That sounds interesting. I would love that. My rib hurts from time to time like it is out of place. Espcecially after pushups other any chest stuff. I will mention to my pt.

Thanks

Hi thunder92, I theorise that this whole TOS business starts off with a wry neck which causes compression to the long thoracic nerve as it passes through the middle scalene muscle. This partial compromise causes the serratus anterior muscle not to function correctly. This causes scapular instability and muscle imbalance around the shoulder girdle. When you do push ups, you require significant scapular stability. If you stress a muscle which has already got nerve supply compromise it will weaken significantly. The serratus anterior works with the pectoralis minor when you put your arm out in front of your body. If the serratus anterior is weakened the pec minor will have to work much harder, hence pec minor syndrome. When you are compromising your brachial plexus under your pec minor you will find that you compensate by moving your head forward to relieve any normal pressure on the brachial plexus Continuous use of the serratus anterior will lead to secondary and tertiary compromise of the long thoracic nerve as it bowstrings or is trapped over the 2nd rib. This is a much more difficult position to recover from. In most cases the long thoracic nerve will heal itself. It takes anywhere between 6 months and 2 years but only if it is given the chance. Quite clearly push ups cause your condition to worsen I suggest that you rest your scapular stabilizers.
Regards towelhorse

Peter Edgelow, (a pt who specialized in TOS) showed me research that shows the longus colli muscle in neck becomes weak in chronic neck pain patients and needs to specifically be retrained and strengthened BEFORE you try arm strengthening exercises where you support your head againist gravity. Otherwise you are increasing compression in the thoracic outlet. THe exercise for strengthening the longus colli is described in his home exercise kit www.edgelow.com The longus colli muscle is the muscle that holds up your head and also balances the scalenes. If it's weak the scalenes will overwork, which is not good for TOS.

That said, pushups are probably not the exercise for TOS patients and arm strengthening exercises, in general, shouldn't be tried too soon in a course of PT for TOS.

People vary in how they can do arm and shoulder strengthening with TOS, bad cases can do none or almost none but less injured people usually can do some.

I can't do anything with weights, even 1 or 2 pound ones but I can do pool exercises. Most people I know with TOS find exercises in warm pool the best way to start strengthening arms.