Costoclavicular compression is a wildly common cause of chronic chest, arm, neck and upper back pain, but is not well known. It is also the most important corrective in neurogenic thoracic outlet syndrome. Moreover, sadly, it is monstruously mistreated with cues such as "lower your shoulders", or worse, "pull your shoulders back and down". This worsens costoclavicular impingement and inevitably worsens the patient. Further, healthy patients may quickly get injured from these cues, and can drift on for years until they are cued to stop doing it.
The trapezius is an important stabilizer of the neck and shoulder complex, and two main roles it has is to decompress the costoclavicular passages' neurovascular bundle (brachial plexus and subclavian vasculature), as well as appropriate instigation of upwards scapular rotation. This is crucial for good neck and shoulder health.
Either way, even patients who are indeed aware of the benefits of keeping their shoulders up are often doing it wrong. This video will sirve as a "howto", and will also teach you what common pitfalls to avoid. Keeping your shoulders up, contrary to popular but deceptive beliefs, is one of the most helpful things you can do for your long- and short-term neck and shoulder health.
I want to add a couple if things that I forgot to mention. 1., the "de-numbing" period when getting the shoulders up, although usually only affecting as mall proportion of patients with TOS, will generally last anywhere between a few days to a few weeks. Hang in there. 2., if patients develop symptoms of VASCULAR TOS, eg., venous congestion when raising their shoulders, this suggests severe pec minor dysfunction. It will help to bring the scapulae up and forward a litte bit, along with stretching of the pectoralis minor a few times weekly. See my pec minor stretch video, as there are pitfalls there as well.
6 окт 2024
