Conservative Treatment for TOS: Exercise Alone vs Other Modalities
Rehabilitative exercises are a crucial component of conservative treatment for thoracic outlet syndrome (TOS).
Exercise rehabilitation can be effective on its own for treating TOS. By strengthening the muscles around the thoracic outlet and improving range of motion in the affected joints, exercise can help reduce compression on the nerves and blood vessels that pass through the thoracic outlet. However, thoracic outlet syndrome exercises may be more beneficial when combined with other modalities such as physical therapy or manual therapy.
A qualified and licensed physical therapist can correct the underlying structural issues that cause compression of the nerves and blood vessels of the thoracic outlet, reducing or resolving the symptoms of thoracic outlet syndrome. Treatment programs may address postural imbalances or muscle tightness that are causing compression in the thoracic outlet. Physical therapists may use techniques such as massage or stretching to help alleviate pain and improve mobility.
Manual therapy involves hands-on techniques such as joint mobilization or soft tissue manipulation to help restore proper alignment and function of affected joints and muscles. This can be particularly helpful for individuals who have developed adhesions or scar tissue due to chronic thoracic outlet syndrome.
Given the fact that there are many causes of thoracic outlet syndrome, there is no one-size-fits-all approach. The appropriate type and amount of exercise will depend on an individual’s specific symptoms, severity of their condition, and overall health status. It is important to work with a specialized physical therapist or other healthcare professional who has experience treating TOS to ensure that the exercise is integrated safely and effectively into the overall treatment plan. While some thoracic outlet syndrome patients respond to muscle strengthening, others respond to relaxation techniques such as the ENVEST program.
In general, rehabilitative exercises for TOS may focus on strengthening the muscles around the shoulder girdle while also improving flexibility in affected joints. Exercises may include shoulder shrugs, scapular retractions, external rotations with resistance bands or dumbbells, and stretches for tight chest muscles.
In general, it is important to start with low-intensity exercises and gradually increase the intensity and duration of these exercises as tolerated. Overdoing any thoracic outlet syndrome exercise can exacerbate symptoms and delay healing. Additionally, It is important to avoid exercises that involve overhead movements or heavy lifting, as these can further compress the thoracic outlet and aggravate symptoms of thoracic outlet syndrome. Once your therapist documents progress, you can progress slowly to overhead exercises.
Incorporating other modalities such as physical therapy or manual therapy into a thoracic outlet syndrome exercise plan can help address underlying structural issues and provide additional pain relief. However, exercise rehabilitation remains a vital component of conservative treatment for many patients with thoracic outlet syndrome. By restoring strength, flexibility, and range of motion in affected muscles and joints, exercise can help reduce compression on the nerves and blood vessels in the thoracic outlet, leading to improved function and reduced pain.