How to alleviate thoracic outlet syndrome with Clinical Somatics exercises
To prevent and alleviate thoracic outlet syndrome, you need to release the chronic muscle contraction in your neck, shoulders, and chest, as well as your abdominals. The abdominals are often tight in people with thoracic outlet syndrome because of their tendency to round forward, bringing their rib cage downward.
If you try stretching or getting a massage to release your tight muscles, you’ll likely find that these approaches provide only temporary lengthening of muscles. Your muscles will tighten back up within a few hours due to the stretch reflex. Static stretching and massage do not change the messages that your nervous system is sending to your muscles to stay tight—active movement is necessary to retrain the nervous system.
The most effective way to reduce the tension in your muscles is with a movement technique called pandiculation. The technique of pandiculation was developed by Thomas Hanna, and is based on how our nervous system naturally reduces muscular tension. Pandiculation is the reason why Hanna’s method of Clinical Somatic Education is so effective in releasing tension, retraining posture, and relieving pain. Hanna created many self-pandiculation exercises that can be practiced on your own at home.
Pandiculation sends accurate feedback to your nervous system about the level of tension in your muscles, allowing you to change your learned muscular patterns, release chronic muscle tension, and retrain your proprioception. You can read more about pandiculation in this post.
If you’ve learned Clinical Somatics exercises from my online courses or from another Certified Clinical Somatic Educator or Hanna Somatic Educator, you can use this section to help guide you in releasing the muscles that are causing your thoracic outlet syndrome. If you’re new to Clinical Somatics, the best place to start is the Level One Course.
Now, some specific exercises. Here are the exercises from the Level One Course that help to relieve thoracic outlet syndrome:
Arch & Flatten: I recommend practicing this every day. It’s best to begin your practice with this exercise, because it gently releases the abdominal and lower back muscles and prepares you for the rest of your practice.
Arch & Curl: Practice this every day. Really squeeze your shoulders together as you curl up. Release your abdominal muscles as slowly as you possibly can on the way down, imagining that you’re resisting gravity. Then, release your shoulders down and elbows out to the side as slowly as you possibly can—try counting to 16 or more as you release.
Side Curl: This exercise releases the obliques; however, these can play a role in your TOS if your obliques are tighter on one side, pulling your rib cage down and causing you to round your shoulder forward. So, be sure to practice the Side Curl on the side in which you have TOS. To do this, lie down on your opposite side, and practice this exercise curling up to the side on which you have symptoms. Really try to get a sense of the muscles on the side of your waist contracting, then release them as slowly as you possibly can—resist gravity as you lower down. Completely relax for a few moments before repeating the movement.
One-Sided Arch & Curl: This exercise gives you the opportunity to do the Arch & Curl while focusing on just one side at a time. Like with the Side Curl, you can practice this just with the side in which you have TOS. To do this, lift up your knee on the side on which you have TOS, put your hand on the same side behind your head, and practice the exercise.
Diagonal Arch & Curl: This exercise is an important one for TOS sufferers to do on a daily basis, as it releases the pectoral muscles. Like with the two previous exercises, you can practice this just with the side in which you have TOS. To do this, bring your hand up behind your head on the side in which you have TOS, lift up your opposite knee, and practice the exercise.
Washcloth: You can practice this exercise as instructed, going back and forth from side to side. When rolling your shoulders forward and backward, notice how your right and left shoulders feel different. You can learn a great deal about your body by comparing your two sides. Feel free to practice just the upper body part of this exercise so that you can focus completely on the movement of your shoulders.
Flowering Arch & Curl: You can practice this exercise as instructed, and like the Washcloth, feel free to practice just the upper body part of the exercise so that you can focus completely on your shoulders and chest. The upper body part of this exercise is an important one for TOS sufferers to do, as it releases the pectoral muscles.
And more exercises from the Level Two Course:
Head Lifts: This exercise releases the neck muscles and corrects forward head posture. If you have TOS, you should do this exercise on a regular basis. Practice this after you’ve warmed up your abdominals and lower back muscles with the Arch & Flatten and Arch & Curl.
Scapula Scoops: Both parts of the Scapula Scoops are important for TOS sufferers. Part 1 helps to release the scalene muscles, and Part 2 releases the pectoral muscles. You can practice these as instructed, or do them just with the side in which you have TOS.
Diagonal Curl: This is a very important exercise for TOS sufferers, as it releases both the abdominals and pectorals. To practice this just on the side in which you have TOS, lie down on your opposite side, put your hand behind your head and let your upper body rotate open, and practice the exercise.
Shoulder Directions: This exercise releases the shoulder and chest muscles, and develops fine control of shoulder movements in all directions. To practice this just on the side in which you have TOS, lie down on your opposite side and practice the exercise.
Finally, be aware of how you’re using your body as you go through your daily life. Your progress with the exercises will be slower if you continue to do activities or habitual postures that are keeping you stuck in your patterns of tension and exacerbating your symptoms. Notice the tension that you hold in your neck, shoulders, chest, and abdominals, as well as how you might be using the sides of your body differently when you:
- Carry your bag or your child: Do you always use the same side? Do you round one shoulder forward, rotate it inward, and bring it in toward your body?
- Work at a computer: Do you use a mouse with the same hand a great deal? Do you spend a lot of time typing with your shoulders rounded forward and rotated inward? Do you bring your head and neck forward?
- Exercise: Do you lift weights or play sports that require throwing with one arm or using the chest and shoulders a great deal?
- Relax on your couch: Do you slouch down, rounding your upper back and shoulders?
- Sleep: Do you sleep more on one side than the other? Sleeping on your back is best; put a pillow under your knees if that makes you more comfortable.