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Totally lost on TOS rehab contradictions/different approaches

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Old 06-23-2019, 08:57 AM   #1
sangoku
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Question Totally lost on TOS rehab contradictions/different approaches

Hi everybody,

I come back at this board since first of all i'm totally lost on what is a "good" TOS's rehab.

Besides this, I come back here since obviously no physio's rehab seems to work at releasing my very tight and stiff neck and cervical, with sometimes mild pain/ache in my little finger/hand and right shoulder and even in my neck (it has began 5 months ago)

Even i'm aware that each TOS rehab should not be the same, there seem to be a lot of contradictions on the "right" approach that are the following :

1) On the one hand, some people advocate to stretch the tight muscles (upper traps, scalenes, etc..) in order to release them but on the other hand, another people claim that tight muscles are weak muscles and so they need to be strenghtened and therefore not be stretched because stretching weaken them more and more and finally increase brachial plexus's compression.

2) On the one hand, some say a little pain's increase is not necessary bad after doing exercices/stretches but on the other hand, other people advocate to stop all exercices/stretches that provokes even a bit of pain.

3) Finally, how many days/weeks/months do we need to stick to a particular rehab in order to determine if it is working or not ?

Excuse me in advance for my poor english but i'm french.

This said, i would be very happy if you could shed your lights on the issues i've raised.

God bless you in your struggle against TOS.
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Old 06-23-2019, 12:42 PM   #2
Jo*mar
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Good info in our sticky threads.. if you haven't seen them yet..
This one has a lot of thought on PT -
Trigger point information {TrPs} for short

DOCTORS & PTs List and saved PT info threads

Our Useful Links - Websites, Articles & Polls
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Old 06-27-2019, 11:06 AM   #3
Dontbeamelvin
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Quote:
Originally Posted by sangoku View Post
Hi everybody,

I come back at this board since first of all i'm totally lost on what is a "good" TOS's rehab.

Besides this, I come back here since obviously no physio's rehab seems to work at releasing my very tight and stiff neck and cervical, with sometimes mild pain/ache in my little finger/hand and right shoulder and even in my neck (it has began 5 months ago)

Even i'm aware that each TOS rehab should not be the same, there seem to be a lot of contradictions on the "right" approach that are the following :

1) On the one hand, some people advocate to stretch the tight muscles (upper traps, scalenes, etc..) in order to release them but on the other hand, another people claim that tight muscles are weak muscles and so they need to be strenghtened and therefore not be stretched because stretching weaken them more and more and finally increase brachial plexus's compression.

2) On the one hand, some say a little pain's increase is not necessary bad after doing exercices/stretches but on the other hand, other people advocate to stop all exercices/stretches that provokes even a bit of pain.

3) Finally, how many days/weeks/months do we need to stick to a particular rehab in order to determine if it is working or not ?

Excuse me in advance for my poor english but i'm french.

This said, i would be very happy if you could shed your lights on the issues i've raised.

God bless you in your struggle against TOS.
In my opinion if you are doing rehab for over a month or two and you aren't getting any relief it is probably time to switch it up. I spent 5 months on the stretching routine and it didn't help me at all. I'm starting to see modest improvements from neck and upper trap strengthening. Look up depressed shoulder syndrome and see if it fits your issues.
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Old 07-10-2019, 09:46 AM   #4
sangoku
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Quote:
Originally Posted by Dontbeamelvin View Post
In my opinion if you are doing rehab for over a month or two and you aren't getting any relief it is probably time to switch it up. I spent 5 months on the stretching routine and it didn't help me at all. I'm starting to see modest improvements from neck and upper trap strengthening. Look up depressed shoulder syndrome and see if it fits your issues.
Hi Dontbeamelvin,

First of all, I want to give you a big thanks for the very interesting approaches you have raised both on this post and on your "depressed shoulder" one.

This said, could you please tell me if your symptoms/aches were looking like mine which are basically very tight and achy (not strong but very deep and displeasant) neck/cervical and upper traps with from time to time, ache in my 4th and 5th finger and also in my shoulder.

To be more accurate, these achy feeling tends to worsen if I try to weigthlift, even with very very light weights, and especially if my head and neck go forward. At rest, i have nearly zero pain appart my neck and traps that stay rock hard.

In a nutshell, as a guy who loves sport and lifting, i am stuck in an "impeachment" situation because, in spite my pain is not disabling and horrible, i am not able to resume things I like and it is quite depressing to be in this "dead end" feeling.

So, if have well understood what you wrote, you are basically following a regimen of shrug and neck isometrics in addition with lat and pec minor's stretches ?

So, do you feel a release in your neck/traps and less aches in you arm and fingers ?

In all cases, i sincerely hope your condition continues to improve.

I thank you in advance for your thoughts.

God bless you

P.S : excuse me for my mistakes but i'm a french guy
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Old 07-10-2019, 04:53 PM   #5
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If you have trigger points in the muscles, those muscles cannot be fully released/relaxed until the trigger points are resolved..
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Old 07-10-2019, 11:49 PM   #6
Dontbeamelvin
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Quote:
Originally Posted by sangoku View Post
Hi Dontbeamelvin,

First of all, I want to give you a big thanks for the very interesting approaches you have raised both on this post and on your "depressed shoulder" one.

This said, could you please tell me if your symptoms/aches were looking like mine which are basically very tight and achy (not strong but very deep and displeasant) neck/cervical and upper traps with from time to time, ache in my 4th and 5th finger and also in my shoulder.

To be more accurate, these achy feeling tends to worsen if I try to weigthlift, even with very very light weights, and especially if my head and neck go forward. At rest, i have nearly zero pain appart my neck and traps that stay rock hard.

In a nutshell, as a guy who loves sport and lifting, i am stuck in an "impeachment" situation because, in spite my pain is not disabling and horrible, i am not able to resume things I like and it is quite depressing to be in this "dead end" feeling.

So, if have well understood what you wrote, you are basically following a regimen of shrug and neck isometrics in addition with lat and pec minor's stretches ?

So, do you feel a release in your neck/traps and less aches in you arm and fingers ?

In all cases, i sincerely hope your condition continues to improve.

I thank you in advance for your thoughts.

God bless you

P.S : excuse me for my mistakes but i'm a french guy
Hi sangoku,

In my current situation what I have realized is that the lats are actually what is tight. So the muscles that depress the shoulder like the lats, pec minor, low traps are actually pulling the scapula down. This causes the upper traps and levator scapula to be extremely tight because they are being over powered by the downward rotators.

You can try and stretch this muscles and release them (the downward rotators) but this will provide temporary relief in my experience. Something that has helped me tremendously is to release these muscles and get the upward rotators to start firing again. One exercise that has helped me tremendously is called the wall slide. You stand facing a wall with your forearms on the wall and you get pretty close to the wall. Then you slide your forearms up the wall as high as you can. Try not to clench your jaw or use your neck muscles. This is just another way of compensating. If you do it correctly you will feel it the next day in your mid back, armpit area and upper back area. This retrains your upward rotators to work again allowing your scapula to sit higher and takes some of the tension off of your upper traps and levator.

I recommend looking up Eric cressley wall slide on YouTube. So as your scapula movement is retrained and it sits higher it takes tension off of some of the muscles in your upper back like the traps and levator, and also as it turns out, the scalenes relax a bit as well.

Hope this helps.
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Old 07-10-2019, 11:52 PM   #7
Dontbeamelvin
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Quote:
Originally Posted by sangoku View Post
Hi Dontbeamelvin,

First of all, I want to give you a big thanks for the very interesting approaches you have raised both on this post and on your "depressed shoulder" one.

This said, could you please tell me if your symptoms/aches were looking like mine which are basically very tight and achy (not strong but very deep and displeasant) neck/cervical and upper traps with from time to time, ache in my 4th and 5th finger and also in my shoulder.

To be more accurate, these achy feeling tends to worsen if I try to weigthlift, even with very very light weights, and especially if my head and neck go forward. At rest, i have nearly zero pain appart my neck and traps that stay rock hard.

In a nutshell, as a guy who loves sport and lifting, i am stuck in an "impeachment" situation because, in spite my pain is not disabling and horrible, i am not able to resume things I like and it is quite depressing to be in this "dead end" feeling.

So, if have well understood what you wrote, you are basically following a regimen of shrug and neck isometrics in addition with lat and pec minor's stretches ?

So, do you feel a release in your neck/traps and less aches in you arm and fingers ?

In all cases, i sincerely hope your condition continues to improve.

I thank you in advance for your thoughts.

God bless you

P.S : excuse me for my mistakes but i'm a french guy
Quote:
Originally Posted by Jo*mar View Post
If you have trigger points in the muscles, those muscles cannot be fully released/relaxed until the trigger points are resolved..
Also the answer is yes. The pain at the back of the neck in like the trap area is probably a spasm of the trap/levator. Most of the pain in the front of the shoulder, shoulder blade and down into the fingers and wrist can actually be many different trigger points. The ones I found to be really bad are the lats, pec minor, and the main one is the scalenes. In my opinion it is not a good idea to work on the scalenes to stretch or release them. It is good to strengthen your neck as a whole. Lats usually don't have a strength issue so you can most likely release them. If you practice upward rotation the pec minor should sort itself.

By the way I'm still working my way through this but this is what has been working for me!
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Old 07-11-2019, 02:22 AM   #8
sangoku
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Hi Dontbeamelvin,

I thank you again for your feedback and the very valuable informations you bring on this board.

This said, if I have well understood what you wrote, you basically say that "wall slide" is the exercise that gave you the more relief ?

Besides this, are you still shrugging in order to strenghten your upper traps ?

Also, do you practice "traps prone raises" (aka the "Y" exercise) ? I ask you because "Remy Remedies" advocate them on his blog, even he stresses the importance of Shrugs and neck's isometrics.

I thank you again in avance for your thoughts and feedback.

God bless you.
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Old 07-11-2019, 10:38 AM   #9
Dontbeamelvin
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Quote:
Originally Posted by sangoku View Post
Hi Dontbeamelvin,

I thank you again for your feedback and the very valuable informations you bring on this board.

This said, if I have well understood what you wrote, you basically say that "wall slide" is the exercise that gave you the more relief ?

Besides this, are you still shrugging in order to strenghten your upper traps ?

Also, do you practice "traps prone raises" (aka the "Y" exercise) ? I ask you because "Remy Remedies" advocate them on his blog, even he stresses the importance of Shrugs and neck's isometrics.

I thank you again in avance for your thoughts and feedback.

God bless you.
Yes I do all of them. I don't do the Y as much because it is kind of an awkward movement for me. I do the shrugs regularly and the neck exercises regularly. When you do wall slides with your forearms the forearms should be in a Y shape as well. So it hits similar muscles I would imagine.
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Old 07-11-2019, 11:33 AM   #10
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It really is a figure out what works for your body..

Arms upward on walls & door ways was a no go for me..
I lose blood flow to arms/hands in about 30 seconds, lose hand/finger coordination follows a bit after that.
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