Before anybody reads this post, I just want to say that this is my OPINION and that it may only make sense to me and my tos.
I believe I got my TOS because I have weak joints that can be unstable. My left shoulder is more unstable because I had an injury to it. I continued to lift weights (chest and bi's the most), swim 3x/week, and surf. Additionally, I worked on excel spreadsheets all day at my job. This helped rotate my left shoulder in just enough that it started irritating my Brachial Plexus (BP). Then the fun began.
Originally Posted by nospam
My left shoulder is now already very near to the ideal position while my right is still slumping far forward. This is now making me think that TOS in and of itself can cause the postural problems.
This is the conclusion I have come to. Check this site out:
Dr. Nath is a brachial plexus (bp) injury expert and the muscle/postural problems we have are all too common to him because because it is more obvious in his patient population. Never the less, I believe we are dealing with much of the same development of muscle imbalances, etc.
For the longest time, I thought the muscles were the primary problem and through overuse/repetitive use, the imbalances occurred. Once this happened, this caused compression on the nerve --- and the neuro-vascular problems follow. For a while now, I no longer believe this is the case. I believe that the bp gets injured/irritated. The nerve damage then causes weakness in some muscles and other muscles remain strong. Ultimately, this causes the postural problems --- the inward rotated shoulders, etc. I believe the BP injury causes the intractable
muscle imbalances and ultimately the downward spiral into TOS hell ensues. For me, when I am flared up, there is a spot just above my collarbone that causes all my problems. When that nerve is sensitive/inflamed/irritated, the muscles become spasmed and very tight, then the blood flow problems start --- I get light headed and superficial veins in my arms and chest start popping out. Also, my left shoulder starts to creep up and gets higher than the right. I believe it all starts with the nerve getting irritated --- then everything else follows.
To quote Dr. Nath: The situation of muscle imbalance is very common among patients with Erb's palsy and with other brachial plexus injuries. In our experience the majority of children whose injury does not resolve completely by 3 to 4 months of age will end up with a specific series of arm restrictions caused by a muscle imbalance between injured and uninjured muscles.
Among the muscles injured in Erb's are the abductors of the shoulder (that lift the arm over the head), as well as the external rotators (that help to turn the upper arm outward and to open the palm of the hand).
At the same time, the internal rotators (muscles that turn the arm and palm inward) and adductors (muscles that pull the arm to the side) of the arm are not involved in the injury because they are supplied by the lower roots of the plexus.
Therefore, these strong muscles overpower the weak muscles and over time the child cannot lift the arm over the head or turn the palm out, because of the muscle imbalance.
Imagine a Dr. looking at one of these kids and telling them they have muscle imbalances and that physical therapy will help straighten them out.
Look at the MRI's and see how the shoulder of the affected side is rotated in. After his mod quad surgery, that is corrected. I have called his office and tried to talk to him to beg him to look into the TOS population to help restore their posture ---- but no luck. I believe that a tos surgery along with a reattachment of the latissimus dorsi and teres major to the outside (lateral aspect) of the humerus (as he does in his mod quad) could be an even better tos surgery with a higher success rate. If I ever get PPO ins, I would like to fly to see him and ask if he would be interested in teaching TOS DR's how to reattach the lat and teres major --- and also explain to them that the BP injury is what is causing the medially rotated shoulder, and all the other postural problems---- that PT is not able to overcome because contractures have developed and nerve problems are the cause of the intense spasms.
Right now I am 60% normal with the medications and possibly the exercise i do. I focus on neuroinflammation,inflammation in general, and muscle inflammation/spasming. My blood flow problems (superficial veins) go away when I focus on these things.
Sorry for this reeeeaaaaallllllllly long post. I just wanted to put my thoughts out there.