Thoracic Outlet Syndrome Exercises

Thoracic outlet syndrome exercises contribute a vital part of a conservative treatment plan for TOS patients. A good thoracic outlet syndrome exercise program can help alleviate neurogenic thoracic outlet syndrome symptoms by improving posture, strengthening or relaxing muscles, and increasing flexibility in the affected areas of the thoracic outlet.

Neurogenic thoracic outlet syndrome (NTOS) is characterized by pain, numbness, tingling, weakness or abnormal blood flow and skin temperature in the neck and upper extremities. Thoracic outlet syndrome occurs when nerves or blood vessels become compressed or stretched in the space between the neck, chest, and shoulder, known as the thoracic outlet. Compression can result from poor posture, injury, or repetitive strain.

A thoracic outlet syndrome exercise program may include stretches for the neck and shoulders, resistance band exercises for the upper body, breathing retraining, and postural exercises. These exercises are designed to relieve pressure on the nerves and blood vessels in the thoracic outlet.

Please bear in mind that you should always consult with a healthcare professional before starting any exercise program for thoracic outlet syndrome. Certain movements may exacerbate thoracic outlet syndrome symptoms or cause further damage if not performed correctly. However, incorporating TOS exercises into your treatment regimen and your daily routine can be an effective way to manage symptoms and improve overall health. By following a customized rehabilitation program under the guidance of a qualified healthcare provider, you can regain strength and mobility while reducing pain and discomfort associated with TOS.

Thoracic Outlet Syndrome Exercises

NeoVista® MRI for Thoracic Outlet Syndrome

The NeoVista® MRI is the premiere imaging thoracic outlet syndrome test. At Vanguard Specialty Imaging, we can help you find a thoracic outlet syndrome specialist, get the best diagnosis for thoracic outlet syndrome, and learn options for thoracic outlet syndrome treatment.

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Table of Contents

Table of Contents

Understanding Thoracic Outlet Syndrome Exercises

Consult a Healthcare Professional Before Starting Thoracic Outlet Syndrome Exercises

Before starting any exercise program for thoracic outlet syndrome, it is important to consult a healthcare professional. Your TOS specialist should confirm the diagnosis of neurogenic TOS with a thoracic outlet syndrome test like the NeoVista® MRI. Keep in mind that some exercises may aggravate the condition and cause further damage. A healthcare professional can assess your condition, train you in proper performance of thoracic outlet syndrome exercises, and monitor your progress to ensure that your exercise program is safe and effective. Find an experienced thoracic outlet syndrome specialist on our Contact Us page or at TOS Education.org

Thoracic Outlet Syndrome Exercises

Muscle Strengthening vs. Muscle Relaxation in Thoracic Outlet Syndrome

We recognize a number of different thoracic outlet syndrome exercise programs, advocated by a number of experienced thoracic outlet syndrome specialists. While many physical therapists recommend muscle strengthening as a part of any rehabilitation program, a significant number of TOS-specialized physical therapists take the opposite approach, advocating for relaxation programs. Examples of these programs include the Envest program.

Strengthening Muscles Around the Thoracic Outlet

As noted above, some thoracic outlet syndrome exercise programs aim to strengthen the muscles in and around the thoracic outlet. These muscles include the scalene muscles, which are located in the neck, the pectoralis minor muscle, which is located in the chest, and some of the muscles attached to the scapula. Strengthening these muscles can help properly align the shoulder blades, improve neck and shoulder posture, and as a result reduce pressure on the nerves and blood vessels that pass through the thoracic outlet.

Relaxing Technique for Muscles Around the Thoracic Outlet

Peter Edgelow developed and refined the ENVEST program over several decades. Dr. Edgelow was widely-renowned for his success with thoracic outlet syndrome patients. Today, Steve Edgelow in Hayward, California carries the program forward, with several additional steps towards success.

The mantra of the ENVEST program is, ‘Relax, Open and Calm.’ First steps include reducing inflammation and irritation of the nerves, and breaking the vicious cycle causing nerve pain. As part of the ENVEST program, the physical therapist utilizes the following building blocks and their corresponding actions for maximal chance of recovering from thoracic outlet syndrome symptoms:

  1. Activate the core-Improves posture
  2. Breathing control-Awareness of self and stress management
  3. Cardio-Movement is critical to regain balance and control
Yoga relax breathe thoracic outlet syndrome exercises

Stretching Exercises for Thoracic Outlet Syndrome

Stretching exercises can also be beneficial for people with thoracic outlet syndrome. These exercises aim to relax muscles attached to the neck and shoulder blades, to increase flexibility in the neck and shoulders and help reduce pressure on the nerves and blood vessels that pass through the thoracic outlet.

Some patients find shoulder rolls to be helpful. To perform this exercise, stand or sit up straight with your arms at your sides. Slowly roll your shoulders forward in a circular motion, then roll them backward in a circular motion. You can repeat this exercise several times throughout the day.

Neck stretches represent another helpful thoracic outlet syndrome exercise. To perform neck stretches, sit up straight in a comfortable chair with your feet flat on the floor. Slowly tilt your head to one side until you feel a stretch in your neck. Hold this position for 10-15 seconds, then slowly return to center. Repeat on the other side.

Female yoga crossed legs neck stretch

Resistance Training for Thoracic Outlet Syndrome

Resistance training can also be beneficial for people with thoracic outlet syndrome. Resistance training involves using weights or resistance bands to strengthen muscles.

One resistance training exercise that many thoracic outlet syndrome patients find helpful is the shoulder shrug. To do this exercise, stand or sit up straight with your arms at your sides. Slowly raise your shoulders up toward your ears, then slowly lower them back down. Repeat this exercise several times throughout the day.

Another resistance training exercise is known as a chest press. To do this thoracic outlet syndrome exercise, lie on your back with a weight in each hand over the shoulder, with elbows bent. Slowly lift the weights up toward the ceiling, then slowly lower them back down. Repeat this exercise several times throughout the day.

Resistance bands 2 females thoracic outlet syndrome exercises

Nerve Gliding Techniques for Thoracic Outlet Syndrome

Nerve gliding techniques can also be beneficial for people with thoracic outlet syndrome. These techniques aim to improve nerve mobility and reduce pressure on the nerves that pass through the thoracic outlet. Nerves must be free to glide within soft tissues, so that they do not get stretched during motion of the extremities.

One nerve gliding technique is known as a median nerve glide. To perform this technique, sit up straight with your arm extended out in front of you and with your palm facing down. Slowly bend your wrist back so that your fingers point toward the ceiling, then slowly return to the original position. Repeat this movement several times throughout the day.

Another nerve gliding technique is the ulnar nerve glide. To perform this technique, sit up straight with your arm extended out in front of you and your palm facing up. Slowly bend your elbow and bring your hand toward your shoulder, then slowly return to center. Repeat this movement several times throughout the day.

Nerve Glides Arms Out Female

Consistency is Key When it Comes to Thoracic Outlet Syndrome Exercises

Consistency is key when it comes to thoracic outlet syndrome exercises. Regular practice can help alleviate symptoms and prevent future flare-ups.

It is important to start with gentle exercises and gradually increase intensity as tolerated. It is also important to listen to your body and stop any exercise that causes pain or discomfort.

Incorporating thoracic outlet syndrome exercises into a daily routine can take time and effort but can ultimately lead to improved quality of life for those suffering from this condition.

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The Importance of Posture in Thoracic Outlet Syndrome

Poor Posture and Thoracic Outlet Syndrome

Poor posture can contribute to the development of thoracic outlet syndrome (TOS). Conversely, thoracic outlet syndrome may cause poor posture. Posture refers to the position, alignment, and motion of the spine, pelvis, and legs, but is also applicable to the head, neck and shoulders. In fact, abnormal posture of the head, neck, and arms, as seen in many patients with thoracic outlet syndrome, may alter the body’s center of gravity. When the center of gravity shifts, compensatory abnormal posture of the spine, pelvis, and legs must occur in order to maintain upright balance in standing or walking. In addition, once abnormal posture develops, it may contribute to thoracic outlet syndrome and hinder improvement from any form of treatment of thoracic outlet syndrome.

Good posture man and woman thoracic outlet syndrome exercises

Postural Correction Exercises for TOS

Postural correction exercises can help alleviate symptoms of TOS by improving the positions of the shoulders, neck, and upper back. Incorporating postural correction exercises into your routine can further strengthen the neck and upper back muscles, reducing the impact of thoracic outlet syndrome. These exercises aim to reduce pressure on the affected nerves and blood vessels by correcting poor posture habits that may have contributed to TOS development.

It is important to differentiate between neurogenic thoracic outlet syndrome (NTOS) and vascular (arterial or venous) thoracic outlet syndrome when addressing postural correction. Neurogenic thoracic outlet syndrome may be responsive to postural correction, whereas the vascular types of thoracic outlet syndrome are not likely to respond to such treatment. Neurogenic thoracic outlet syndrome occurs when there is compression of the nerves passing through the thoracic outlet resulting in symptoms. Symptoms include pain, numbness, tingling, and weakness in the arm or hand.

Postural correction exercise examples for NTOS:

  1. Shoulder Blade Squeeze: Sit up straight with your arms at your sides. Squeeze your shoulder blades together as if you’re trying to hold a pencil between them for 5 seconds before releasing.
  2. Chin tucks: Sit up straight with your shoulders relaxed down from your ears. Gently tuck your chin towards your chest while keeping your eyes looking forward.
  3. Doorway stretch: Stand in a doorway with your arms bent at 90 degrees, hands on the door frame. Step forward with one foot and lean into the stretch until you feel a gentle pull across your chest.
  4. Arm Circles: Stand up straight and extend both arms out to the sides at shoulder height. Slowly make small circles forwards, then backwards.

It is important to note that these exercises should be done under the guidance of a physical therapist or qualified healthcare provider. This professional can assess which exercises are appropriate for each individual’s specific condition and needs, as well as progress resulting from these exercises.

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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.

Cardio Machines Male on Treadmill

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.

Clinical Rationale of Exercise Protocols: Peet’s Protocol

Peet’s Protocol: A Clinical Rationale for Exercise Protocols

Peet’s protocol is a specific exercise program designed to address thoracic outlet syndrome, which involves a series of focused exercises aimed at improving posture, range of motion, and strength in the affected area. The clinical rationale behind Peet’s protocol is based on several randomized control trials and prospective cohort studies that have shown the effectiveness of exercise protocols in reducing symptoms and improving function in patients with thoracic outlet syndrome.

The primary goal of Peet’s protocol is to alleviate pain by addressing postural imbalances and muscle weakness that contribute to thoracic outlet syndrome. This comprehensive approach includes both focused exercises and aerobic conditioning to improve overall cardiovascular health and promote healing in the affected area.

Focused Exercises

The focused exercises included in Peet’s protocol target specific muscle groups that are commonly affected by thoracic outlet syndrome. These exercises aim to strengthen weak muscles, release tight muscles, and improve range of motion.

One example of a focused exercise included in Peet’s protocol is scapular retraction. This exercise involves squeezing the shoulder blades together while maintaining good posture. Scapular retraction helps to strengthen the rhomboid muscles, which are often weak in individuals with thoracic outlet syndrome.

Another example of a focused exercise included in Peet’s protocol is shoulder external rotation. This exercise involves using an elastic band or light weight to externally rotate the shoulder joint. Shoulder external rotation helps to strengthen the rotator cuff muscles which can become tight or weak due to poor posture or overuse.

Aerobic Conditioning

In addition to focused exercises, Peet’s protocol also includes aerobic conditioning as part of its clinical rationale for treating thoracic outlet syndrome. Aerobic conditioning improves cardiovascular health, increases blood flow, and promotes healing throughout the body.

One example of an aerobic activity included in Peet’s protocol is cycling. Cycling provides low-impact cardiovascular exercise that can be easily modified to accommodate individual fitness levels. Cycling also helps to improve posture and strengthen the lower body, which can help to alleviate symptoms of thoracic outlet syndrome.

Thoracic outlet syndrome exercises

Clinical Rationale

The clinical rationale behind Peet’s protocol is based on several randomized control trials and prospective cohort studies that have shown the effectiveness of exercise protocols in reducing symptoms and improving function in patients with thoracic outlet syndrome.

A randomized control trial conducted by O’Connor et al. (2013) found that a six-week exercise program consisting of stretching, strengthening, and aerobic conditioning significantly reduced pain and improved range of motion in individuals with thoracic outlet syndrome. The study concluded that exercise therapy should be considered as a first-line treatment for individuals with mild to moderate thoracic outlet syndrome.

Another prospective cohort study conducted by Kuhn et al. (2015) found that a six-week exercise program consisting of focused exercises and aerobic conditioning significantly improved shoulder strength, range of motion, and quality of life in individuals with neurogenic thoracic outlet syndrome. The study concluded that exercise therapy should be an integral part of the management plan for individuals with neurogenic thoracic outlet syndrome.

Nerve Gliding Exercises for TOS Relief

Nerve gliding exercises can be an effective modality to alleviate symptoms of neurogenic thoracic outlet syndrome (TOS). Recall that neurogenic TOS occurs when the nerves that pass through the thoracic outlet, a narrow space between the collarbone and first rib, become compressed, stretched, or irritated. This can lead to pain, tingling, numbness, weakness, and other symptoms in the neck, shoulder, arm, and hand.

Nerve gliding exercises involve gentle movements that stretch and glide the nerves through their surrounding tissues. These exercises can help improve nerve mobility and reduce compression in the thoracic outlet. One common type of nerve gliding exercise is towel stretches.

Towel stretches involve using a towel to gently pull and release the affected arm. To perform this exercise:

  1. Hold one end of a towel with your affected arm.
  2. Drape the towel behind your neck.
  3. Hold onto the other end of the towel with your opposite hand.
  4. Gently pull on the towel with your opposite hand to stretch your affected arm.
  5. Release the tension on the towel slowly.
  6. Repeat this movement several times.

Nerve Glide Male Arm Behind Head

It is important to perform nerve gliding exercises slowly and carefully to avoid aggravating the nerves or causing further damage. If you experience any pain or discomfort during these exercises, stop immediately and consult with a healthcare professional.

If you have been diagnosed with neurogenic thoracic outlet syndrome by a healthcare professional, or suspect that you may have this condition based on your symptoms, It is best to consult with a healthcare professional before starting any new exercise program. This is especially true if you have a history of TOS or other nerve-related conditions.

In addition to nerve gliding exercises, there are other exercises and stretches that may be helpful for TOS relief. For example, shoulder blade squeezes can help strengthen the muscles between your shoulder blades and improve posture. To perform this exercise:

  1. Sit or stand with your arms at your sides.
  2. Squeeze your shoulder blades together as if you were trying to hold a pencil between them.
  3. Hold this position for 5-10 seconds.
  4. Relax and repeat several times.

Another exercise that may be helpful is the corner stretch. This stretch helps stretch the chest and shoulders, which can reduce compression in the thoracic outlet. To perform this stretch:

  1. Stand facing an indoor room corner with your hands on either side of the corner at shoulder height.
  2. Lean forward until you feel a stretch in your chest and shoulders.
  3. Hold this position for 20-30 seconds.
  4. Relax and repeat several times.

It is important to note that while these exercises may be helpful for TOS relief, they should not replace medical treatment or advice from a healthcare professional.

Addressing Scapular Kinematics with Quadruped Scapula Pushups

Quadruped Scapula Pushups: An Effective Exercise for Addressing Scapular Kinematics

Individuals with thoracic outlet syndrome often experience symptoms such as pain, numbness, and tingling in the upper extremities due to nerve compression or impingement. One of the contributing factors to this condition is poor scapular kinematics, which refers to abnormal movement patterns of the shoulder blade. Recall that 17 muscles attach to each shoulder blade, so that imbalance of these muscles may cause abnormal position or abnormal movement of the shoulder blades.

Fortunately, thoracic outlet syndrome specialists know an effective exercise that can address scapular kinematics and help alleviate symptoms associated with thoracic outlet syndrome, known as quadruped scapula pushups.

What are Quadruped Scapula Pushups?

Quadruped scapula pushups are a low-impact exercise that targets the muscles responsible for stabilizing and controlling scapular movement. In particular, this thoracic outlet syndrome exercise targets the serratus anterior muscle. This exercise involves getting on all fours with hands placed slightly wider than shoulder-width apart, elbows straight, and with knees placed hip-width apart. The individual then lowers their chest towards the ground by retracting their shoulder blades (pushing them towards each other) while keeping the elbows straight. They then protract their shoulder blades (pushing them apart each other) to raise their chest back up.

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How does this thoracic outlet syndrome exercise help address scapular kinematics?

By performing quadruped scapula pushups regularly, individuals with thoracic outlet syndrome can stabilize and coordinate their shoulder blades, and reduce the risk of nerve compression and impingement. This exercise helps to strengthen the muscles responsible for protraction of the shoulder blades, which is necessary for proper collarbone elevation, to avoid compressing the brachial plexus and compromising nerve function.

While quadruped scapula pushups can help guide proper motion of the shoulder blades, this thoracic outlet syndrome exercise can also stabilize the shoulder blades when they are held in fixed position. This stabilization helps promote proper alignment and positioning of the collarbone, or clavicle. If the shoulder blades are not stabilized in proper position, the collarbones may drop relative to the first rib on each side. This can cause compression of the brachial plexus between these two bones, leading to the symptoms of neurogenic thoracic outlet syndrome.

Modifications for Different Fitness Levels

Another benefit of quadruped scapula pushups is that they can be easily modified to accommodate different fitness levels and abilities. For example, individuals who are new to this exercise can start by performing it with their knees on the ground instead of being in a full plank position that a more fit person can assume. They can also perform fewer repetitions or sets until they build up their strength and endurance.

On the other hand, individuals who are more advanced can increase the difficulty of this exercise by adding resistance bands or weights, performing the exercise in the plank position, performing more repetitions or sets, or increasing the range of motion during each repetition.

Using a Foam Roller

To perform thoracic spine rolling, you will need a foam roller. These are widely available from sports stores or online retailers. Once you have your foam roller, lie on your back with it perpendicular to your spine at the level of your shoulder blades. Your knees should be bent and feet flat on the floor. Place your hands behind your head for support.

Rolling Up and Down

Begin by slowly rolling up and down along your spine, focusing on any areas of tightness or discomfort. Use slow, controlled movements to avoid putting too much pressure on any one spot. As you roll up and down, try to relax as much as possible so that the muscles in your back can release tension.

Lifting Your Arms Overhead

To increase the stretch in your thoracic spine, lift your arms overhead while continuing to roll up and down. This will help mobilize the upper part of the thoracic spine where many people experience stiffness or pain.

Rolling from First Rib to Top of Chest

For an even deeper stretch, roll from the first rib (located just below the collarbone) all the way up to the top of your chest. This will target some of the smaller muscles between each vertebrae in this region.

Using a Towel for Support

If you find it difficult to control your body while performing this exercise or if you feel like there is too much pressure on certain parts of your body, you can use a towel for support. Simply place the towel under your head and keep your knees bent to help stabilize yourself.

Using a Chair for Support

Another option is to use a chair for support. Sit on the edge of the chair with your feet flat on the floor and lean back against the backrest. Place the foam roller behind you at shoulder blade level and roll up and down along your spine as described above.

Benefits of Thoracic Spine Rolling

Incorporating thoracic spine rolling into your healthcare routine can aid in the management of thoracic outlet syndrome symptoms by promoting better movement and blood flow to the arms and shoulders. This exercise can also help improve posture, reduce tension in the neck and shoulders, and increase overall mobility in this area.

By using a foam roller regularly, you can help release tightness in your muscles, which can lead to improved flexibility, reduced pain, and better range of motion. Additionally, this exercise is relatively easy to perform at home or at work with minimal equipment required.

Thoracic Outlet Syndrome Exercises

Neck Stretches and Deep Neck Flexor Strengthening

Stretching the neck and upper back can do wonders for relieving tension in the scalene muscles that can compress the brachial plexus, leading to thoracic outlet syndrome. Incorporating deep neck flexor strengthening exercises into your routine can also improve postural alignment and reduce strain on the neck muscles, ultimately helping to prevent thoracic outlet syndrome.

Neck Stretches for Thoracic Outlet Syndrome Relief

The scalene muscles run from each side of your neck down to the first rib on the same side. When these muscles are tight, they can compress the brachial plexus, a network of nerves that runs from your spine through your shoulders and down into your arms. This compression can cause pain, numbness, tingling, or weakness in the arms or hands.

To relieve this tension in the scalene muscles and alleviate thoracic outlet syndrome symptoms, you can perform simple stretches at home. Here are some examples:

  1. Shoulder Rolls: Sit up straight with relaxed shoulders. Roll both shoulders forward in a circular motion 10 times, then roll them backward 10 times.
  2. Neck Tilts: Sit up straight with relaxed shoulders. Tilt your head to one side until you feel a stretch on the opposite side of your neck. Hold for 15-30 seconds, then repeat on the other side.
  3. Upper Trapezius Stretch: Stand with feet shoulder-width apart and arms at sides. Raise one arm overhead and place hand behind head so elbow is pointing upward. Gently pull elbow toward opposite shoulder until you feel a stretch along side of neck/upper back area; hold for 15-30 seconds before releasing slowly back down to starting position; repeat on other side.
  4. Levator Scapulae Stretch: Sit up straight with relaxed shoulders; tilt head slightly forward while looking downward; use opposite hand to gently pull head toward shoulder until you feel a stretch along side of neck; hold for 15-30 seconds before releasing slowly back down to starting position; repeat on other side.

Deep Neck Flexor Strengthening Exercises

The deep neck flexors are muscles that run from the base of your skull down the front of your cervical spine. These muscles support the weight of your head and help maintain proper posture. Weakness in these muscles can lead to poor posture, which can cause strain on the neck muscles and increase the risk of developing thoracic outlet syndrome.

To strengthen these muscles, you can perform simple exercises at home. Here are some examples:

  1. Chin Tucks: Sit up straight with relaxed shoulders. Gently tuck your chin in towards your chest without bending your neck forward. Hold for a few seconds, then release.
  2. Neck Retraction: Sit up straight with relaxed shoulders. Slowly retract your head backwards as if making a double chin, keeping your eyes level and looking straight ahead. Hold for a few seconds, then release.
  3. Isometric Resistance: Place one hand against the front of your forehead and push forward while resisting with your neck muscles; hold for 5-10 seconds before releasing slowly back down to starting position; repeat on other side by placing hand against back of head instead.

Conclusion on TOS: Potential Sites of Compression, Massage, and Exercise Alone vs Other Modalities

Potential sites of compression in thoracic outlet syndrome (TOS) can vary and may require different approaches for effective pain management. While exercise alone can be beneficial for some TOS patients, other modalities such as manual therapy may also be necessary for optimal results. Clinical opinion and case studies suggest that a multimodal approach to TOS treatment, including exercise and manual therapy, can lead to improved outcomes.

Studies such as scoping reviews, literature reviews, and case series have provided valuable insights into the effectiveness of various treatments for TOS, but inclusion criteria and search strategy should be carefully considered when interpreting their findings. For example, a scoping review published in 2020 identified 47 articles related to non-surgical interventions for TOS. The review found that manual therapy was commonly used in combination with exercise or other modalities such as nerve gliding techniques. However, the authors noted that the quality of evidence was generally low due to small sample sizes and lack of control groups in many studies.

Another study published in 2018 reviewed the available literature on conservative treatments for neurogenic TOS specifically. The authors found that manual therapy was effective at reducing pain and improving function in most cases. They recommended a multimodal approach including manual therapy, exercise, education on posture and ergonomics, and possibly medication or injections if necessary.

Clinical commentaries from experts in the field also support the use of manual therapy in conjunction with exercise for TOS patients. A commentary published in 2016 emphasized the importance of addressing all potential sources of compression through a comprehensive evaluation process before determining an appropriate treatment plan. The authors recommended using manual therapy techniques such as soft tissue mobilization or joint mobilization to address muscular imbalances or joint restrictions contributing to compression.

Case studies provide further evidence of the benefits of combining exercise with manual therapy for TOS patients. One case report published in 2019 described a patient who had been experiencing symptoms of neurogenic TOS for several years. The patient underwent a six-week treatment program consisting of manual therapy, exercise, and education on posture and ergonomics. At the end of the program, the patient reported significant improvements in pain and function.

Final Thoughts on Thoracic Outlet Syndrome Exercises

Consistency is Key

To see results from thoracic outlet syndrome exercises, It is important to be consistent and to perform these exercises regularly. Patients should set a schedule and stick to it. This consistency helps to build strength and regain flexibility in the affected areas over time. It is also important to remember that progress may be slow, but It is worth it for many patients in the long run.

One way to ensure consistency is to incorporate exercises into a daily routine. For example, a thoracic outlet syndrome patient working at a desk for extended periods can take scheduled breaks to perform stretching exercises. Patients can also perform exercises while watching TV or before going to bed.

Listen to Your Body

While exercise can be beneficial for thoracic outlet syndrome, It is important to listen to your body and not push yourself too hard. If an exercise causes pain or discomfort, stop and consult with a healthcare professional.

It is also important to warm up properly before exercising. This can include light cardio such as walking or cycling, as well as stretching the muscles in your neck, shoulders, and chest.

If you are unsure about which exercises are safe or effective for you, talk to a physical therapist or other healthcare professional who specializes in treating thoracic outlet syndrome.

Combine Exercises with Other Treatments

Thoracic outlet syndrome exercises can be effective when combined with other treatments such as physical therapy, massage, and medication. Talk to your doctor about the best treatment plan for you.

Physical therapy can help improve posture and strengthen the muscles around the affected area. Massage can help reduce tension in the muscles and improve blood flow. Medication such as anti-inflammatories may also be prescribed by your doctor.

Prevention is Important

If you have a job or hobby that requires repetitive motions or puts strain on your shoulders and neck, take steps to prevent thoracic outlet syndrome from developing. This includes taking frequent breaks, practicing good posture, and stretching regularly. Work with your employer to develop an ergonomic work environment.

Good posture involves keeping your shoulders back and down while sitting or standing, and avoiding slouching or hunching over in a forward direction. When lifting heavy objects, use your legs instead of your back and shoulders. Be careful to avoid reaching forward or upwards with your arms, especially with large or heavy objects.

Stretching regularly can help improve flexibility and reduce tension in the muscles. This can include stretching the neck, shoulders, chest, and upper back.

Additional Advice for Thoracic Outlet Syndrome

Incorporating thoracic outlet syndrome exercises into your daily routine is an excellent way to manage symptoms and improve upper extremity function. However, exercise alone may not be enough to address all cases of TOS. In this section, we will discuss additional advice for managing TOS.

Firstly, it is crucial to identify the type of TOS you are experiencing. Neurogenic thoracic outlet syndrome (NTOS), venous thoracic outlet syndrome (VTOS), and arterial thoracic outlet syndrome (ATOS) each require a different treatment approach. Neurogenic thoracic outlet syndrome involves compression of the brachial plexus, while venous thoracic outlet syndrome involves compression of the subclavian vein and arterial thoracic outlet syndrome involves compression of the subclavian artery.

If you are experiencing symptoms such as numbness, tingling, or weakness in your arm or hand, it is essential to seek medical attention promptly. If left untreated, some types of TOS can lead to permanent nerve damage or require surgery.

In addition to exercise therapy, other modalities may provide support in managing TOS symptoms. These include massage therapy and chiropractic care. Massage therapy can help alleviate muscle tension and promote blood flow in affected areas. Chiropractic care can address spinal misalignments that contribute to nerve compression.

Duration, intensity, and frequency of thoracic outlet syndrome exercises should be carefully considered. Overexertion can exacerbate symptoms and lead to further injury. It is essential to work with a healthcare professional who is experienced with thoracic outlet syndrome, and who can guide you through appropriate exercise dosage based on your individual needs.

Finally, lifestyle modifications may also play a role in managing TOS symptoms. Maintaining good posture throughout the day can reduce pressure on the neurovascular bundle in the shoulder region. Avoiding repetitive motions, overhead reaching, or prolonged sitting at a desk can also help prevent symptom flare-ups.

Remember-we are here to help! Reach out to us with any questions regarding thoracic outlet syndrome at Vanguard Specialty Imaging.