The Game-Changing Approach To Thoracic Outlet Syndrome (you’ve never tried this)

Physical Therapist in the video is James Guzman. Check him out: ( jamesguzmanprc?...)
0:00 What causes Thoracic Outlet Syndrome?
3:40 Manual Therapy Technique #1
9:06 Manual Therapy Technique #2
13:00 Step & Exercise #1
17:22 Step & Exercise #2

[@conorharris]

Thank you for watching everyone! If you are interested in learning more, I recommend watching this video on the ribcage and thoracic position: kzbin.info/www/bejne/jqS7YX2thM-qidE. If you want more free education, I recommend you check out my newsletter which I send out weekly with exclusive content I don't have anywhere else: www.conorharris.com/newsletter

[@umeshparmar2592]

​@conorharris please make a video on hiatal hernia pleasseeeee.

[@davestrongside8805]

Trevor is probably the best model/demo, works so well in tandem with your do's and don'ts

[@deniseteraoka3374]

I have been contending with frozen shoulder and 1st rib/clavicle displacement, subluxation. I have never heard of thoracic outlet syndrome but this totally explains what’s been happening! Thank you.

[@lilglilg2011]

every video you drop, you address all of my issues, you are a magician, THanks very much!

[@coachpaul-vedicfitness]

James is the man !!!! All my love from France to you two

[@denachea7533]

Absolutely love your videos Conor. So informative. I never realized my shallow breathing caused so much problems for me.

[@littlejOwnsU]

Would love more TOS videos from you. This is a unique approach I haven’t seen. It is ALL about the breath and tension for me. It’s been 6 years I’ve dealt with this

[@motherholisticcbd2038]

Exactly what I’m suffering with. Thank you for making such a great video

[@user-rt7wl2yg3u]

You changing my life ovah here, thank you so much

[@conorharris]

Happy to hear that!

[@dmcgill9360]

There's only one Connor, and he's a genius ❤❤

[@awrightmate5826]

Nice to see some hands on treatment before exercises :)

[@xdeepak12]

best coach thanks for the great insight. It never made sense to me to hyper extend spine and squeeze shoulder blades all the time

[@nexnexusnex]

Conor show us more manual techniques please!

[@andreasmerkle1011]

thanks for this new idea. Can you please explain in more detail why the angle of the clavicula changes? That's not clear to me. And please do more TOS videos.

[@Caribbeanlori]

Im 59 female. I've been suffering so very badly 5 years with this problem. So many x rays and mri no doctor has been able to diagnose me. I even saw the TOS specialist in Boston, and he said he didn't believe I had this. I can't live like this because I can't sleep. I don't know what to do.

[@erkind9687]

Another great video, Conor. Do you see a benefit in one doing foam rolling of the chest, lats, as is traditionally recommended THEN doing the breathing exercise at the end of the video?

[@divineglitch9550]

thats amazing thank you.

[@user-bk2dn7sv7f]

Absolutely love your videos. I was recently diagnosed with Arterial TOS (it took over a year to get). It's interesting how only the basic symptoms (such as arm numbness) are discussed, when there are so many other symptoms that arise (and overlooked) from TOS. I do have a forward posture, with some spinal curvature, a slightly 'winged' scapula on the left with the left shoulder rolling. I also have 'flared' ribs on the left side. I was wondering if you would suggest working on the the alignment of the spine first?

[@lorenzoquintana90]

it would be really great if you add some links to articles in the description

[@Urukior4]

I had right side first rib resection surgery for TOS earlier this year and I have a pec minor tenectomy in a few weeks. I am a complicated case though as I deal with cervical spine nerve and right brachial plexus trauma, in addition to a moderate/severe tbi, majority being left hemisphere. So for me there is much physical trauma as the root cause of my TOS. The hope was that the first rib surgery would be enough to alleviate this and not need pec minor tenectomy, but that was not the case (though I did get some nice improvements that made it worthwhile... and some fun scar tissue pain). I had the more modern version of the surgery where it was video assisted robotic surgery, not the large incision manually done. My pec minor is still very much an issue though as it is essentially overactive and a constant problem for my arm. Let me tell you though... the first 2 days in ICU from first rib surgery were PAINFUL for breathing. Losing my front and middle scalenes definitely were noticeable with breathing, so I wonder how messed up my before surgery breathing was like you have shown. They essentially reteach you to breath and have you constantly using a spirometer to improve at it. Coughing and sneezing? Near pass out pain, even on tons of IV drugs and nerve block injections.

[@lemonpulpmusic]

It's hard to find specialists or physical therapists who are willing to watch a video. It would be awesome to find someone nearby who could perform these techniques

[@tormendor8585]

I've got cervical ribs and apparently that causes some compression in those areas. I'll give this a try and see how it goes!

[@shawnermcgregor]

Sucks that theres such a talent gap between PT's. I've been to many and i have 100% insurance coverage with no limit per year and none of these issues that have most certainly have have ever been addressed.

[@calllialea]

the first one i did it myself and it relaxed my left side of my neck

[@chamelious]

Been dealing with what I/various doctors and PTs think must be minor TOS that gives me very quick fatigue in my arms when playing guitar. They seem to get vascular when I'm playing too. Would love to see more content on this. (I've had every scan and test possible and nothings been found)

[@TheHollowGram]

For me it was a rare condition of tight forearm fascia that restricts space for forearm muscles. Next year will have a simple procedure where they open fascia w surgery that should fix it.

[@yesssir7561]

Wow same man, they don’t get fatigued but very hot and veiny too, does it hurt if you hit those veins ?

[@Kyliethegreat]

I want you do an exercise program for me ,dextroscoliosis , A good looking guy like you teaching me will motivate me to do it everyday while I can see you teaching me on television ;)

[@user-mr1ik3nw2q]

Hi can you please make a video about Hallux rigidus?

[@GT_V]

I've had a major issue that just developed this past January. My left Pec Major (specifically the sternocostal head) will not contract. The functional result is symptoms that look like muscle weakness during pressing exercises, however, I don't think it's a muscle "weakness" but rather just one large portion of muscle not getting innervated (so only the clavicular head, front delt, etc are working to help any chest pressing movement). I also have noticed a lack of innervation of my left triceps muscle but just one head not all three (lateral head contracts fine). I've weight lifted the majority of my life and I've experienced significant and very noticeable atrophy over this year since the symptoms began in January 2023. I've had an MRI that yielded a "negative" report, however, I'm not sure that they scanned down into my chest where nerve impingement could be occurring. I've also had an EMG but that only concluded what I already knew which is that the sternocostal head of my left Pec Major isn't receiving any electrical signal. I'm having to deal with a lack of understanding of my condition from several medical professionals, and the only saving grace is that I just recently graduated and became licensed to practice physical therapy in my state (my final seminar research essay in fact happened to be over TOS). Because of this, I'm very familiar with all the anatomical intricacies of TOS which is how I am at least able to narrow the muscle innervation impingement to most likely the lateral pectoral nerve for the sternocostal head of the pec major and the radial nerve for the left triceps). Due to the MRI not giving me any productive conclusions about the chest area impingement ("Left arm weakness" diagnosis ended up getting me an MRI of my left arm, not the musculature that controls the left arm, i.e. Left pec major/minor). The only thing I have to go on at this point is this thick, fibrous band of tissue right in the center of my left pectoral muscle, about 3-4 inches inferior to my left clavicle. My problem is this, I have been performing every single conventional bit of TherEx possible for almost an entire year now (radial nerve glides, tennis ball pec minor release, graston, doorway/corner stretching, first rib mobilizations, etc). This has got me absolutely no resolution to the muscles not contracting. I am not experiencing any other typical TOS symptoms such as pallor, tingling/numbness, or pain. The *only* thing I can imagine that caused this was my introduction to camber bar bench pressing late last year (around November 2022) where I was aiming to increase muscle hypertrophy through deep stretch under tension. My best guess is that this produced hypertrophy in my pectoral muscle which became imbalanced and caused impingement. I need SOMETHING to head towards in regard to treatment for this issue. I believe this can still be resolved with soft tissue work, but my primary care physician has just defaulted to suggesting surgery without being well-educated on the subject. I'm of the understanding that outside of nTOS caused by a C7 "cervical rib" bony anomaly, or some kind of actual nerve damage trauma (neither of which I'm experiencing), all other cases of TOS can be resolved with conservative therapy techniques. Do you have any other direction I can go in to release this fibrous band of tissue in my mid-pec major? I've tried everything and none of the stretches or soft tissue mobilizations I've done so far seem to work. I'm not certified in dry needling, although I've seen it many times throughout my clinicals. However, I believe its intended use is to encourage blood flow and healing rather than releasing tight muscle.

[@antonvannelli9085]

Interesting, I used to have the SAME exact issue. To the T. In fact when i first attempted to contract the area that I found, I felt intense referral into the neck and the shoulder itself. What is even more interesting is that you (like myself) figured out what the real problem is, that the muscle will not contract. I had multiple shoulder injuries through my early 20s and playing sports such as basketball/football. We have a very similar story. It got so bad that I could not even do a modified push up at one point without severe shooting pain. Instead of writing an essay in response to you (because I most certainly could), I will simply direct you to google atheq system and read/research as much as you like. I can say though, that you would be extremely surprised to learn about how many mysterious and unexplained conditions are at least related to the issue that you have mentioned. The brain no longer having the ability to "contract" (let alone load) that area. Wishing you the best!

[@lukedunn6107]

The pec thing sounds really familiar 🤔

[@walkwagrepeat]

12:59 Thank you!

[@swaha55]

My right hand gets colder than my left hand in the winter. Could this be from a mild form of thoracic outlet syndrome?

[@louisacurrier2951]

I’d love to find a therapist eco could do this. My osteo is good but every tine he adjusts my top rib it only last a few hours

[@jakesacquitne]

I was born with very mild pectus excavatum, and have dealt with chronic pain in my left side, neck, and shoulder my entire life. Ive always been told that’s why I have the pain and I’ll just have to manage it. Super active and healthy otherwise. No one has told me about TOS and I’m really excited to try looking into this. I’ve seen different doctors for 17 years and have had no improvement (I’m 34 now). And no one has mentioned this the entire time.

[@conorharris]

Hoping this helps you 🙏🏻

[@klankius]

As someone who had surgery for pectus as a teen (also 34 now), and has been dealing with neck and back pain their whole life, I can also share my experience. Inward sloping ribs causes my body to really not prefer using scalene/rib/neck muscles at all for breathing, since the ribs require so much more work to be moved since they are at a tighter angle inwards toward the chest. Also, the lack of support of chest bones causes sitting posture to automatically reinforce forward head posture, as the chest is not support the weight of the head/neck. For me, this manifests in my neck, trap, and even scalp muscles all completely tightening up and shutting off from my nervous system. I kind of gave up on medical professionals being able to help me in any way, as I've done years of physical therapy and have to do exercises every few hours to mediate my symptoms, and it really has bogged down my life with no long term help in sight. However, learning a bit about ToS from the internet and these videos is the closest I've felt to finding some help, and feeling like I'm understanding the problem more comprehensively, so I think this is the right track to explore. The best things I've found to help me are to stay active (literally every few hours, every day), focus on full breathing whenever I feel a lot of physical symptoms, neck decompression therapy or devices, minimize stress if possible, no alcohol. It may be worth asking your doctor about pain management. I've also wondered about stress buildup, and how our bodies deal with physical stressors like cortisol and lactic acid. as well as Co2 buildup/oxygen exchange and how these functions relate to chest cavity pressure during breaths (for those of us with compressed chests who take way smaller breaths on average). Good luck out there

[@yesssir7561]

Did you get results?

[@jakesacquitne]

@@yesssir7561 100%. This has unlocked some stuff in my upper body and neck that’s giving me some nice progress in other areas now.

[@DamiJlo]

In some countries, there are laws regarding manual therapy. ToS is one condition that requires manual therapy. So it may be possible the physios dont feel comfortable due to poor and healthsystems antagonising people. Sadly if you dont learn it in your early years of practice. It won't be done in more senior years because of the embarrassment of improper technique. There are many approaches to managing TOS, as you may have noted on the internet. All have the same goal, They dont all work because the mechanisms that lead😂 to it are not the same, although the same area of the body reacts the same way as such it is called a syndrime. So,It takes a not of clinical judgement to tell which will Often, simpler is better

[@sterrell12]

How do you differentiate between TOS and cervical radiculopathy?

[@giggiofaffo7231]

Could you please do a video on how to fix ql pain / tightness ?

[@amelin1612]

Yes this please

[@tamarasonmez8077]

What do you think about chiropractor care…I went to a sports chiro and he did active release technique but he really wants to do an adjustment on me…crack my neck and I won’t let him. Thoughts?

[@PercentFirst]

should I do the #1 exercise with the blade contract or just relax.cuz I feel not flat on the blade area

[@ashleytaylor994]

What about pain under clavicle associated with winged scapula

[@ArchlordZer0]

I think I might have Venous TOC and I'm really afraid. My arms feel fine most of the day and the exercises improve my symptoms, but my neck always feels tight. I just don't want to get surgery. Does Venous TOC always require surgery?

[@dwayne4260]

This video seems to be more for the medical person applying these techniques than for the patient who needs the exercises because the patient can't perform these exercises by themselves. Well at least most of them. Great video though

[@sbro17]

It’s for the patient so they can understand the mechanics of the issue and the fixes involved, it’s always better for the person to understand the how and why in order to prevent it in the future. He says before the demonstration that it must be performed by a professional with specific licensing to perform the techniques.

[@eemerald2323]

Does this fix a raised first rib? Even lateral or rotated????

[@dominatorkd]

bro just got felt up. jk thanks for the good work!

[@Stoffendous]

You're my Harris, Conor!

[@StoneAgePHD]

I didn’t know thatMatt Damon is doing PT work?

[@G4mer_D4d]

Sifu once said, "it hangs off the shoulders like a clothes hanger" I feel its all hanging off my right shoulder and im twisting like an unbalanced thing on a string. Ive got a chiro on Tuesday. Ill mention this. I always forget if its up the front, down the back or vise versa 😂

[@marija.maravic]

Can I fix my bad posture? I'm 42. Or is it too late ?Decades of bad posture caused my bilat.TOS😢😢😢 please give me some hope.

[@sambbbb]

Which of your programs do you think would be best for TOS, pain around the ribcage, and neck issues?

[@conorharris]

Shoulder health program for sure

[@AlRayyanFoundation]

Lot of information in this video. My daughter have TOS.can I discuss with you. I have her reports

[@ILoveWeightedPullups]

TOS sucks. Will have to have surgery in May due to it being Vascular.

[@LkGfx7]

Please can I ask what symptoms you've been having with vascular TOS ?

[@nevoarad8276]

​@@LkGfx7if he talks about vtos he had a blood colt or another significant vascular event (more than just some color change)

[@T3hAlex]

14:40 My hands start to tingle at about 40 seconds of having them rotated like that

[@blink99v]

What if we feel the neck kick ok during exhale too?

[@delmar1387]

I have had this same issue as you. What I’ve found is if you put a little pressure on down with the heals and make a light effort to keep the neck and low back pressed into the towel and ground respectively while exhaling and during the pause, you can start to feel things open up as long as you “stay relaxed” within the effort of keeping the neck and back down. Hope this can help!

[@FakhrurrazieJaffar]

I need some clarity. The ribcage is rigid and as we breathe, the lungs will expand and contract within the thoracic cavity. So, just wanna know how the pushing as he breathe can alleviate the problem. I'm not an expert, I just wanna learn and understand.

[@BlackMesaTrainee]

The way I understand is that it is about the reactivation of the primary resparation muscles / diaphragm, to reduce the tension of the secondary ones like the scalenes. When the ribcage moves/inflates the propper way the muscles causing tos won't overwork.

[@FakhrurrazieJaffar]

@@BlackMesaTrainee hm...that could be the case too. Thanks for your insight bro.

[@chombbii7989]

Can I run, jog, or sprint during pri? For long distance?

[@jonathansenkow3955]

Do so by breathing thru your nose only. Check out oxygen advantage on the tube best thing I've discovered.

[@manixburn6403]

Poor skeleton, leave it alone you monster. ;p

[@fritztheman749]

This dude has issues. You don't have to take my word for it. He steals intellectual property and will eventually be taken down.

[@jkrisanda2011]

Time to let the hair go for the second guy. Shave it off and get SMP.

[@Stoffendous]

You tell em man!

[@shawnermcgregor]

Would have gotten more views with a female example 😂