Menu
Cart 0

Trigger Point Therapy - Thoracic Outlet Syndrome

Posted by Team NAT on

 

Treating Thoracic Outlet Syndrome

 

 

Thoracic outlet syndrome (TOS) is a frequently overlooked peripheral nerve compression or tension event that is often difficult to diagnose - but can often respond surprisingly fast to manual therapy

TOS occurs when nerves and/or blood vessels become compressed in their passageway through the thoracic outlet which sits between your collarbone and first rib.

The thoracic outlet is surrounded by bone, muscle and other tissues. Movement or enlargement of these tissues near the thoracic outlet as a result of conditions such as cervical rib, tumors in the chest, muscle enlargement and weight gain, may lead to TOS.

These conditions may cause the collarbone to slip putting pressure on the blood vessels and nerves that sit underneath it leading to TOS.

 

 

TOS Awareness

TOS is one of a group of conditions that cause pain into the arm hand and fingers.

Not everyone is too aware of TOS and it's not unusual for clients to work their way through a number of visits to doctors and therapists by the time they receive a confirmed TOS diagnosis.

Types of TOS

The symptoms of TOS can be really disturbing and cause much anxiety (which doesn’t help).

There are generally two types of TOS – one is an unmistakable blockage pressure (organic) to the nerves or blood supply and the other is a functional or temporary pressure issue.

This functional group tends to respond very well to trigger point self-help techniques.

That’s because functional TOS results from a combination of poor rib mechanics and tight muscles (especially the Scalenes and Pectoralis Minor) that cause pressure on the neurovascular structures (sometimes called a myogenic plexopathy).

What Are the Symptoms of Thoracic Outlet Syndrome?

This will depend on the blood vessels or nerves that are compressed. It is more common to have symptoms from nerve compression than from blood vessel compression.

- Both types of compression may make overhead activities difficult.

- Discoloration or swelling in your arm.

- Depression in your shoulder.


- Limited range of motion.

- Redness or swelling of the arm due to a reduction in the blood flow from pressure on the blood vessels. Symptoms may also be felt in the arm and hand.

- A dull ache from nerve pressure may be felt in the hand, arm, shoulder or neck. Tingling, pain or numbness may also be felt on the inside of the forearm and 4th and 5th fingers . The hand may feel clumsy.

 

 

Who is Prone to Thoracic Outlet Syndrome?

- Physically active, younger adults whose occupations involve repetitive raising of the arms e.g. machine operators, truck drivers and dental workers

- Those born with an extra rib (known as cervical rib)

- Those with deformity resulting from a fracture to the first rib or collarbone
- Weight lifters - leading to enlargement of a muscle


- Older people - sagging of the shoulder

Differential Diagnosis - What Else Could It Be?

Here is a list of other conditions which can present as thoracic outlet syndrome; some of them can be serious, so if you are concerned please check with your doctor or therapist:

  • Extra cervical rib or ligamentous (false) rib

  • Pancoast tumor

  • Brachial plexopathy – infective or traumatic

  • So tissue damage (from a whiplash)

  • Heart attack (le side)

  • Vertebral artery disease or aneurism

  • Hyperkyphosis or scoliosis of the thoracic spine

  • Neck degenerative changes, cervical bars and osteophytes

  • Radial Neuropathy

  • Syringomyelia

  • Complex Regional Pain Syndrome 1(CRPS1) - RSD

  • Problems (age related) with the neck including discs and spinal joints

  • Ankylosing spondylitis

  • Median neuropathy

  • Ulnar neuropathy

TOS and Trigger Point Therapy

Trigger points can develop in muscles for a number of reasons especially overuse.

When present, trigger points cause the host muscle to be shorter, tighter and tenser and they also add to the cycle of increased input to the peripheral and central nervous system.

With TOS, the results of trigger point therapy can be startlingly fast; will almost always provide relief; and accelerate well being.

As is usually the case with trigger point therapy, the hands-on treatment is likely to be most effective when combined with correct stretching and strengthening exercises.

When treating TOS, these typically include neck stretching, ulnar glides, upper trapezius and pectoralis stretching, back mobilization, and rhomboid strengthening.

Self treatment with pressure tools can also be very effective. See examples below:

 

 

Self Help - Subclavius

 

Self Help - Infraspinatus

 

Self Help - Infraspinatus

 

Self Help - Pectoralis Minor

      

    Links

    Find a Trigger Point Professional in your area

    More Articles About Shoulder Pain

    More Articles About Rotator Cuff Injuries

    More Articles About Frozen Shoulder

    Neuromuscular Stretching

    NAT Professional Courses

    Certify as a Trigger Point Therapist

    Membership

     

    About NAT Courses

    As a manual therapist or exercise professional, there is only one way to expand your business - education!

    Learning more skills increases the services that you offer and provides more opportunity for specialization.

    Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.

    Help Desk

      

    About Niel Asher Education

    Niel Asher Education is a leading provider of distance learning and continued education courses.

    Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.

    Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.  

    Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).

    More About Us

     

    NAMTPT AWARD 2017

    We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

    Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

    Read Full Article 

     

    Award Winning Instructors

    Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.

    Meet the Instructors

     

    Accreditation

    If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.

    In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.

    There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.

    Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below. 

    About NAT Certification

     

    Niel Asher Technique

    Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

    The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.

    Read More

     

    International Students

    Most of our courses are available as either "Printed" or 'Download" editions, wherever you live. Internet connection is required to access online and downloadable material.

    When you purchase a download edition, you receive immediate lifetime access to all course material. Course texts can be downloaded and printed if required. 

    When you purchase a "Printed" edition, you will also receive free access to the download edition.

    We ship Worldwide from locations in the USA, UK, and Australia. Most items are despatched within 24 hours and shipping is FREE for all orders over US$50.

    Shipping

     

    Where to Start?

    We offer a range of over 50 courses, presented by some of the worlds leading manual therapists. All courses are reviewed annually, and new courses are regularly added.

    Our courses are modular, and designed to build on what you already know. For more information, please visit our "Where to Start?" page.

    Start Here

     

     

    Trigger Point Therapy CE Course

    Trigger Point Therapy Master Course

    Click for Details

     

     

     

    Related Posts


    Share this post



    ← Older Post Newer Post →


    Leave a comment

    Please note, comments must be approved before they are published.

    Words from our students

    Sale

    Unavailable

    Sold Out