TOS *and* keeping fit

[BKRich]

I was prompted to return by the thread resurrection.

I am thankfully about 85% recovered from the worst of my TOS symptoms and over the past 18 months have gradually restarted most exercise activities I previously engaged in. Results are somewhat surprising, and as follows. I share in case my discoveries can be of use to anyone else seeking to engage in exercise.

Resistance Exercise (weight-lifting):
# I can do almost anything without provoking any symptoms
# Overhead presses for reps remain problematic because I lack blood flow to my peripheries (arms) whilst they are abducted beyond 90 degrees
# Even exercises which involve holding on to a heavy load, like shrugs and deadlifts, I can perform without issue

Swimming
# Any significant period of swimming has led to significant stiffness bordering on pain in the muscles surrounding and to the side of the cervical spine area. The pain is entirely different to the muscular pain I am very familiar with from regular exercise over the last 20 years in that it doesn't feel muscular in origin.

Cycling
# I've found that the more upright my riding position, the better, to avoid placing my upper body load upon my arms and shoulders
# I've experienced flare-up of symptoms following a period of cycling each day for 4 weeks. Specifically, I began to awake during the night with part of my arm (all of it, or some of it, or just some fingers) numb. The numbness is caused by nerve impingement, not by cut off of blood flow

Other Cardio
# Running, skipping, Eliptical training, Stepping, all okay. Rowing a definite no no, that leads directly to symptoms within hours, I believe due to the tension in the upper back.

[Haute Mess]

Originally Posted by BKRich

Both physio's I've had have encouraged me to swim, which I've found odd. I have experimented however, and found that I can perform breast stroke and . . . . I can also lie on my back and do what I can only describe as breast stroke whilst lying on my back, with my arms performing the stroke action beginning with arms at 90 degrees to the body and ending against the obliques. Crawl and Backstroke are out, Freestyle I'm incapable of anyway

This gives me hope becasue it is too hot to run in Cuba and since there is plenty of water I would love to take advantage of the year round swimming - without causing a lot of pain and discomfort of course. I went kyaking the other day without any problems but then maybe the botox is working.

[jkl626]

Originally Posted by BKRich

I was prompted to return by the thread resurrection.

I am thankfully about 85% recovered from the worst of my TOS symptoms and over the past 18 months have gradually restarted most exercise activities I previously engaged in. Results are somewhat surprising, and as follows. I share in case my discoveries can be of use to anyone else seeking to engage in exercise.

Resistance Exercise (weight-lifting):
# I can do almost anything without provoking any symptoms
# Overhead presses for reps remain problematic because I lack blood flow to my peripheries (arms) whilst they are abducted beyond 90 degrees
# Even exercises which involve holding on to a heavy load, like shrugs and deadlifts, I can perform without issue

Swimming
# Any significant period of swimming has led to significant stiffness bordering on pain in the muscles surrounding and to the side of the cervical spine area. The pain is entirely different to the muscular pain I am very familiar with from regular exercise over the last 20 years in that it doesn't feel muscular in origin.

Cycling
# I've found that the more upright my riding position, the better, to avoid placing my upper body load upon my arms and shoulders
# I've experienced flare-up of symptoms following a period of cycling each day for 4 weeks. Specifically, I began to awake during the night with part of my arm (all of it, or some of it, or just some fingers) numb. The numbness is caused by nerve impingement, not by cut off of blood flow

Other Cardio
# Running, skipping, Eliptical training, Stepping, all okay. Rowing a definite no no, that leads directly to symptoms within hours, I believe due to the tension in the upper back.

Hi BK . Did you have surgery? How did you get 85% recovered? Thanks JKL

[BKRich]

Originally Posted by jkl626

Hi BK . Did you have surgery? How did you get 85% recovered? Thanks JKL

Recovered is not quite the right word. I no longer suffer symptoms very frequently, and those I do are mild.

I was diagnosed with the neurogenic & arterial types of TOS following EMG, MRI, X-Ray, CT scan, Ultrasound and of course physical examination. I have no cervical rib or structural abnormality other than a depressed right clavicle. There was no obvious reason for the onset of symptoms and absolutely no direct help available from physicians other than physios.

However, even at the worst of my symptoms, I was no candidate for surgery. I did get 2 consults, but the shared conclusion was there was no reason to expect improvement from surgery and I wasn't badly enough off to justify the risk.

What I did and do:

1. Stopped all forms of physical activity for a 6 month period (because I could not know which if any were contributing to TOS)

2. Lost approximately 10kg as result of 1 (mainly lean mass I'm afraid)

3. Engaged in a program of 3 x daily stretches and nerve glides, developed with 2 physios with specific knowledge & positive experience of treating TOS

4. Sleep with elbows encased in a wrap which limits the angle of contraction at the elbow joint, thus allowing the nerves running down the arm to relax overnight

5. Gradually re-introduced physical activity, spaced 3 months apart so that if an activity re-introduced symptoms, I'd have a chance at isolating the cause

6. Converted my home and office environments into ergonomic paradises. Specifically, I have only chairs that ensure proper alignment of the whole spine and provide support for the cervical spine, and never have my elbows or wrists in contact with a hard surface)

I do still have arterial TOS, it just doesn't affect me very much in daily life. If I would walk with a heavy backpack, or just spend a day with my head and neck unsupported I'd develop pain symptoms in the cervical region. There are some things I just can't do - like cycling.

[jkl626]

Originally Posted by BKRich

Recovered is not quite the right word. I no longer suffer symptoms very frequently, and those I do are mild.

I was diagnosed with the neurogenic & arterial types of TOS following EMG, MRI, X-Ray, CT scan, Ultrasound and of course physical examination. I have no cervical rib or structural abnormality other than a depressed right clavicle. There was no obvious reason for the onset of symptoms and absolutely no direct help available from physicians other than physios.

However, even at the worst of my symptoms, I was no candidate for surgery. I did get 2 consults, but the shared conclusion was there was no reason to expect improvement from surgery and I wasn't badly enough off to justify the risk.

What I did and do:

1. Stopped all forms of physical activity for a 6 month period (because I could not know which if any were contributing to TOS)

2. Lost approximately 10kg as result of 1 (mainly lean mass I'm afraid)

3. Engaged in a program of 3 x daily stretches and nerve glides, developed with 2 physios with specific knowledge & positive experience of treating TOS

4. Sleep with elbows encased in a wrap which limits the angle of contraction at the elbow joint, thus allowing the nerves running down the arm to relax overnight

5. Gradually re-introduced physical activity, spaced 3 months apart so that if an activity re-introduced symptoms, I'd have a chance at isolating the cause

6. Converted my home and office environments into ergonomic paradises. Specifically, I have only chairs that ensure proper alignment of the whole spine and provide support for the cervical spine, and never have my elbows or wrists in contact with a hard surface)

I do still have arterial TOS, it just doesn't affect me very much in daily life. If I would walk with a heavy backpack, or just spend a day with my head and neck unsupported I'd develop pain symptoms in the cervical region. There are some things I just can't do - like cycling.

thanks for all this info. Can you describe the wrap? I'm not familiar with it. type of wrap and brand name?

[BKRich]

Originally Posted by jkl626

thanks for all this info. Can you describe the wrap? I'm not familiar with it. type of wrap and brand name?

Oh dear, here I expose my DIY.

I did indeed visit a custom-maker of splints for various nerve & bone injuries, but didn't get them to make me anything.

Here is what I actually do, and it is gosh-darn effective:

1. I take a fleece like this one: http://www.amazon.co.uk/gp/product/B...ls_o05_s00_i01
2. I cut it into 2-3 strips, then fold it until one strip is no more than about 30 cm long
3. I wrap the strip around a juice bottle
4. I duct-tape the strip so that it stays together

Bingo, I have a wrap. It restricts movement without preventing it. Wearing this, I never experience numbness during sleep. Without them, I'd be waking up 5-6 times per night. Want me to post some pictures to help bring this to life?

[mspennyloafer]

that's amazing!!

i do wonder how my sleep position is aggravating my tos

what kind of nerve glides did you do? were they just median/ulnar or specific to the brachial plexus?

very encouraging, ty

[chroma]

@BKRich, can you share which stretches you do?

[rbn4jsus]

Do it!! I would LOVE to have this. Seriously, if you ever do...even if you could uploa a few youtube videos to help TOS people and you may gain exposure for your yoga classes that way? I have wanted to see TOS specific yoga for a while now...I hope you will seriously consider doing it!