Thoracic Outlet Syndrome (TOS) is one of those medical terms that isn't nearly as scary as it sounds. Massage can help a lot, as can thoracic outlet syndrome exercises and stretches that will help fix the unbalanced muscles that are probably the source of the problem.

What Is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome Exercises

The most common cause of TOS is "tight," shortened muscles in the neck and chest -- specifically the scalenes in the neck and the pectorals minor in the chest. The good news here is that thoracic outlet syndrome exercises and stretches that target these muscles and their partner (antagonist) muscles can provide considerable if not total relief for many cases of TOS. Here are some exercises and stretches to try.

Brill Chicken

• Sit or stand straight.
• Tuck your chin and slide your head back so that the back of your neck is elongated and your ears are over your shoulders,
• Push your chest out and lift it, pinching/squeezing your shoulder blades together.
• Bend your arms at the elbows so that your hands are up and palms facing outward. Keeping your elbows close to your torso and your palms facing outward, pull your hands back toward your shoulders.
• Hold the position for 10-20 seconds. Release slowly to a relaxed position. Repeat several times.

Scalene Stretch

From a seated position in a chair:

• Place the hand of the side you're going to stretch on the bottom of your chair. As you stretch, you'll be holding on to the bottom of the chair to
• Turn your head slightly up toward the ceiling.
• Bring your ear as far as you can toward your shoulder. You should feel the stretch in your sternocleidomastoid and anterior scalene muscles, at the front/side of your neck, about half-way between the exact front and the side, all the way down to your collar bone (and under it). Experiment with the rotation of your head to get the best stretch. Hold the stretch for 10-30 seconds.
• Repeat the stretch without rotating your head up slightly toward the celling to stretch the middle scalene muscle.
• If you want, you can intensify the stretch by placing your other hand on your head and pulling your ear gently and evenly closer to your shoulder. (Don't overstretch or do this move in a jerky way!)
• Hold for 10 to 30 seconds. Repeat twice and switch sides.

This is a good time to discuss the finer points of stretching:

• Never stretch to the point of pain.
• Hold 10-15 seconds
• Don’t bounce

Doorway Stretch for Pectoralis Minor

1. Stand in an open doorway, with both your hands & forearms resting on doorframe.
2. Place one foot in front of the other with the knee of the forward foot flexed.
3. Keep your head upright; don’t allow it to move forward.
4. Place your hands on the door frame just above shoulder height, forearms also on doorframe. Lean through the doorway, holding the stretch for 15-30 seconds.
5. Move your hands to a position on the doorframe that is just above your head (forearms still on the doorframe). Your upper arms will be straight out from your body, with your forearms at a right angle to them. Lean through the doorway, holding the stretch for 15-30 seconds.
6. Move your hands and forearms up the doorframe, so that your upper arms are at about a 120 degree angle to your body. Lean through the doorway, holding the stretch for 15-30 seconds.

Other Self-Care for TOS

Other ways to prevent or improve TOS include:

• Don't carry heavy bags over your shoulder.
• Don't sleep with your arms overhead.
• If you lift weights, take a break to see if weight-lifting is causing your symptoms, and if it is, modify your work-out. (Overhead work may be the culprit.)
• Certain repetitive motions can cause or contribute to TOS. If you can, avoid work or play that requires you to keep your arms overhead or out in front of you for long periods of time.
• Observe good posture: keep your shoulders back and your head directly over your shoulders.
• Take frequent breaks during activities including sitting at a desk.
• Sleep with a pillow that allows your head to be in a neutral position, that is, that allows your neck to be fairly flat.
• Avoid drafts on you neck and shoulder.
• Applying moist heat to the side of the neck and the outside of the chest before bedtime can be helpful.
• Practice deep, belly breathing as much as possible during the day. Notice when you are breathing into your chest and return to fuller, slower, deeper breathing.

Most people can eliminate or greatly improve TOS with massage,thoracic outlet syndrome exercises, other self-care, and/or physical therapy. However, rarely more aggressive medical care, such as surgery, is needed. If conservative treatments are not helping relieve your symptoms, be sure to be evaluated by a medical professional.

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