Hi,

Does anyone knows how to differentiate the ntos symptoms due to pectoralis minor or scelene muscles ?

My physical therapist concluded that my pectoralis was at least involved when we realized that changing my arm position caused pain. But that's all I know on the subject. I suggest finding a skilled and experienced PT or MT, if that is a possibility for you.

One thing I had done was having my Pain doctor Numb the pectoralis minor muscle to see if the TOS symptoms changed before I had my left pectoralis minor muscle detached.

He did this by injecting right into the muscle while looking at a ultrasound to make sure he injected it in the correct muscle.

This chart is older , but I always thought it was helpful- in post #1 useful stickies-
http://tos-syndrome.com/newpage12.htm

Many thanks!

Pectoral minor dominance is usually related to 2 things-

1. anything cervical. If you have cervical pain, issues then the Pminor starts taking over since its not linked to the cervical spine directly and the brain recruits it for more tasks in moving the hand.

2. posture. all of us who work on computers with hunched shoulders and infrequent breaks will have some amount of pec minor dominance especially on the dominant hand.

question is what amount of stretching works, is safe and dosage, i.e. how many times per day etc. there is a point of view that instead of stretching, one should just practise "relaxing the muscle" but in my experience stretches do help more than just relaxation methods.

As with any other treatment program, proceed cautiously with pectoralis stretching. I had an RSI specialist recommend that I stretch my (visibly shortened) pecs, and I went at it with a little too much excitement. By stretching too much too fast, I think I just caused further compression of the nerve, and therefore worse pain. I only later found out that conventional pec stretching can sometimes worsen TOS. So, to repeat, take it slow!

Thanks JNT, so what worked? How many stretches, method, number of times/day?

So far, nothing. If stuff had worked, it's unlikely I would be spending so much time looking at this forum (pardon the dark sarcasm).

My symptoms mimic RSI, in that if I avoid problematic activities, the pain goes down fairly quickly. The trouble is that so many activities cause pain that I end up more or less partially disabled.

Right now I am on a program of lots of myofascial release, pieced together from my physical therapist, some books, and my own experience. I only started a couple weeks ago, and so far I haven't noticed a ton of benefit. But on the other hand, it doesn't seem to be making anything worse, and given my past experiences that's a step in the right direction.

Sorry I can't be more helpful.

Hi, I understand your frustration, grapple with the same issue daily.
The fact that Pec stretches aren't working for you, would imply (to me), that your issue is really scalene related/and or cervical. Please try taking a tennis ball and (gently at first) massaging your scalenes. Does that make things better? If so, it might be worth continuing.
I can do pec stretches provided my neck isn't flared up. If my neck is flared up, then chances are, your pec stretching will backfire.
Another tip I recently learnt. Being more and more bound to the bed etc, I was propping my head up and reading. It made things much worse. If you must do this, make sure the pillow and support are from the shoulders and not the neck. Otherwise, it forces the bottom of the neck into further flexion, and activates the scalenes.
The things we learn..