I always felt that a scientist owes the world only one thing, and that is the truth as he sees it.
—Hans Eysenck
The optimum management of TOS requires an understanding of the underlying cause(s) of the neurovascular compression or tension (1). Don’t you hate when doctors give you a treatment without determining the cause?
What is the cause of your thoracic outlet syndrome?
Regardless if you have a work injury, auto accident, sports injury, repetitive motion, poor posture, or even cervical ribs, there is usually only one cause of your thoracic outlet syndrome, compression.
Many common, difficult-to-treat conditions share one cause: compression.
What if I told you that all these conditions share one thing in common? They are most commonly caused by too much compression or compressive tension on your human spring.
Why are doctors so confused about which approach is best for conditions caused by compression? In the United States, during the past two decades, there has been a dramatic increase in spinal fusion surgery for backaches. The doctors said the discs needed to be fused, because the discs were compressed. Because the discs were compressed, the surgeons fused them together. Again, there is that word, “compressed.”
All doctors agree that thoracic outlet syndrome is a compression of the outlet and tunnel where the blood vessels and nerves pass. When the muscles compress the outlet too much, the doctors perform surgery to cut them out.
They cut muscles out when they compress the outlet, and fuse the bones together when they compress the discs. Why don’t they cut out the muscles around the herniated discs, when they are compressed?
Why don’t they fuse the structures around the thoracic outlet tunnel?
Their approaches to two conditions that are perpetuated by compression are approached completely different. It doesn’t make sense, does it? Again, it’s a painful misunderstanding of human mechanics.
Doctors who practice the human spring approach would approach both compressive disorders with the same treatment. We remove the cause of the compression and we use the same effective therapeutic approach. Guess what? It works magnificently virtually every time.
Now is the time to ask the magic question, “What is causing the compression?”
There is only one tissue that can cause compression of your thoracic outlet and twist your upper body into a chronic state of suffering. The main way you compress the thoracic outlet is if muscles contract and pull bones into the outlet or if muscles contract and compress the outlet.
Causes of Compression of the Thoracic Outlet and Tunnel
In 2,300 studies that came up in the search of the U.S. National Library of Medicine database, part of the National Institutes of Health, there are more than a dozen different ways the thoracic outlet and/ or tunnel can become compressed. They all come down to four main causes. The rest are so incredibly rare, that they aren’t worth mentioning.
As you learned previously, the body is a spring. The balance of muscle strength and tension (tonus) on the spring mechanism is what allows your body to stay upright, protect you from collisions, recycle energy, and maintain spaces and tunnels for arteries and nerves to pass.
Muscles are the only tissues that can change the tension on your spring, and the nervous system is what controls the tension on the muscles. This strength of your spring mechanism and the balance of tension on the spring are programmed by you through your activities of daily life or programmed for you by your nervous system.
As I mentioned many times, muscles are the only tissues in the body that can contract. Therefore, muscle contraction is the main cause of abnormal compression of your neck, upper back, shoulder, thoracic outlet, and tunnel.
My father was an old-school traditional chiropractor. He knew how to move the bones. The core philosophy of chiropractic technique, which he and I were taught, was to adjust bones off the nerves.
I asked someone neutral, my anatomy professor, Dr. Bachop, “You told us that muscles move bones, so why aren’t we working on the muscles so they can move the bones without being adjusted?” He said he spoke to a chiropractor, Dr. Raymond Nimmo (1904–1986), who asked the same question.
Dr. Raymond Nimmo (1904 – 1986)
I started to research Dr. Nimmo’s work starting with an article he wrote in 1957 titled, “Receptors, Effectors and Tonus—A New Approach.” In this article, he stated that muscles are the source of pain and dysfunction. He called the points “noxious generative points.”
Dr. Nimmo’s technique, receptor tonus saw that the body had a certain tonus. Balanced tonus of muscles maintained the body in its upright position without bones pulled out of the near-perfect anatomical position. Unfortunately, Dr. Nimmo died the year I graduated.
Hypermyotonia or constant muscle contractions or muscle spasms, are what pulls bones out of alignment and distorts the body, which leads to musculoskeletal pain syndromes, such as thoracic outlet syndrome and others.
It made sense, as I was learning the same philosophy from sports that a healthy body possesses symmetry, with a balance of strength and tone.
First of all, calling these muscular superspasms “trigger points” is like calling pneumonia a “head cold.” I don’t call these trigger points. I call them superspasms!
Trigger points are described as sensitive, stiff bands of sore muscles. In reality, these muscle contractions are powerful superspasms that can drag your entire neck, upper back, and shoulder down so hard into your outlet and tunnel, that they can cut off the blood flow in and out of your arm and squash large nerves. In fact, they can compress your human spring so hard that combined with abnormal impacts or collisions of simple walking, these trigger point superspasms can cause your spinal discs to plastically deform, causing bones to break in the form of stress fractures and even avulsion fractures.
An avulsion fracture is a bone fracture that occurs when a piece of bone tears away from the main mass of bone as a result of a muscular contraction that is so strong it exceeds the forces holding the bone together. This happens when you try to do activities, such as run, with impacts on your pew-loaded spring. The spring is unable to absorb the impacts, because it is locked by muscle superspasms.
The Earliest Detection of Human Spring Compression
The scary fact is that these superspasms can exist without pain or any warning signal. The best way to find them is by studying the movement of the human spring during walking or by just feeling for them with your hands.
Active Superspasms (Painful) vs. Latent Superspasms (Non-Painful)
There are active trigger points and latent trigger points. An active trigger point is characterized by spontaneous pain or pain response to movement, while a latent trigger point is a sensitive spot with pain only elicited in response to compression. Scientific studies also found that both active and latent trigger points have increased electrical activity beyond that of normal muscles. When these super contractions lock in, they will squeeze your spring mechanism. If you don’t know they are there, you could be causing damage without knowing it, for years or decades. If you don’t know what makes them worse, they will cinch harder and stronger to compress and lock your body in a chronic state of suffering.
These spasms are exacerbated by stress, and the pain is described as dull, achy, and deep (8). However, when I push my thumb into these super contractions, patients have been known to scream out loud and hyperventilate, saying that this excruciating pain shoots all over. When the spasms are there for a long time, they are more resistant to treatment. In fact, when they are really bad, sometimes the muscles twitch under my thumb, like they are trying to get away from my treatment. It’s like they feel they should be there to protect you, when in reality they are making you sick with chronic pain (2, 7). Muscular pain is often attributed to this myofascial pain disorder, a condition that was originally described by Doctors Janet Travell and David Simons (3).
Scientists Mense and Simons did biopsies of the areas of known trigger points and revealed that these tissues contained “contraction knots.” These contraction knots were described as large, round, darkly stained, muscle fibers, with a statistically significant increase in average diameter of normal muscle fibers (10).
Scientific Objective Proof They Exist
Although the examination of choice is to find them with deep palpation of the hands, they have become visible with sonoelastography, which is an ultrasound technique that evaluates the elasticity of any given tissue.
Sonoelastography uses a typical ultrasound machine to measure tissue stiffness. By giving physicians the ability to measure stiffer and softer areas inside the tissue, doctors might be able to detect increased tension on the body’s spring mechanism and the precise location of this increased pathologic spring tension. When scientists did an analysis of these trigger points with needle electromyography (EMG) and surface EMG, the electrical activity of the trigger points was similar to normal healthy muscle contractions. What that means is that trigger point muscle spasm is the same muscle tension as any other muscle contraction, capable of moving bones similar to what happens when you lift weights or have a cramp (14).
So, are these superspasms in the scalene muscles capable of lifting ribs into your thoracic outlet? Of course!
Are these superspasms in the pectoralis minor, subclavius, coracobrachialis, biceps short head, lower trapezius, and latissimus dorsi capable of pulling your shoulder down into the thoracic tunnel? Of course!
Science says that trigger points could be involved in the cause of muscle cramps. An increase in trigger point sensitivity is associated with the occurrence of cramps or spasms that compress the area (14). The cause of these painful muscle trigger points has been underexplored by investigators, leading to not enough or no training of healthcare professionals, and a lack of appreciation of their importance (15).
These aren’t random pressure points or random trigger points a massage therapist finds incidentally.
These are extremely painful, super contractions of muscles that follow a specific pattern, according to how your body is positioned or moves outside the ideal motion of spring engineering—when the pattern of the abnormal motion of the human spring matches the pattern of the muscle spasm. These spasm patterns are based on the pattern of your walk, how you sleep, or how you sit in your chair. For me, it’s easy to know exactly where they will be by watching the pattern of your walk, because the pattern of these spasms matches the pattern of your walk. That’s because it’s a harmonious combination of the laws of physics and the laws of nature falling into a precise, engineering, harmonious, predictable relationship.
I demonstrated how easy it was to predict where these painful superspasms would be in the frame and exactly what conditions patients would have without knowing anything about them by watching the pattern of their walk.
I accurately predicted what conditions volunteers would have, during a lecture I gave at the Royal College of Physicians in London, England, in addition to a lecture I gave at the famed Bumrungrad International Hospital in Bangkok, Thailand. I urge you to watch the lecture on my Vimeo channel.
The compression they cause on the human spring can preload your human spring to bring the compressive forces so high that they can reach the yield point, leading to plastic deformities, such as herniated discs and other permanent injuries. These super contractions are what are getting in the way of the healing process for patients with thoracic outlet syndrome, herniated discs, and other chronic musculoskeletal conditions related to compression of the human spring.
The muscles that either directly or indirectly compress the thoracic outlet and tunnel are these.
What causes these super contractions? As you probably know, the healthiest way to lift weights or exercise the body is by repetitions of movement, such as lifting weights. You lift the weight, then relax the muscle, then lift the weight, and relax the muscle for four series of reps, of 1–20 reps, when you are exercising the body as a simple lever system. That is resistance exercise or training with your lever mechanisms.
What about spring training? Professor Verkhoshansky stated that plyometrics was performed most efficiently and effectively when the athletes jumped and spent as little time as possible in contact with the ground. This maximized, elastic efficiency was done by springing through the tendons and not the muscles, so they were able to minimize muscle fatigue.
Unlike the lower body, the neck, upper back, rib cage, and shoulders don’t have a lot of tendons in the design. Most of this area moves by muscle contraction, because we mostly needed to run up to the tree and do one arm sweep to pick a piece of fruit. We weren’t required to do fine manipulations of the fruit for 11 hours a day, like we are required to do with a mouse, smartphone, iPad, or remote control. When you use muscles versus tendons, you have more rapid fatigue. You get tired faster. We all know it’s not healthy to lift something and hold it for long periods of time. If you lift a purse or briefcase with your arm and hold the muscle contracting for 5–10 minutes, you begin to feel a strain. Then you begin to feel a burning sensation. Soon your elbow and shoulder start to hurt. If you hold this position long enough, you might find you are unable to relax your muscles, leaving your elbow stiff, sore, bent, and unable to fully extend. This leaves you in a chronic state of suffering.
What exactly is happening?
Normal Muscle Contraction
Muscle contractions are controlled by your brain. Your brain sends an electric signal through nerves that connect to muscles. When the signal arrives, a chemical, acetylcholine, is released into the space between the nerve and the muscle. The acetylcholine docks or binds to the receptors of the muscle’s surface. This causes calcium to enter the muscle cell. This starts the contraction of the muscle.
During the contraction, the pressure on the capillaries squeezes the blood out of the area. When the contraction releases, the pressure releases blood flow back into the muscle, flushing lactic acid and inflammation out and pumping oxygenated blood in. After a healthy contraction, a little bit of lactic acid is released. This makes the area a little acidic. Under normal circumstances, lactic acid is flushed out of muscles into the bloodstream within 30 minutes after the exercise.
After the muscle has contracted and performed its function, an enzyme called acetylcholinesterase breaks up the acetylcholine to end the contraction, so your muscles can relax and further prevent the acetylcholine that is lingering in the area from constantly triggering the muscle contraction. In fact, it is recommended to rest 90 seconds after a full set of rigorous exercise to allow the blood flow to return to the muscle to supply it with oxygen and nutrients for the next set and normalize the pH, a measure of the hydrogen ion concentration.
Abnormal Muscle Contractions (Super Contractions)
Myofascial pain syndromes, such as thoracic outlet syndrome, can occur when soft tissues (muscles, ligaments, tendons) are exposed to single, recurrent episodes or patterns of sustained biomechanical overloading (13) of the human spring mechanism. The worst trigger to cause super contractions in muscles is when the contraction is sustained for a long time without rest.
arms for 30 minutes or more without rest.
muscle contraction with no rest.
Muscle damage caused by sustained muscle contractions is well documented. This constant or sustained contractions happens when you perform the same movements with the same muscles repeatedly without rest or you hold something in one place for too long. For instance, your trapezius muscles, the muscles that suspend the shoulder over the thoracic outlet and tunnel, can fatigue and become damaged when they are required to suspend the weight of your entire upper extremity from your spring mechanism.
Thirty years ago, I would see a lot of cases where the trapezius would fall victim to fatigue strain spasms. Now, since we are in the age where we are constantly manipulating our high-tech gadgets with outstretched arms, we are contracting the muscles that suspend the shoulder and the muscles that depress the shoulder into the outlet and tunnel.
The neck pains of the past, caused by these fatigue strain spasms would take 5–10 hours of deep tissue to reverse, are now infecting almost every muscle of the upper body, are extremely resistant to treatment, and take 10–30 hours or more to relax back to a pain-free equilibrium state. The problem is that patients with these more complex, chronic, resistant cases of thoracic outlet syndrome are still treated with approaches used 30 years ago, which don’t work on these extremely difficult cases.
Theory 1: Chronic Elevated Lactic Acid Can Cause Superspasms
So, when you contract muscles too long or do too many repetitions without a rest, this sustained contraction compresses the tiny capillaries to cut off blood flow carrying oxygen and nutrients to the area. Also, restricted flow out of the muscle means there is lingering lactic acid and a lack of oxygen in the muscle, so the area becomes acidic.
The total pH scale ranges from 1 to 14, with 7 considered neutral. Solutions less than 7 are said to be acidic, and solutions with a pH greater than 7 are basic or alkaline. Researchers at the National Institutes of Health found that the pH of the area around trigger point spasms can fall below five. As I mentioned, acetylcholinesterase, an enzyme, breaks down acetylcholine in the space between two nerves (the synaptic cleft) so the acetylcholine minimizes muscle contraction. However, this enzyme cannot work in an acid environment. So, the acetylcholine constantly triggers muscle contractions until the muscle is in a constant state of contraction.
Theory 2: Chronic Elevated Inflammation Can Cause Superspasms
We discussed nociceptors in a previous chapter. They are thin nerve fibers in muscles that sense and send information about harmful, mechanical, temperature, and mainly chemical stimuli in and around muscles. These nerves send this information about the chemistry of the tissue surrounding them to the brain. As the muscles become stiff and become soaked with inflammation, they begin to activate tiny chemically and pressure-sensitive nerves, nociceptors, which send messages to the brain that there is some damaged tissue producing inflammation in this area. This triggers the brain to send a message to the muscles to contract or spasm repeatedly.
The more inflammation, the greater the pain. The more pain you have, the more you guard or stiffen up.
The more you stiffen up, the worse the contractions, the worse the compression, the less circulation, the lower the oxygen, and the worse the pain. You become locked (by muscle spasms) in a chronic state of suffering.
Also, scientists think there is some leakage in the poles of the muscle spindles (12) that could allow the inflammation into the muscle spindle cell, triggering more spindle cells to react, creating more muscle spasms and compression. Eventually, these feedback loops can lead to what I call super contractions.
The super contractions have been found in animal studies and in one biopsy study on fresh cadavers.
Super Contractions Cut Off Blood Supply Making Things Worse
You know that doctors use splints to limit or prevent movements that can further injure an area that is already injured. The brain also tries to splint to protect you from further injury. By “splinting”
the area with spasm, the hypercontracted (shortened) muscles, ligaments, and fascia effectively produce painful joint movements. Splinting is a common form of protective guarding that clinicians address daily.
If there is too much pressure in the tight, contracted muscle, the blood cannot enter the muscle to deliver the oxygen and nutrients and the blood cannot flush out the lactic acid and inflammatory chemicals.
The lack of oxygen and nutrients can reduce the flow of blood vessels in the area because, like all living tissues, capillaries need oxygen and nutrients to stay healthy. When these blood vessels shrivel up, the circulation is reduced in the area. There are fewer blood vessels to remove the inflammation, lactic acid, and other chemicals we call toxins from the area, making it even worse.
This constant state of muscle contraction damages muscle tissue. These damaged muscle fibers become inflamed and release chemicals. These chemicals have fancy names, such as adenosine triphosphate (ATP), bradykinin (BK), serotonin or 5-hydroxytryptamine (5-HT), prostaglandins, and potassium.
These chemicals are found in high concentrations when there is a lack of oxygen in the area.
One Reflex Triggers Another
Logical Explanations for Confusing Chronic Fatigue and Fibromyalgia
Layering the area with protective spasms happens when there is a constant retriggering of these reflexes, which makes it almost impossible for them to subside on their own. Left untreated inflammation, lactic acid, and superspasms can invade the entire body.
Many of you have a complete compression of your entire body’s integrated spring. This is why so many people who have had a single traumatic injury, such as a whiplash or a work injury, end up in chronic pain and with other conditions, such as chronic fatigue and fibromyalgia.
I have seen thousands of cases, and it is quite possible and highly probable for many of you to relieve your chronic pain, chronic fatigue, and misdiagnosed fibromyalgia. As I mentioned previously, within 48 hours, I was able to reverse chronic pain, chronic fatigue, and misdiagnosed fibromyalgia for Anthony Field, cofounder of The Wiggles famous children’s entertainment group. In 2012, he released a book he wrote about his remarkable recovery, titled How I Got My Wiggle Back (16). He did interviews on CNN, ABC, CBS, NBC, and many other media outlets talking about how this chiropractor healed his chronic conditions with this new human spring approach. I recommend you read his book.
These constant, protective, superspasms can cause a variety of problems for you.
compression of the spring won’t allow it to recycle energy through this natural spring mechanism, leading to chronic fatigue and even chronic fatigue syndrome.
leading to compressive conditions, such as thoracic outlet syndrome, headaches, neck pain, cubital tunnel syndrome, median nerve compression of the forearm, carpal tunnel syndrome, and compression of Guyon’s canal.
accelerated wear and tear and chronic arthritis during years or decades. This might end up necessitating joint replacements or other radical surgery that was never necessary.
in the spine.
What do mainstream physicians think of trigger points?
More than 1,600 American Pain Society members were surveyed in 1997 about their opinion of myofascial pain syndrome. Approximately 89 percent of respondents reported that myofascial pain syndrome was a legitimate diagnosis, with 81 percent describing myofascial pain syndrome distinct from fibromyalgia (17).
So, why don’t doctors short-circuit these self-perpetuating reflexes that are leaving you in a chronic state of compressive suffering?
examination.
normal muscle or what is an abnormally contracted muscle.
I will teach you how to examine yourself for super contractions and also teach you the self-help
treatments you can use to reduce them in Chapter 13, “What Works and Why.”
However, let’s not spring ahead just yet. There are other causes of abnormal compression of the thoracic outlet that some doctors think contribute to TOS.
Something Grows into the Outlet (Scar Tissue, Tumor)
Other acquired causes are rare, but must be systematically considered: pancoast tumor, hyperostosis, osteomyelitis, and others. An accurate diagnosis is based on clinical examination and medical imaging (CT and MRI).
It’s rare that this happens. If you have a pancoast tumor of the lung, you are more concerned with survival than the thoracic outlet syndrome.
You will read how to differentiate between tumor or growth and thoracic outlet syndrome in Chapter 9, “Is It TOS, This, That, or All the Above?” under differential diagnosis, where I list 30 other similar conditions, disorders, and diseases that mimic thoracic outlet syndrome.
(Cervical Ribs, Elongated Bones)
Cervical ribs are an extra set of ribs at the top of the rib cage. There can also be partial ribs or elongated prominences, called thoracic processes, that doctors think can compress the outlet.
It is rare for patients with an extra rib to spontaneously develop thoracic outlet syndrome. Cervical ribs are rare. The incidence of cervical ribs has been found to vary from 0.58 percent in the Malaysian population to 6.2 percent in the Turkish population (18). The incidence of cervical ribs has been estimated at 2 percent (19), with one expert quoting the incidence to be less than 1 percent, of the population in the United States (20).
I have been in practice for 30 years and have not seen one case where an extra or deformed rib was the cause of thoracic outlet syndrome. This is a congenital anomaly that is something you are born with, that usually compensates to allow your thoracic outlet and tunnel to have a normal amount of space for nerves and blood vessels to pass. Remember, the spring suspension system supported by muscles is what maintains the integrity of the thoracic outlet and tunnel.
However, when doctors who are unfamiliar with the true spring design see these extra ribs on X-rays, oftentimes they just make a snap judgment that they are the cause of the compression and advise the patient to have them removed. When patients see them, they are oftentimes in shock and right away think they should be removed too.
However, scoliosis curves and deformities can get so bad before the age of 18 that they can require surgery to correct them. Surgery for adolescents with scoliosis is only recommended when their curves are greater than 40–45 degrees and continuing to progress, and for most patients with curves that are greater than 50 degrees.
My father was the chair of the Shriners Hospitals Committee for Crippled Children. To this day, he is the number-one sponsor of children into Shriners Hospitals. I am not against surgery that is medically necessary. I just haven’t had one case of TOS I thought could not be reversed with my logical nonsurgical approach.
Scalene Muscle Abnormalities
The scalenes are three pairs of muscles in the neck. The human body’s design is fairly predictable, however, there are differences in the engineering structure of some bodies. For example, some people are born with different locations and ways that the scalene muscles attach.
Various congenital anomalies of the scalene muscles have been reported (21) (22). Doctors claim that fibrous bands have been found within the thoracic outlet area, increasing the stiffness, and decreasing the flexibility and mobility of the area, potentially elevating, kinking, and compressing the nerves, arteries, and veins against the surrounding borders of the thoracic outlet (23) (24) (25)
(26) (27).
If you are born with congenital abnormalities, such as scoliosis, extra ribs, or elongated transverse processes, then your body will accommodate for that. If you have symptoms of thoracic outlet syndrome, perhaps you are no different from someone with no congenital anomalies. Perhaps your doctor or therapist selected one or more of the 16 treatment approaches that do not relieve compression on the outlet.
First, assume the pain in the area and compression is caused by the super contractions compressing the area around the cervical ribs and do the treatments I describe in Chapter 13, “What Works and Why.” Then if you still suffer, call me. You need a second opinion before you allow your doctor to cut bones and muscles out as the only way to decompress the outlet and tunnel.
Now, if you know your stuff, you won’t make a snap judgment when a doctor says you need surgery for these inconsistencies of nature. You can have cervical ribs and plenty of room in the outlet and tunnel for the blood vessels and nerves to pass. Also, scoliosis and cervical ribs do not cause pain. They only cause pain when they have shifted into a painful position or movement. This is more commonly caused by muscle super contractions.
More Nontraumatic Causes of Thoracic Outlet Syndrome: Large Breasts (28) (29) (30), Breast Implants, and Large Arms
Another factor that might cause a sagging of the shoulder into the thoracic outlet, in addition to stress and strain on the upper back and rib cage, is heavy, large breasts or arms. Wearing a good support bra with wide, crossed, back straps might decrease pressure and strain on these tissues. Reduction mammoplasty or breast reduction has been recommended for extreme cases (30).
Surgical decompression should only be considered for those patients with true neurological symptoms, such as weakness and wasting of the hand intrinsic muscles (28).
We consulted with two women who developed thoracic outlet syndrome after breast augmentation.
They felt that when the breast implant was secured to the pectoralis minor, the muscle dragged the shoulder into the outlet and misaligned ribs, causing chest and rib cage pain. If you already have signs or symptoms of TOS, I highly recommend you do not get breast implants.
A Traumatic Shift (Rib Fracture, Clavicle Fracture, Car Accident, Work Injury, Sports Injury)
When you are involved in an auto accident, there is a traumatic shift of the neck, upper back, shoulder, rib cage, and even jaw. You can suffer chronic pain for a lifetime. Most sports, work, and auto injuries involve a similar injury cycle. There is a period of pain, stiffness (compression), and sometimes compressed nerves, leading to a diagnosis of thoracic outlet syndrome.
What people don’t understand is that even the most severe injuries heal. Why is it that severe ankle sprains that involve torn ligaments, torn tissues that bleed inside, causing 1–3 inches of swelling, heal more than auto accident and impact injuries?
If you had an auto accident, sports injury, or work accident, and you got every form of recommended therapy, yet you are still experiencing signs of thoracic outlet syndrome, then you need to read Chapter 10, “What Treatment Doesn’t Work and Why?” You will probably see your doctor’s approach listed in that chapter.
So, when we revisit the other possible causes of thoracic outlet syndrome, you must have a new perspective on why you are not improving. After a work injury, car accident, or sports injury, as long as there are no constant triggers of these muscle super contractions, you should heal just like any other injury.
Sometimes unethical personal injury and workers’ compensation attorneys send patients to what I call, “Medical Bill Mills” to get a diagnosis and some worthless treatment that produces a bill they can submit for payment from the insurance company to get you money for your pain and suffering. It’s interesting how patients who do not improve and are left in a chronic state of suffering have higher financial settlements than those who get healthy after treatment from an auto accident or work injury.
Sometimes, you have to wonder what the motive is of the attorneys when they send you to a doctor who really doesn’t do much for you to improve your condition. I would recommend that you fire the doctor and the attorney and find somebody who can help you. The settlement is usually about the same, but you’re not. You are locked in a lifetime of chronic pain, if the treatment is done right. Find a doctor that will treat you according to what I recommend in this book or call me and I will personally help you myself. For those of you who feel you have been misguided into treatment that did not provide maximum medical improvement, there is still hope for you. Please call my office, and let’s talk this over.
Conclusion
Now that we know what causes compression of the body, we can determine what muscles compress the outlet and develop the optimum treatment approach to reverse the compression. What makes this easy is that there are 10 muscles that either contribute to or cause compression of the outlet when in a state of constant contraction. Also, there are two muscles that lift the shoulder off the thoracic outlet.
If you know what activities of your daily life cause contractions of these muscles, you should now be able to track down the cause of why you are still suffering with thoracic outlet syndrome.
Spring forward to find out what activities of daily life cause these super contraction, muscle spasms and what keeps them turned on. You never know. The way you are reading this book might be causing them.
Spring forward and find out!