Hi Beth, my best wishes and high hopes for good results in the surgery for SCS.
Di

nerve compression syndromes
Repeated or prolonged pressure on a nerve root or peripheral nerve leading to ischemia, the response to which is oedema above and below the source of pressure. If the pressure is not relieved, fibrosis tends to develop. Types of nerve compression syndromes are the neuropathy caused by intervertebral disk herniation, compression of the median nerve in the carpal tunnel, compression of the ulnar nerve in the elbow, and compression of the lateral cutaneous nerve of the thigh in meralgia paresthetica. This is also called pressure neuropathy.

cicatrix;"new skin forming"(the external scar) But we all know as consumers that this scar is not what we expect in pre or post surgery. That scar matter is from the damaged nerves and soft tissues.

I can guess that many new to TOS may get confused to the term we use in scar matter and fibrous bands, and adhesions.

fibrous adhesion
Fibrous strands resulting from the organization of fibrinous adhesions.
fibrinous
fibrinous adhesion
An adhesion that consists of fine threads of fibrin resulting from an exudate of plasma or lymph, or an extravasation of blood.
(05 Mar 2000)

fibrin
<protein> The insoluble protein formed from fibrinogen by the proteolytic action of thrombin during normal clotting of blood. Fibrin forms the essential portion of the blood clot.
(12 Nov 1997)


connective tissue
<pathology> Rather general term for mesodermally derived tissue that may be more or less specialised. Cartilage and bone are specialised connective tissue, as is blood, but the term is probably better reserved for the less specialised tissue that is rich in extracellular matrix (collagen, proteoglycan etc.) and that surrounds other more highly ordered tissues and organs.


extracellular matrix
Any material produced by cells and secreted into the surrounding medium, but usually applied to the noncellular portion of animal tissues. The ecm of connective tissue is particularly extensive and the properties of the ecm determine the properties of the tissue.

In broad terms there are three major components: fibrous elements particularly collagen, elastin or reticulin), link proteins (e.g. Fibronectin, laminin) and space filling molecules (usually glycosaminoglycans). The matrix may be mineralised to resist compression (as in bone) or dominated by tension resisting fibres (as in tendon). The basal lamina of epithelial cells is another commonly encountered ecm. Although ecm is produced by cells, it has recently become clear that the ecm can influence the behavior of cells quite markedly, an important factor to consider when growing cells in vitro: removing cells from their normal environment can have far reaching effects.
(18 Nov 1997)

Concern is not so much in post op-PT as far as I ever expected from post-op range of motion, but not over doing venerable ill nerves recovering from surgery.PT as range of motion is much different then a regime to work harden as w/c calls it.

Two weeks after surgery from TOS attributed to being a wall painter and consistent compression to a body prone to TOS, would not be smart for a person to go back to wall painting again.....

Post surgery, if you developed TOS from a repetitive job, and go back to the repetitive job, you can expect new damage to re-occur and symptoms to return. Some do some do not...it is historically accepted that it is even with sedentary no work, that a person can develop "scar matter/adhesions /fibrous bands".

De had surgery and there was much scar matter/fibrous bands pulled the scalense and other connective tissue into odd places causing compressions. For example, the scalene are attached to the collar bone by bands in a manner...almost 1/2 of society has these smaller bands. BUT for the injury or assault, TOS can occur.

One of these short bands caught up a tissue and pulled it from the collar bone to the arm pit area in a "Spasm" (located during the arm pit portion of surgery). Dr T located and released it and the band snaked up into the body. When he reached the part of the surgery from the collar bone area; at that time he removed the "band" that had formed and measured it at 1 1/2 inch long....streching all the way to the armpit OUCH!

So it was hoped a lot of symptoms would be resolved. BUT, this band had been a problem for years prior to surgery and created restrictions, compressions and nearby tissues and nerves were affected.

During her second surgery, fibrous bands were found entwined among the C3-4-5-6-7 nerves entangling them.

Damaged tissue and blood lying in the area from the first surgery, even though a drain was used collected and did not, does not dissolve. Dead tissue or matter attaches to any nearby structure including the nerves.

The entanglement was clean-up and nerves were wrapped in pericardial patch-gortex. It was hoped that the covering prevented new growth attachment of matter.

But, it seems to have grown over the coverings and entwined.
Redo's I jokingly tell her that she was roto-rooter to clean up. There was improvement, BUT as early as two months scaring, adhesions, fibrous strands or bands can form.
Dianne

The way Sharon Butler talks about myofascial adhesions in her book {in most libraries} and her online RSI programs, is that it can also be a sticky tissue issue. {try to say that 3 times -LOL}

http://www.selfcare4rsi.com/fascia.html
http://www.selfcare4rsi.com/thoracic...-syndrome.html

That is why she strongly advocates drinking lots of water and gentle stretching techniques to loosen those sticky tissues.

The deep breathing using the diaphragm aids with oxygenation, relaxation, and helps to release toxins during the complete exhale process. I'm sure it may aid with a stretching to some of the internal tissues with a full inhale.

For more info on proper diaphragm breathing see these-

http://www.pe2000.com/breathe_diaphragm.htm
http://www.alexanderworks.org.uk/breathing.html
http://www.cchs.net/health/health-in...asp?index=9445
http://www.swamij.com/diaphragmatic-breathing.htm

Hi Jo, Do you remeber the post or links we had about nerve glides to detach the scar matter?
Di

I'll do some looking in the cache for some of those.
i found this so far-
{from one of my old posts}

I know there is supposed to be a progression to give the slack and then slowly stretch and take up the slack of the nerve.
But I didn't have the nerve pain for very long so I never really got into it.

My PTs always started with heat {warm up body for use}, then ultra sound, massage, stretches & strengthening {when I was to that stage} and then ice after or when I got home & then rest.

the ice part was mostly for my forearm tendinitis symptoms but experiment to see what combo of ice or heat is best for you also don't be afraid to experiment to find the best stretches, glides, posture, body work that is best for YOU.

Chiro uses adjustments, low level laser, NIMMO {deep massage/triggerpoint type}, infra red, and ultrasound.

It's all a bit of trial and error, don't forget the diaphragm deep breathing and drink plenty of fluids.

PS- I have a infra red heating pad {regular one works too} permanently strapped to the back of my recliner use it almost every evening.
__________________

looking in the cached files is like looking for a needle in a haystack!
darn it all lost data!!! sheesh
whew ,that's outta my system -for now anyway.

plus if I do find something good I can't copy it here if it is posted by someone else.
and so many of the old timers haven't found us here yet.

odd to look thru those old posts and see the ones that have moved on for whatever reason- I hope they are doing well.

found info somewhere else- link and the text
http://www.handhealthresources.com/S.../Exercises.htm

see the link for the photos-

[If you are experiencing nerve symptoms, these exercises to glide (or slide, or pump) the nerves are critical. In fact, in one study, the chances of avoiding surgery improved dramatically when nerve glides were added to the therapy program.

It is very important not to over-stretch the nerve while exercising or you will create symptoms. Perform these exercises at a quiet time when you can pay close attention to the signals from your body. Feeling some tension is good but do not stretch to the point that you feel pain or numbness. You may feel tension anywhere along the nerve pathway, sometimes at quite a distance from the site of pain. I've had clients feel tension in their arms, shoulders, neck, even chest and back!

I teach clients to gently "pump" the nerve so that it is carefully teased out of adhesions. Some therapists instruct their clients in a sustained hold of 10 seconds. Try it both ways and see which feels better for you.
* Median Nerve Glide (the carpal tunnel nerve)


o Sweep your arm out to the side until it is slightly behind you, palm facing forward, elbow gently straight
o Pull your wrist back until you feel a gently tension somewhere in the arm
o Relax the wrist forward until tension is relieved
o Repeat 10 times


o Ease the tension on the wrist to about half
o Holding this position, gently raise your arm until you feel tension (stay below shoulder height)
o Lower the arm until tension is relieved
o Repeat 10 times


o Ease the tension on the arm to about half
o Tilt your head (bring opposite ear towards opposite shoulder) until you feel tension
o Straighten the neck until tension is relieved
o Repeat 10 times



* Ulnar Nerve Glide (the funny bone nerve)


o Place your arm out to your side with the wrist pulled back as if you are saying "stop"
o Bring your fingers toward your ear as if to cup the ear with the palm, fingers pointing to the shoulder. Stop when you feel a gentle tension.
o Bring your hand back out to the side until tension is relieved
o Repeat 10 times.

As an alternative:
o Hold your arm out to the side, elbow straight, fingers gently curved but not in a fist
o Rotate your arm fully until the palm is up.
o Gently tilt your head (bring opposite ear towards opposite shoulder) until you feel tension
o Straighten the neck until tension is relieved
o Repeat 10 times


* Radial Nerve Glide (the back of the hand nerve)
o Place your hand at your side with the back of the hand facing forward
o Push your shoulder down towards the floor (the movement comes from the shoulder, do not lean)
o Bend your wrist toward the palm until you are in the "waiter's tip" position (as if you are a waiter unobtrusively taking a tip)
o Move your arm back behind you and up at a slight angle to the side until you feel tension
o If you feel as if you need more stretch, gently tilt your head (bring oppositie ear towards opposite shoulder) until you feel tension
o Straight the head or move the arm back down until tension is relieved
o Repeat 10 times



These nerve glides deserve a repeat of the previous cautions. Stretch only until you feel a gentle tension. Avoid pain. Perform in a quiet environment and listen carefully to your body's feedback while performing.]

OK now I'm not so frustrated cause I found something about it!
yeah!!!

another link with photos too-
http://www.kineticconditioning.net/Carpal.htm

Should this stuff not be posted up at the top??? So that we don't lose it???

Just a thought

Have a great night,

Victoria

Jo- I like your stretch page link. thanks


johanna

I did add the links into my list on the sticky under nerve glides - I'll copy & add the text part in a separate post there- good idea.