pun there, shut up), and either personality type or cultural mores (hey, i'll take what i can get at this point!), on the other.

because if prepubescent japanese children can fling themselves out of highrise windows for not getting accepted at the right school (gomen nasai/forgive me, won't you yasuko-san, for that visual, i know it's dramatic but also a classic example of the type of inner conlict i think we are talking about, not to mention despair...) because they "know" they have disgraced their family, cannot possibly face them again and life, as they knew it is quite over,......

then caucasians certainly do NOT have the market cornered on what it takes to develop the type of muscular bracing i personally believe is necessary to SUSTAIN a major neurovascular entrapment disorder such as TOS, not to mention for the pain and dysfuntion to become chronic and neural plasticity, central sensitization and everything else to occur. there is the original injury, and then, to me anyway, there is the LARGER ISSUE of why it DOES NOT RESOLVE, despite the amazing healing powers of the human body and some of the finest medical care in the world. that's the part that i think has everyone totally clueless and frustrated, isn't it.

there are only 3 races on the planet, unless i am sadly mistaken. while i am not personally aware of anyone of african descent (or haitian, jamaican, etc.) on this forum, it would be VERY cool to hear from you if you are out there and reading.

but the human brain being what it is, we love to subdivide, so of course you get into lots and lots of cultures, subcultures, ethnic and linguistic differences, geographic, political socioeconomic and religious stuff and what do you have, really? BOUNDARIES. mostly arbitrary crap, though, so would be irrelevant for purposes of our discussion here, i think, anyway.

i do think it's useful to look at though.

OK, think i've rambled on enough for one evening. i need a leash! a timer would be good....

sorosoro shitsurei shimasu, yasuko-san.

alison-san

It is noted about our rib cage and large collar bone for Myself, son, uncle; my daughter though was small bones/frame and outlet opening. Even though she was a big girl at 165 lbs. even her carpal tunnel outlet was tiny/ as were wriste.
She had a stretch injury,cervical strain/whiplash they first diagx.

Di

My thoughts run on (and on) along the so-obvious to me male-female disproportion. It appears that MOST (not trying to fit everyone into the same square peg-hole here, honest!) guys with TOS tend to come by it via work - either overhead mechanic, heavy lifting, house painting type labor or logging mega hours in front of a computer, and sometimes bodybuilding. They still must have a pre-disposition for TOS. However, many of the men may stand a better chance of recovery because they have stronger upper back and chest muscles than a lot of us women.

While there are certainly a number of couch potatoes, many guys continue to shoot hoops, play baseball, football, some type of sports with friends, whether they work out or not. They are also more often the ones who work on the car and mow the grass, do the heavy work, not that wmen don't or can't, but lots of single guys do it for themselves, and in a couple, it is still often the guy who does the car and lawn, etc. type work. All of this keeps the muscles strong. Men also tend (not all, but many), to deal with one thing at a time; when they're at work, they think about work, when they're at home, they relax. They deal with problems straight-on and then forget about them.

We women, however, often try to please everyone, and put everyone's else's needs first. Finding time to work out regularly is a struggle; taking an afternoon to spend with our girlfriends is a guilty luxury (and we can think of better ways to spend it than running around after a ball!) But womens' back, chest and arm muscles are weaker than mens' to begin with, and without regular exercise additional strength is lost. And gravity also takes a toll - the more endowed you are, the higher the price you pay. But I really think FOR ME, and maybe many of us, childbirth caused havoc with those oh-so-important core muscles that are the foundation for the rest. My first daughter was born by c-section, so the abdominals were cut. At 29, I worked like mad to get back a flat stomach. But 4 1/2 years later child #2, born the regular route, undid all that exercise, and with 2 small children and very little sleep I had neither time nor energy to care about the Battle of the Bulge.

Instead I took on all the needs of two little people, tried to meet and anticipate all their needs, take care of our home, catch a few quiet minutes with my husband when we could find it, chaired a parent support group, held garage sales. Drove to and from preschool, Dr appts, ballet and Girl Scouts. And worried about everything under the sun - every bump, sniffle or fever, shyness, school bullies, sleepovers, when to go back to work. Then going back to teaching, even part-time, added even more to my to-do list and things to worry about.

And I'm far from alone. Women are good at taking care of everyone else first, leaving no time at all for taking care of themselves! We multi-task like there's gonna be a prize for it! And we worry, worry, worry that we haven't done something or did something wrong or something in the future "might" happen! Again, this doesn't apply to all women, but if you have kids I bet it sounds familiar, am I right?

So, you have weakened core muscles (which allows everything to slump or slide downward), chest and upper back muscles (maybe causing the shoulder girdle to round or pull forward?), plus a whole lot of stress, some admittedly self-induced, and never enough sleep, PLUS a predisposition for TOS.

It makes perfect sense to me why more females than males have TOS. I know the above doesn't apply to all TOSer women, obviously some are college-age or younger, some don't have children, or their children were grown when TOS hit. And some were/are physically fit, and/or very laid back personalities. But some may care for their parents instead of children, or be just as stressed in other ways. I am only saying childbirth takes a huge toll on a woman physically, which can have consequences later, and motherhood along with marriage and working can also take a toll, especially for us intense types.

I was 41, with kids 11 and 7 at time of injury. And I'm learning to take one day at a time, not to worry about tomorrow, and to let go of the trivial and unimportant things in life. Good lessons to learn, but man is the teacher ever harsh!

My thoughts run on (and on) along the so-obvious to me male-female disproportion. It appears that MOST (not trying to fit everyone into the same square peg-hole here, honest!) guys with TOS tend to come by it via work - either overhead mechanic, heavy lifting, house painting type labor or logging mega hours in front of a computer, and sometimes bodybuilding. They still must have a pre-disposition for TOS. However, many of the men may stand a better chance of recovery because they have stronger upper back and chest muscles than a lot of us women.

While there are certainly a number of couch potatoes, many guys continue to shoot hoops, play baseball, football, some type of sports with friends, whether they work out or not. They are also more often the ones who work on the car and mow the grass, do the heavy work, not that wmen don't or can't, but lots of single guys do it for themselves, and in a couple, it is still often the guy who does the car and lawn, etc. type work. All of this keeps the muscles strong. Men also tend (not all, but many), to deal with one thing at a time; when they're at work, they think about work, when they're at home, they relax. They deal with problems straight-on and then forget about them.

We women, however, often try to please everyone, and put everyone's else's needs first. Finding time to work out regularly is a struggle; taking an afternoon to spend with our girlfriends is a guilty luxury (and we can think of better ways to spend it than running around after a ball!) But womens' back, chest and arm muscles are weaker than mens' to begin with, and without regular exercise additional strength is lost. And gravity also takes a toll - the more endowed you are, the higher the price you pay. But I really think FOR ME, and maybe many of us, childbirth caused havoc with those oh-so-important core muscles that are the foundation for the rest. My first daughter was born by c-section, so the abdominals were cut. At 29, I worked like mad to get back a flat stomach. But 4 1/2 years later child #2, born the regular route, undid all that exercise, and with 2 small children and very little sleep I had neither time nor energy to care about the Battle of the Bulge.

Instead I took on all the needs of two little people, tried to meet and anticipate all their needs, take care of our home, catch a few quiet minutes with my husband when we could find it, chaired a parent support group, held garage sales. Drove to and from preschool, Dr appts, ballet and Girl Scouts. And worried about everything under the sun - every bump, sniffle or fever, shyness, school bullies, sleepovers, when to go back to work. Then going back to teaching, even part-time, added even more to my to-do list and things to worry about.

And I'm far from alone. Women are good at taking care of everyone else first, leaving no time at all for taking care of themselves! We multi-task like there's gonna be a prize for it! And we worry, worry, worry that we haven't done something or did something wrong or something in the future "might" happen! Again, this doesn't apply to all women, but if you have kids I bet it sounds familiar, am I right?

So, you have weakened core muscles (which allows everything to slump or slide downward), chest and upper back muscles (maybe causing the shoulder girdle to round or pull forward?), plus a whole lot of stress, some admittedly self-induced, and never enough sleep, PLUS a predisposition for TOS.

It makes perfect sense to me why more females than males have TOS. I know the above doesn't apply to all TOSer women, obviously some are college-age or younger, some don't have children, or their children were grown when TOS hit. And some were/are physically fit, and/or very laid back personalities. But some may care for their parents instead of children, or be just as stressed in other ways. I am only saying childbirth takes a huge toll on a woman physically, which can have consequences later, and motherhood along with marriage and working can also take a toll, especially for us intense types.

I was 41, with kids 11 and 7 at time of injury. And I'm learning to take one day at a time, not to worry about tomorrow, and let go of the trivial and unimportant things in life. Good lessons to learn, but man is the teacher ever harsh!

You hit the nail on the head regarding women, Beth!

You absolutely pegged me: "We multi-task like there's gonna be a prize for it! And we worry, worry, worry that we haven't done something or did something wrong or something in the future "might" happen!"

Guilty as charged.

IT would seem based on this that the at least half and maybe a majority of people have abnormalities that predose them to TOS. According to a recent study, about 70% of repetitive strain injuries are TOS. Maybe people who require surgery for TOS have more severe abnormalities than normal?

Am J Surg. 1995 Jul;170(1):33-7.

Comment in:
Am J Surg. 1995 Nov;170(5):524.

Anomalies at the thoracic outlet are frequent in the general population.
Juvonen T, Satta J, Laitala P, Luukkonen K, Nissinen J.

Department of Surgery, University of Oulu, Finland.

BACKGROUND: Abnormal anatomy at the thoracic outlet is frequent in patients operated on for thoracic outlet syndrome (TOS). The present study was designed to find out the rate of thoracic outlet anomalies in the general population. METHODS: Fifty cadavers representing a general population were subjected to a total of 98 meticulously performed cervical dissections to ascertain the frequency of congenital anomalies in the thoracocervicoaxillary region. RESULTS: During the 98 cervical dissections, 62 instances of abnormal anatomy of the thoracic outlet were found, and fully normal anatomy was found in 36 cases. Of the total 69 abnormalies, 66 could be classified according to Roos: 37 were type 3 abnormalities, 15 were type 5, 9 were type 11, and there was 1 each of type 4, type 6, type 7, type 9, and type 10 abnormalities. The remaining 3 abnormalities did not fit into Roos' classification. Only 10% (5/50) of the cadavers had a bilaterally normal anatomy. CONCLUSIONS: The results demonstrate that abnormal structures, such as congenital bands in the thoracic outlet, are more common in the general population than had previously been described. We suggest that fibrous bands confer a predisposition for TOS following a certain degree of stress or injury.





A comparative study of structures comprising the thoracic outlet in 250 human cadavers and 72 surgical cases of thoracic outlet syndrome.
Redenbach DM, Nelems B.

School of Rehabilitation Sciences and Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada.

OBJECTIVE: We have hypothesized that variations in fibrous, muscular and osseous structures with the potential to entrap the brachial plexus occur within the thoracic outlet of the normal population; and that these variations are different in pattern and frequency from those in patients presenting with thoracic outlet syndrome (TOS). METHODS: Structural anomalies with potential for entrapping elements of the brachial plexus were examined following dissections of the posterior triangle of the neck in 250 human cadavers (N = 500 thoracic outlet dissections) and catalogued jointly by an anatomist and a thoracic surgeon. The pattern and frequency of anomalies in the 250 cadavers was compared to that encountered in 72 surgical cases of removal of the first rib for relief of symptomatic TOS (N = 72 procedures, 55 patients). RESULTS: Relevant structural variations were encountered in 46% of cadavers, exhibiting no left right or gender preference overall. When compared with the surgical group in which 100% exhibited structurally relevant anomalies, significant differences in pattern of anomalous structures and gender distribution were revealed. Anomalies posterior to the brachial plexus, ranging from fibrous bands to cervical ribs in both groups, were prevalent in the surgical group. A 'scissors-like' pattern, with neural entrapment by anterior and posterior anomalies was frequently encountered in females. CONCLUSIONS: Based on these data and embryological considerations, we propose a revised and simplified classification of impingement mechanisms within the anatomic thoracic outlet. Comparing these data to radiological imaging and observations at surgery, we offer a new perspective for the investigation and management of patients with TOS.

PMID: 9641331 [PubMed - indexed for MEDLINE]