Holistic Balance

{Holistic Balance}{363 Burwood Rd}{Hawthorn}{3122}{VIC}{Australia}{(039) 041-3232}
363 Burwood Rd 3122 Hawthorn, VIC
Phone: (039) 041-3232
March, 2024 | Holistic Balance

Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) encompasses a group of disorders caused by compression of the neurovascular structures, including the brachial plexus, subclavian artery, and vein, as they pass through the thoracic outlet. The thoracic outlet is anatomically defined as the passageway between the clavicle and first rib, bounded by the scalene muscles anteriorly, the first rib inferiorly, and the posterior cervical muscles posteriorly. TOS can be classified into neurogenic, vascular, or nonspecific types, each presenting with distinct clinical features.

TOS can arise from various anatomical anomalies or acquired conditions that result in compression of the thoracic outlet structures. Common etiological factors include congenital anomalies such as cervical ribs, abnormal scalene muscle anatomy, muscular hypertrophy, trauma, poor posture, repetitive overhead activities, and anatomical variations in the bony and soft tissue structures. The compression leads to ischemia, nerve irritation, and mechanical distortion, giving rise to the characteristic symptoms of TOS.

Patients with TOS typically present with a constellation of symptoms, including pain, numbness, tingling, and weakness in the upper extremities. Neurogenic TOS primarily manifests with neurological symptoms, such as paresthesia along the ulnar aspect of the forearm and hand, while vascular TOS presents with symptoms related to arterial or venous compromise, such as cold intolerance, pallor, and swelling. Nonspecific TOS may exhibit a combination of neurogenic and vascular symptoms, making diagnosis challenging and often necessitating a multidisciplinary approach.

Manual therapy encompasses a variety of hands-on techniques aimed at restoring mobility, reducing pain, and improving function in musculoskeletal disorders. In the context of TOS, manual therapy interventions target the underlying musculoskeletal and soft tissue dysfunctions contributing to thoracic outlet compression. Techniques commonly employed include:

  • Soft Tissue Mobilisation: Manual manipulation of soft tissues, such as massage, myofascial release, and trigger point therapy, aims to alleviate muscular tension, reduce adhesions, and improve blood flow to the affected area.
  • Joint Mobilisation: Gentle mobilisation of the thoracic spine, cervical spine, and ribs can help restore normal joint mechanics, alleviate restrictions, and reduce nerve impingement.
  • Stretching and Strengthening Exercises: Specific exercises targeting the muscles of the neck, shoulder girdle, and upper extremities can improve flexibility, strength, and postural alignment, thereby reducing compression on the thoracic outlet structures.
  • Postural Correction: Education and training in proper posture and ergonomics are essential components of manual therapy for TOS, as poor posture contributes to thoracic outlet compression and exacerbates symptoms.

Listed below are some details of a client dealing with pain associated with TOS who is seeking treatment here at HBM, which may also serve as a case study:

Age: 40+

Gender: M

Symptoms: Nerve pain in elbow down to index finger on R hand

Medical history: No known injuries of relevance.

Lifestyle: Travels abroad frequently for work, while finishing a PhD at the same time.

The client has received 5x treatments here at HBM over 5 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment even with such a busy schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with TOS, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

Lower Cross Syndrome

Lower Cross Syndrome

 

Lower crossed syndrome (LCS) is a musculoskeletal imbalance condition characterised by specific patterns of muscle dysfunction, primarily involving the lumbar spine, pelvis, and lower extremities. Tightness in the hip flexors (iliopsoas, rectus femoris) and lumbar extensors (erector spinae) is coupled with weakness in the gluteal muscles and abdominal stabilisers (transversus abdominis, internal obliques). The imbalanced muscle activity results in an anterior pelvic tilt, increased lumbar lordosis, and a protruding abdomen, leading to a characteristic swayback posture.

Individuals with LCS often experience chronic low back pain, hip pain, and tightness in the hip flexors. Dysfunction in the lumbar-pelvic region may contribute to secondary symptoms such as sacroiliac joint dysfunction and hip joint impingement. Additionally, LCS can impair functional movement patterns, affecting activities such as walking, standing, and squatting. Reduced hip mobility and stability may also predispose individuals to compensatory movements and increased risk of injury during physical activities.

One method myotherapists may use to address LCS is by manual therapy such as soft tissue mobilisation techniques, which include myofascial release and trigger point therapy, that target tight muscles (e.g., hip flexors, lumbar extensors) to alleviate tension and improve flexibility. Joint mobilisation and manipulation may also be employed to restore normal joint mechanics and address segmental dysfunctions, particularly in the lumbar spine and pelvis.

 

In addition to manual therapy techniques, exercise therapy is very beneficial and complements the above techniques in addressing LCS more comprehensively. Strengthening exercises focusing on the gluteal muscles and abdominal stabilisers are essential components of LCS rehabilitation. Hip extension exercises, core stabilisation exercises, and postural retraining aim to correct muscle imbalances and promote optimal alignment of the lumbar-pelvic region.

Listed below are some details of a client dealing with pain associated with LCS who is seeking treatment here at HBM, which may also serve as a case study:

Age: 40+

Gender: F

Symptoms: Immense pain around lower back suddenly after going down the stairs one day, could barely walk after it happened.

Medical history: No significant injuries shown on MRI/X-Ray

Lifestyle: Works as a music teacher, and is seated for that mostly, also does Pilates to strengthen her muscles

The client has received 3x treatments here at HBM over 1.5 months to manage her symptoms, and even after the first treatment has had great improvement in mobilityand pain. Educating her on the importance of compliance to treatment has made a big difference on her quality of life, and after educating her on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, she’s been able to get back to her daily activities relatively pain-free.

If you or someone you know are dealing with LCS, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see us now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.

Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.

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