In the last post I wrote about restrictions, movement and neural gliding.
Two examples come to mind. Thoracic Outlet Syndrome and Piriformis Syndrome. Both of these conditions illustrate myofascial work very well. In this blog, I will focus on Thoracic Outlet Syndrome (TOS).
What the patient experiences
TOS is more common that you think. A great deal of us have our arms outstretched doing one thing or another. Do it enough and it because an overuse problem. When that happens, people will often feel numbness in their hand, weakness in the arm or a generalized discomfort in their arm. I once knew a person who pulled over on a busy LA freeway and was taken by ambulance because of the right arm pain. A lot of scary pain, thus the ambulance. It turned out to be TOS.
So what is going on in TOS that causes those sensations? First it is important that you understand that the Thoracic Outlet is a very narrow space identified by anatomists in the front of the shoulder, underneath the muscles and ligaments. It is made for myofascial problems, the space is narrow and the nerves have to move through that space with any shoulder and arm movement. The nerve bundle runs from the neck, through the Scalene muscle group, under the collarbone and then through the Thoracic Outlet before entering the arm. Myofascial restrictions can develop in the Scalene muscle group as well the Thoracic Outlet itself. The restrictions in those areas will inhibit arm movement but also interfere with the gliding of the nerves. So decreased movement, myofascial restrictions and neural gliding interference come together to create Thoracic Outlet Syndrome.
At the early stages, TOS is a Myofascial issue. Later on it can become a surgical one, but at the beginning it is really often a soft tissue issue. Myofascial techniques are an effective initial treatment for Thoracic Outlet Syndrome.
If this sound too familiar, get checked out before you have more problems than it is worth.