Scalene and Upper Ribs Release for Thoracic Outlet Syndrome (TOS)

Do you feel pain under the corner of your shoulder blade?
It might be that the second rib is slightly out of place, and causes this pain scalene that is commonly found in thoracic outlet syndrome (TOS).
In this video, I will show you
the link between scalene muscles, first rib & second rib and forward head posture (FHP)
what you should do to release the upper ribs if when they cause upper back pain (which can radiate into chest pain and arm pain, and compress the plexus brachialis)
- 4 exercises to mobilize the upper ribs, taken for most from Karel Lewit (Manipulative Therapy in Rehabilitation of the Locomotor System)
Chapters
00:00 biomechanics of TOS
05:56 upper thoracic spine
07:02 self mobilization of the upper ribs
using scalene muscles cyclic strain
08:45 mobilization of the upper ribs using breathing
09:52 scalene cramping exercise
AND REMEMBER TO FIX FORWARD HEAD POSTURE: here the video with the full posture therapy protocol that I use with my patients: • How To Fix Forward Hea...
A lot of the pain you feel is caused or aggravated by wrong posture, poor ergonomics and a lack of specific exercises for your muscles and joints. Giving you the tools to resolve these issues is the reason why I created this self care channel.
If you need more, check out these two innovative offers that will truly empower you in the subtle art of posture correction:
- you can get THE POSTURE MANUAL, my best-selling book with 15 readers-only posture correction videos - only if you buy it from my website: oliviergirard.ch/en/boutique/...
- to enjoy a personal coach and a lifetime membership to my private Facebook group, consider joining THE POSTURE ACADEMY: oliviergirard.ch/en/posture-a...
---
Medical Disclaimer
All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider.
Full disclaimer:
oliviergirard.ch/en/ytdisclai...

[@ampmodclips]

Fantastic been looking for this type of video for years and is the exercises I needed, thanks so much!

[@heartchakra2]

Superb video. Exactly what I need. Thanks ❤

[@Ruger1bc]

Thanks! Buying your book. After YEARS of serious cycling and limited neck/scalene mobility I must take action. Appreciate you as a resource.

[@craig6460]

THANK YOU ✨️ I'm struggling with pain and pressure due to Thoracic Outlet Syndrome. Your exercises have given me much needed relief this morning. I cannot thank you enough. You're a fantastic human!! 😊😊😊

[@OlivierGirard]

Waoh Craig, thank you so much!! Your comment went straight into my private file of feel-good contributions. I appreciate your feedback immensely, and I'm delighted if I could be of some help!! To push it a bit further, you may want to check this 8-weeks protocol to deal with forward head posture: kzbin.info/www/bejne/b5KYqJ6Co8loaqs 😉

[@hanikhellafi4872]

Merci Oliver. Ces exercices sont tres efficaces.

[@azlizzie]

I feel so great after doing these exercises. Thank you. I love the term bathroom exercises. I definitely can do these every time I’m in there instead of scrolling. Excellent. I wont have to sanitize my phone as often, either. 😅

[@scottdreher8122]

Thank you. Good stuff. I can feel it working.

[@Nidge.]

Such good information

[@gskyle4822]

6:01 exercise 1 8:01 exercise 2 8:55 exercise 3 10:10 exercise 4

[@OlivierGirard]

Excellent point, my friend! I have updated the description to allow the automatic chaptering 😅

[@lindafriedmanschmidt4863]

Thank you. You are a very good teacher because you explain everything in detail as you demonstrate. The 4 exercises are very helpful. Is bending backwards in yoga camel pose with the head all the way down harmful to the scalene and upper ribs?

[@jmagnifico7550]

you are a nice guy thankyou Olivier

[@OlivierGirard]

thank you my friend!!

[@wingsuner9137]

fantastik, thank you

[@michaellieberman9419]

Man this might be my issue. Will be working these in several times a day.

[@OlivierGirard]

... and if you haven't done so already, invest some time on this protocol: kzbin.info/www/bejne/b5KYqJ6Co8loaqs !

[@joshuaroberts6712]

Dr. Girard, thank you! again! lol I was following your other videos for relaxation for my chronic pain that seemingly covered my whole body more specifically when you touched on TOS ( neck issues/shoulder/muscles issues) on other videos it made sense for me. These exercises are unique and helped me in a big way not just pain-wise, but breathing as well!! which is huge because I felt like I couldn't catch my breath or I couldn't do it effectively. This material is so interesting to me I downloaded the book you suggested and want to give it a read. is there more info about TOS and special exercises like these? Does it cover FHP

[@OlivierGirard]

Hey Joshua! Thanks for the super kind feedback!! There's a full video on FHP: kzbin.info/www/bejne/b5KYqJ6Co8loaqs, plus I'm gonna shoot a re-live hopefully this week with a slightly different approach to it. Let me know if these help!!

[@victoriafernandezboron3359]

Hopefully Santa will bring me a copy of Manipulative Therapy in Rehabilitation of the Locomotor System for Christmas this year! it was almost $150 on Amazon!

[@OlivierGirard]

Yep… I know. Write a very kind letter to Santa 😅!!

[@ginny177]

I would like to know how to strenghten hyoid muscles in correlation with scalenes.thank you

[@christinesciortino476]

Salut Olivier, I have this issue and also flat upper back - lost curve in my cervical spine AND thoracic spine. Do you have some videos for these problems. Thank you!

[@ginny177]

Exercise n. 1: Am I activating levator scapula and mm. scalenes? I have a tendency to push up my tight upper trap which is not correct..working on that!

[@Cody27]

Awesome much needed video. Have you heard of MSK Neurology on YT? I think there potential for yall to collaborate on something like TOS!

[@OlivierGirard]

Thank you mate :) I’m gonna check out their page, it’s a perfect plan for the holidays!

[@ginny177]

they are not super impressive? these exercises are the most impressive thing I have seen so far..honestly

[@carlosgonzalezdiaz1529]

Hello, Dr. Girard. I wanna thank you because your videos have really helped me. A couple of years ago I was diagnosed a C6-C7 herniated disc and I wonder if the constant pain I have in the scalene and in the left shoulder blade comes from this problem. Anyway, these exercises you describe in this video really helped me. My question is: since I suffer from chronic pain, how often should I make them? Thank you in advance for your answer. Cheers

[@OlivierGirard]

Hey Carlos! Thanks for your message… the causality of pain is always an immense debate in medicine, and nobody has a definite answer for it. In other words, the pain you feel may come from your old hernia, but it may also be something else. For example, your hernia could come from your bad posture habits, which also overload your scalene…. if so, the cause of your tight scalene is not the hernia, but the bad habits that have also led to the hernia. You see what I mean? This is why I tend to tell my patients: « Listen: forget about being certain. Let’s define a scenario, work along its lines and see where it brings us. If it fails, we’ll adjust. » For you, the scenario would be my usual thing, which is… let’s work on forward head posture :) ! I’m serious… Reg. the exercises in this video, same… there’s no universal answer. But my advice would be that you aim at 3 times a day, bearing in mind that they are symptomatic exercises. Hence, put max 40% of your energy on them, and 60% working on forward head posture as explained here: kzbin.info/www/bejne/b5KYqJ6Co8loaqs Makes sense, amigo :) ?

[@carlosgonzalezdiaz1529]

@@OlivierGirard Thank you for your kind answer, dear Dr. Girard. I will follow your advices. Cheers

[@karlinhahf]

whats the best position to sleep with TOS and atlas misalignment ?

[@midbl]

Evercise 1 - 5:58 Exercise 2 - 7:02 Exercise 3 - 8:46 Exercise 4 - 9:53

[@ali87485able]

Can this effect breathing aswell?

[@tmcc2799]

Hi olivier, would you say the 2nd edition of this book by Karel Lewit would suffice vs the 3rd edition?? :)

[@OlivierGirard]

Hey my friend!! I'm short of an answer for this one, honestly... I only know the 3rd version (bloody difficult to find, btw!!)

[@briangraziano8986]

If you feel strain on scalene muscle and get tingling, is that normal? By strain do you mean like an expanding feeling ?

[@shubkale376]

What could cause pain at the bottom of the shoulder blade where the serratus anterior attaches, I have seen your vid on the serratus anterior.

[@OlivierGirard]

Well, serratus anterior would be my idea candidate indeed. But if you feel it isn't this, check out the pain patterns here and let me know: www.triggerpoints.net/symptom/mid-thoracic-back-pain www.triggerpoints.net/symptom/thoracic-back-pain

[@Stoffendous]

Hi Olivier. Thank you for this video, it is exactly what i am wrestling with currently. What I also have, since about 1 year, is a click in my neck (like a direction indicator of a car) when I move to the left, when I move back to mid it clicks again. So its Tik-Tik everytime I look to my left, and back to mid. So annoying! It seems to have something to do with my scms, cause if I put my fingers between the scms and jaw, and then move my head again, the click is (close to) gone. The click also is worse if i do a chintuck first, and then roate. Especially that last exercise hurts the moment i push my chin down to my collarbone. It also makes a bit of cracking noises. What does this mean?

[@OlivierGirard]

Hey mate! The first and most common explanation for clicks is tension. When there's tension, tissues don't rub smoothly on each other. Hence, the low hanging fruit for you would be to practice the upper body reset a lot (10x a day for 3 weeks) and see if there's any improvement: kzbin.info/www/bejne/gpWnn5Vpgs6qqdU. Next to this, you may want to engage into the deep work of fixing forward head posture, which surely fuels your symptoms: kzbin.info/www/bejne/b5KYqJ6Co8loaqs

[@southern842]

I didnt realize the 2nd rib was a cause for tos.

[@Fedex8016]

Hi Olivier. What do you think of the backpod for the pain/problem you describe? I know it is indicated for chostocondritis do you think it may work?

[@OlivierGirard]

Hi dear... honestly, I would be very cautious with these back-hollowing devices. You don't control anything once you're on them, and you lie down on them with your all weight. If you need to train joint mobility (which I also do daily), this modified cat cow happy dog exercise is much more progressive and precise, therefore much safer: kzbin.info/www/bejne/j2WzdWmLrbh3ac0. Try it before you buy anything ;) ...

[@Fedex8016]

@@OlivierGirard Thank you so much Olivier for your reply! Very helpful and kind as always! I will incorporate the caw-cow modified exercises to my routine :)

[@vishnudevand4493]

I am tamilnadu sir 🙏🙏🙏🙏🙏

[@YOURJOURNEY]

For those who don’t hVe time, do it when u r using the toilet

[@OlivierGirard]

toilet time is indeed an extraordinarily underestimated source of exercising time... and there are many others. I have a full video on that: kzbin.info/www/bejne/eIC4qa2mbLaJgJI

[@Annapekarkova957]

Prosím o nastavení českých titulků..., nerozumím Vám

[@steelsandport3613]

For two years my pain is awful

[@michaellieberman9419]

If someone had this problem, would it also cause chest pain around the sternum and collarbone?

[@OlivierGirard]

yep, it could... e.g., pain like this: www.triggerpoints.net/muscle/scalene and/or www.triggerpoints.net/muscle/pectoralis-minimus, and many others...

[@carlitosoe]

Hey, It doesnt sound as your lavalier mic is the one taking your voice, you might want to check your setup :)

[@OlivierGirard]

You have a very good ear, my friend... I think that I overlooked a messed up connection for a while indeed 😕

[@stephaniegutierrez6222]

Hello Dr. so I have costochondritis they say. My pain originated at my lovely dowagers hump back in October. By December anytime I laid down on my bed for longer than a half of an hour that dowagers hump area and my traps would start burning and tingling until I sat back up! The tingling has since stopped I’m not sure what made it stop but it’s no longer there. Occasionally my upper traps will feel tingly though. The pain/stiffness then went on to my ribs the following weeks and my chest. My scalene‘s are also jacked up and super tight especially on the right side not to mention my upper traps feel like they are constantly engaged! Do you happen to know whether or not the pain from that hump can also cause pain in the ribs a.k.a. costochondritis? One thing I also noticed was in the beginning when my scaling‘s were very tight and irritated the right side of my throat was also slightly swollen… My chest ribs feel like they are locked. How can I tell if I have a rib out of place or if I truly have costochondritis?

[@OlivierGirard]

Hey dear... first of all, sorry for leaving you alone with your pain for so long. Look: chest pain can come from costochondritis, but is also often referred from all these muscles: www.triggerpoints.net/symptom/front-chest-pain. At a distance, establishing a proper diagnosis is nearly impossible for me. But I can tell you that I see a lot of people with severe pain that's just due to daily issues. Hence, my advice is that you escalate progressively, going from the most common issues to the least common ones. Based on the description of your pain, slumped posture / forward head posture sounds like a great candidate for your pain. Take some time to follow the steps of this protocol and get back to me after you finished the job: kzbin.info/www/bejne/b5KYqJ6Co8loaqs.

[@stephaniegutierrez6222]

@@OlivierGirard Thank you Olivier. I will be doing this daily. Starting now. I already have a few other daily routines to help with it in place but I will be adding yours as well and I will get back to you.

[@xmoedervo]

please can you add Arabic translate 😢🙏

[@jimb2868]

Bad sound sounds like your in a tunnel.

[@OlivierGirard]

Yep... old video. I was a newbie 😅

[@guyincognito1985]

Please don't do these exercises on the toilet. Hemorrhoids suck!

[@OlivierGirard]

😂