Alternatives to thoracic outlet syndrome surgery? How you can take control!

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• This Practical Physica... -~-
Thoracic outlet syndrome is a medical condition for which surgery is sometimes recommended. But does a surgical approach make sense? Matt explains why he thinks surgery may not be the best answer to the problem and what people should try to do to improve their own situations.
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This post provides an exhaustive overview of the risks and outcomes of thoracic outlet surgery from peer-reviewed literature:
www.uprighthealth.com/blog/do...
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[@betweenearthandsky4091]

I cried of joy hearing you. Exactly confirmed my intuition. Please make more videos about treatment. 🙏🏻

[@MuscleMindWorx]

Awesome video bro! I am currently helping people all over the world with Thoracic outlet syndrome and have the same thoughts you do! Great explanation and hopefully we can both reach more people with this info as doctors are too quick to do surgery. It's becoming a big business and people are suffering without real results. I had NTOS and ATOS myself and have used my techniques to not only life a normal life without surgery... I have 0% compression.

[@Daniel-dl6cu]

That's encouraging to hear. I've been reading and they say ATOS is most often treated with surgery while NTOS is treated mostly with physical therapy. I haven't even been diagnosed with thoracic outlet syndrome after years of trying to find out what all this mysterious pain is from. I have discolaration in my hands and tingling and numbness too. I'm guessing I may have a little of both and I was scared from reading about ATOS not being corrected from exercise. I'm currently trying to restore stability to the shoulder and correct forward head posture.Hopefuly this will help my collarbone and first rib go back to normal. It's been a journey.

[@Daniel-dl6cu]

@Ilir Cami I'm still looking for help and I'm not sure if the things i'm doing have helped me yet .But I have a straight neck curve so I need to fix that....there's something called a posture pump which can help bring the neck curve back and there's also exercies on youtube, This guy is informative too trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/ . Also this guy is good kzbin.info/aero/PL1VUWgFuYb6lsh4IiLayuG2gAwYKNAaYF

[@ColinResponse]

Muscle Mind Worx Hey how can we connect so that I can get some of your help please.

[@szyszak9424]

@@ColinResponse fix droppy shoulders by strenghten upper back and stretch lats, chest, subscapularis

[@ColinResponse]

@muscle mind Worx ! Can you give me your email so we can connect for help!

[@notflanders4967]

Ive watched soo many videos but i like this one most! Well done! Too many people fail to mention the posture issues

[@warrenchin3782]

Before considering surgery, consider a visit to an osteopathic physician that can diagnose and fix first ribs. TOS is frequently caused by a dislocated first rib and can be fixed in moments by a skilled DO, without surgery!

[@TheBaconBoris]

For those just finding this I recommend you get try to diagnose exactly what type you may have. Whether it's neurogenic, arterial, or venious they all have different approaches and methods of treatment. I have done a combination of pt and ot for four years attempting to achieve the same thing somewhat touched on in the video. While I agree with the message about surgery to some respect it does not cover all bases of tos. I recommend those who struggle with this to get ahold of the most experienced specialist they can get ahold of (preferably a program specifically for tos). Tos and ntos specifically are very misunderstood and complicated issues which should be addressed if symptoms do not aleavitate with different stretches and exercises through professional pt or ot. Even in the medical field there are many misconception about this so I highly recommend those suffering do as much research as humanly possibly while keeping in mind not every professional will have the same understanding of these issues if any at all.

[@szyszak9424]

that's not really the case. On example if it's compression against first rib and clavicle you can have all TOS (neurogeniec, arterial and venious) symptoms cause it's compressing the brachial plexus nerves, subclavian vein and subclavian artery. Expect to see tingling in hands, coldness and weakness also chronic neck pain cause it's stretching out the upper trapezius which fighting 24/7 to elevate your shoulders and decompress the outlet. Make the upper trapezius stronger and shorted is fundametal to treat patients with TOS

[@Andtheyworkout]

Please recommend some exercises!! 🙂

[@stephenchapman4534]

push ups, pull ups, chin tucks, jumping jacks, rows

[@troppur7355]

Stephen Chapman what’s a chin tuck and why would push ups help for this?

[@martaakh8105]

Clear, it gets about improvement, liquidation of symptoms especially If they are dangerous for life.

[@carnival448]

Totally agree! Great representation

[@Bitachon]

*Interesting example...* Thanks

[@librahim6213]

Do you think just strengthening the upper back to pull the clavicle up is the fix? What about core muscle strengthening help to pull the rib cage down? Are both needed or depends on individual cases?

[@cliffandtessahorton3366]

Oh my goodness!! You described almost ALL of my symptoms. I also have forearm pain. Can you please, please share with me how you over come it and what you did. I am a volunteer fire fighter and I have been struggling with this for 2 years now. I was known to be a strong female but now there's days I can't even open a water bottle My department is about to let me go ( I dont blame them) because I've been out for so long. It's my passion though. I don't want to give it up. Thank you- Tess

[@megancolasono1108]

I have been on major pain meds for many years and I have no function. I’ve done everything from PT to Botox. Everything in between for years. I want these muscles removed so I can get off pain meds and love a somewhat normal life. I don’t want to be an athlete star just a good mom and wife.

[@pablito1904]

Hi Matt, is the,"shoulder fix program" targetting thoracic outlet syndrome ? Best regards

[@matineyang]

I’ve been dealing with TOS for about a year and 1/2 now. I’ve been slowly coming out of it. I was so fixated about shoulder depression that I overly strengthened my lats not knowing that hyper tonic lats can cause anterior rotation of your shoulders coupled with tightness of the pecs. So I started stretching my lats with my pecs and strength training with more upper trap exercises to pull my shoulders up and alleviate the nerve compression. It seems to be helping as I’ve felt less pain and have had more strength out put with my push exercises.

[@sky2833]

I also got TOS from doing too much lats work. How are you doing now?

[@matineyang]

@@sky2833 I don't have the same strength on my right side as before but the burning, pain, and general discomfort as gone away. I use to bench press 225 but my max is 175 now. It's frustrating and can be depressing at times. Pulling exercises hasn't dipped though so that's a good thing. The things I've done is stretch my lats so much more now. Obviously pec and bicep stretches as well. Added more shrug variations to my routine. The only time I use my computer now is if it's docked and I have elevated external monitors onto arms. I don't exaggerate scapular depression in my posture anymore. So far it's getting better. It took me a 2 years to have some sort of idea of how to treat this. I'm hoping I fully recover some day.

[@sky2833]

@@matineyang thanks for the reply! Are you still strengthening your lats or back? Do you do any scalenes strengthening exercises? How long has your treatment been?

[@silverfullbuster9177]

@@matineyang what were your main symptoms like? Was yours Venus or neuro or both?

[@matineyang]

@@silverfullbuster9177 def all neuro.

[@benacewoofstorm]

Does this help for cervical rib?

[@constancept]

How do i train for this???

[@PhillMidwinter]

Hey Matt, great video, I just had some questions based on my own experience. I had surgery 3 or 4 days ago now to remove a cervical rib, section of the first rib and as you say, some scalenes were cut. In my case the artery was compressed which is the rarest form of TOS and despite years working on the shoulder with swimming, yoga, physio and specific stretches and exercises it just kept degenerating. Generally I agree that cutting stuff out of you is really a last ditch effort which is exactly what it was for myself. There are definite risks to doing this and I seem so far to have been lucky with my results and had a great surgical team. Given that I'm now missing those parts, what would you suggest to help rehab this shoulder? My pain is already pretty manageable and far less than it was pre surgery in terms of nerve pain.

[@shadowharmon9001]

Phill Midwinter I have the same issue how where your results if you don’t mind me asking?

[@topknotchmarcydesanto]

New response to this old thread as I also have bilateral cervical ribs also Hairstylist for over 25 years in significant pain on my right I am thinking surgery is best option instead of the exercises and stretching that I’ve done for so many years to manage the pain the pain is now hard to ignore. Wondered Phil how are you what type of surgeon did you see? So many questions

[@stephaniegutierrez6222]

Hello. I have a stumper for you. Maybe. When I lay flat on the floor I can hear crackling either in my thoracic spine or my cervical spine every time I breathing or exhale mainly when I exhale. I’ve held my cervical spine and pushed it in different spots to see if the crackling would stop but it didn’t so then I tried engaging my rhomboids and breathing and when I do this the crackling stops until I release my upper back muscles then the crackling begins again. Thoughts? I’ve been told I have costochondritis however I am already seeing a physical therapist for this and I’m seeing some improvement but I’m not there yet.

[@AJSimonTalks]

Will this cause heart palpitations and dizziness?

[@Garahan]

I wish I had listened to you... 9 months Post op and suffering

[@jonathankr]

Oh no. What are the symptoms like now? What are the other new issues. Are you able to use your arms now?

[@ranawiselove2497]

What exercise would you recommend? Mine is nerve related from the seat belt in a car accident.

[@szyszak9424]

modified shrug to make upper trapezius stronger

[@DinkAndDrive]

@@szyszak9424 Hey can you link a video on something similar?

[@szyszak9424]

@@DinkAndDrive sure here you go: kzbin.info/www/bejne/f6OynYqXmsqFqrc What exactly you got problem with? maybe i will can try to help you.

[@faithlynn2083]

i can’t afford your program 😞💔

[@dustyd.9555]

I'm 99% sure i have TOS. i'm terrified of surgery, what kind of therapy should I do?

[@szyszak9424]

upper back strenghten, stretch lats, chest, subscapuilaris with PNF method

[@KT-ed8hj]

i was diagnosed with arterial tos last year. pinching my shouders back actually exacerbates my symptoms.

[@silverfullbuster9177]

What were your main symptoms like. I'm not sure whether I have neuro or vascular? Did your hands turn blue?

[@KT-ed8hj]

@@silverfullbuster9177 i saw two neurologists who said i was fine after mris and emgs then i a cardiologist who was able to diagnos me right away after a few tests.

[@KT-ed8hj]

@@silverfullbuster9177 hands going numb while laying bed and texting. Arm pain throwing balls.

[@gobi123taw]

@@KT-ed8hj Any luck with the recovery? i too have ATOS.

[@KT-ed8hj]

@@gobi123taw ya postural restoration institute everyday. (pri) bunch of free content on here and online

[@R4dr1ar]

I think this is a simplification of TOS genesis. I is well known (histological studies) that the scalene muscles of most TOS sufferers have structural changes i.e. more rigid collagen I instead of type II, and amounts of fibrosis. This, in turn, actually does pull up the first rib ("the ground"). Furthermore, can you really pull up the clavicle? I mean it is fixed in the AC joint, won't this give you arthrosis in the long term?

[@Stoffendous]

So you're saying once your scalenes are fucked it's all over?

[@alexanderh.6603]

If it's the scalenes do a first rib adjustment. And work on your weak scalenes

[@bobsinclair2026]

survived the surgery? there has been no reported deaths from first rib resection surgery. most patients have good outcomes. massage work and PT is OKAY for mild cases like what you had but some people have venous compression like me and get DVTS. thrombolysis followed by first rib resection is currently the gold standard and standard of care for people who get clots from TOS (look at steven stamkos nhl player who did the surgery who had tos who is the posterboy for this problem)

[@Uprighthealth]

Hi Bob, thanks for your comment. At 2:52, I did not intend to imply that people die from this surgery. It was simly poor word choice for those who have undergone the surgery. To your point, from our literature reviews death from this surgery doesn't seem like much of a risk - which is great. While we are of course glad when people get good results from whatever they do to relieve their TOS problems, this video is intended to provide a perspective which might not otherwise be presented. For people considering surgery, the promised relief can be very appealing, and at the same time, part of the story often doesn't get told. There is a very high rate of recurrence of symptoms following TOS surgery. This is a strong indicator that the surgical approach may not be the best balance of risks and rewards. This post provides an exhaustive overview of the risks and outcomes of thoracic outlet surgery from peer-reviewed literature: uprighthealth.com/does-surgery-for-thoracic-outlet-syndrome-work/

[@bobsinclair2026]

thanks for the reply, the link provided good info. i think i will still proceed with the surgery because my tos is venous and not nerve related.. my surgeon said if i dont do it i will have to be on blood thinners for the rest of my life

[@michaelb6510]

@@bobsinclair2026 did you do PT though or strength training

[@stephaniegutierrez6222]

Another question. Will doing shoulder shrugs make an elevated first rib worse? They say my first rib is elevated.

[@dejankanazir3927]

no. but shoulder shrugs works the levator scapulae the most . but you should try kelso shrugs for upper traps

[@shermac8463]

I tried PT for many months and ended up having surgery for my TOS. The surgery didn’t hurt me, but it didn’t help. I am one who has severe TOS pain. I ended up with TOS being a long time competitive swimming and having many shoulder surgeries as a result. I take Lyrica for nerve pain because i need to function, I am a very active woman and would be in bed with pain everyday without nerve pain medicine. I know many other TOS sufferers who would be on permanent disability without medication. Please don’t pill shame those of us with severe TOS pain. You think we like to take it?

[@jcchaffin1]

I’m having surgery tomorrow. I too tried therapy for 6 months but I can not take this pain. I hope the surgery works!

[@szyszak9424]

@@jcchaffin1 Did you include any exercises which elevate the shoulder girdle? Make the upper trapezius much stronger which keep and preventing shoulder and collarbone from collapsing and impining the brachil plexus

[@jcchaffin1]

@@szyszak9424 no, I just did deep tissue massage therapy. And ultra sound. I did a few stretches. I had the surgery 3 days ago and my hand and arm pain has now subsided. Recovery so far has not been too bad, I just have an ache in my back and chest. I hope I did the right thing.

[@szyszak9424]

@@jcchaffin1 I hope you will be healthy and it never came back.

[@silverfullbuster9177]

@@jcchaffin1 what were your main symptoms? Also was yours Venus tos or Neuro TOS and has the surgery helped?

[@betweenearthandsky4091]

Does this work also for venous cases please ?

[@kurtdaniels5470]

I have been dealing with TOS bilateral for about a year. When I was doing PT for it, it seemed to make it all so much worse. Is this normal? Should I just push through it or is there something better I can be doing?

[@sara_qr6nl]

was the physiotherapist trained to specifically treat TOS?

[@IzVlad]

How are you now? Please respond me, i have it bilateral one with so much pain i want to kill myself i cant live like this, what has helped u?

[@marija.maravic]

@@IzVlad how r u now? What type of TOS you have

[@kristinas5714]

Why does physical therapy fail so often is the goal is to improve muscle strength and posture ?

[@a451F]

Hi ! Thanks for the video ! I'm also dealing with artery TOS, it's very complicated to live with, and sometime i will prefer die, nobody around me really understand.. i have been doing physio for several months and i can only see few results but i'm wondering now if the good choice is to do surgery... i don't want the thing going worse.. I have no extra rib or scalene muscle, or clavicle anomaly.. do you an idea of how much time it's need to heal or if it's possible ? I've lost all hope...

[@a451F]

@@astonh8499 Thank you !

[@astonh8499]

@@a451F don't loose hope, after doing the neck exercises recommended on the video for the scalenes, (I did them twice a day five days a week) it will make you feel very sick but I saw great improvements on my symptoms in about a month, I've been doing them now twice a week , and I am 90% better it's been 9 months. DO NOT GIVE UP.

[@a451F]

@@astonh8499 Thank you very much for your help and you support ! I will try this !

[@szyszak9424]

@@a451F I admit this article has very useful informations. Upper trapezius is the muscle to strenghten for people who suffer from TOS

[@a451F]

@@szyszak9424 Yes a lot things make sens in this article but i don't understand why strengthening the scalene can be useful...

[@lw7654]

What exercises do you recommend?

[@szyszak9424]

modified shrugs and overhead shrugs choose any which you feel the upper traps.

[@lw7654]

@@szyszak9424 thank you for your reply & exercises. Did you also have neck issues...ie balance issues? That’s the newest thing for me. I did a little upper trap shrugs today. and will slowly continue. Just wondering , did you happen to have an elevated first rib? My one pt said she thought that’s what I may have. Have you had any experience with that? Thank you again, just trying to figure this all out.

[@szyszak9424]

@@lw7654 Yes bro unfortunatelly I suffer from chronic neck pain and slowly recovering from this by strenghtening the right muscles. Shrugs are great but try also over head shrug and release, stretch pec minor. You can email me here : [e-mail] so we can talk more about the exercises.

[@motomax629]

those of us with extra cervical ribs really don't have any choice but surgery

[@rtkl13]

Sounds like more of a therapy for venous vs. neurogenic problems

[@carbotradingcompany4794]

Great concept with no solutions. A ton of people commenting below asking for exercises recommended to lift that clavicle and no response at all from you. Kind of a dumb video with no way to use the information.

[@jaypalani]

I second your opinion. Its not only the reasoning behind TOS but a workable solution everyone is looking for... the very purpose why we are watching this video. pls suggest some workouts. and not just illustrations of why... what next is the need of the hour.

[@vh448]

Good point but if he provides all free info here, why would people go to his site to pay for his program? The purpose of his videos or anybody's KZbin video is to promote your service or product.

[@dorionm2683]

This surgery seems too crazy , to cut off a bone and muscles just like that... I am no doctor but I would think wouldn’t it be better to do the same type of procedure as they do with shoulder impingement... they shave down part of the acromion and clavicle bone to allow better spacing between the bursa and the rotator cuff tendons... they should be able to do the same for TOS, shaving down part of the clavicle and 1sr rib rather than cutting it off... I would believe that TOS surgery would have a negative effect on people who have active lifestyles such as weightlifting or sports or a job that requires to be strong or moving a lot and as people get older it would be very difficult to live without their 1st rib and scalene muscles there... there has to be better methods as technology and scientific research is only being more advanced especially in the medical industry... TOS surgery is like unnecessary amputation I’m my view..

[@steveshao24-77]

You just said you’re no doctor. Clearly. You sound ridiculous

[@Izzazzo]

no exercises? c'monn

[@megancolasono1108]

Your facts are not correct at all?! Wow! Go to the John Hopkins or Baylor Medical college site and watch videos by Dr. Lum and Dr. Burt. It is so important to do intense PT after surgery or you will have scar tissue and more pain. Try PT and botox before and if it doesn’t work do surgery and PT after all the efforts you have made. Most of us have tried just about everything before we look at surgery.

[@Uprighthealth]

Hi Megan, we haven't had time to update this video yet, but we feel the PT protocols for "TOS" are generally too passive and do not adequately address the muscular weakness that leads to poor scapular/rib/clavicle positioning. Based on the research on surgical success rates for TOS, cutting muscles does not seem to solve the problem in the long run AND produces some nasty side effects. Cutting muscles out does not solve problems. It kicks the can down the road and creates new ones. That's a reality that surgeons generally do not acknowledge or discuss, but it's something anyone considering surgery should consider. If you temporarily paralyze the muscles of your lower leg, you'd end up compensating with a limp. That would create body-wide compensations. If you REMOVE muscles, you are creating a situation that will likely require permanent compensation.

[@Uprighthealth]

And best of luck on your journey! I (Matt) suffered with constant arm and forearm pain for years before finally figuring out what my body needed to get more stable and strong.

[@megancolasono1108]

Upright Health while I can agree with that side unfortunately I have compression of the rib over nerves and arteries going on. I have lack of circulation and my quality of life is mostly bed bound. I think of patients take PT seriously and understand what you just said about muscle they can recover well from surgery. Not all cases require removal of muscle and some just a piece of rib. I think it depends on the state of the patient and in my case nerve damage. I have done PT and botox for years and it’s only getting worse. I’m 34 and was a hairstylist then when I had a baby it got past the point of no return. My case is more complicated because I have diagnosis of Fibro and Chronic Fatigue now. I had three severe whip lash injuries and scoliosis plus stenosis in cervical spine, bulged disc and slipped discs in lumbar spine. I’m a bit of a mess. If I can alleviate even 30% of my pain that’s a win in my book. I’m no athlete and only want to have better quality of life vs going back to a physical career. Expectations are important as well. I’m the last person to have surgery but I don’t know that I have much choice with how bad my tos is. I’ll know more after proper imaging in two weeks.

[@Chosen45612]

Fultz

[@aleksandarbastajic2782]

Exactly! His posture is horrible, shoulders rolled forward... After many years of accumulating he came into situation today - TOS! What is unbelievable is that there was no one to tell him "dude keep your back straight, go to gym and make back muscles stronger"... :/

[@kamakazifate]

bro chang, pls jus help a nigga out and give him the muscle name to work on before he clots up and dies... aka help me

[@ericGT50]

Ummm you don’t say anything about how to fix this - all this is, is an anatomy explanation. You’ve done zero to explain any treatment modalities.

[@szyszak9424]

make stronger upper trapezius muscle which elevate the shoulders to decompress thoracic outlet.

[@5driedgrams]

Thank you so much, I was almost getting surgery. My right arm veins also doesn't show a lot and I'm feeling pain in the shoulder and neck, plus a lot of clicking. Is there any exercise specifically that you recommend?

[@Mistress_Macabre13]

Sounds like exactly what I have and have had for 13 years. I only just got a diagnosis three weeks ago. Or course the Dr recommend surgery. Made removing part of rib sound like a piece of cake! 😳