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Key Takeaway

Thoracic Outlet Syndrome is not just a neck or shoulder problem. It is a compression problem in a vital corridor that can affect nerves, blood vessels, and quality of life.

Chapter 14: Spring Training

Chapter 14

Spring Training

Self-preservation is the fi rst law of nature.

—Samuel Butler

In chapter 13 we learned the first step of the human spring approach which is to Step 1—Release the compression of your body’s spring and the compression on your thoracic outlet and tunnel.

Now in chapter 14 we will learn step two which are how to use strengthening exercises to open the thoracic outlet and how to strengthen the outlet and tunnel to prevent future injuries and compression A few years ago, I was involved in a very high-speed impact motor vehicle accident in Los Angeles, California. The impact was so hard that the vehicle was totaled and my friend who was driving suffered multiple injuries to the neck, back, and shoulders that kept her out of work for months. I did not feel a single ache or pain after the accident. That is because I train with the strategy outlined in this The exercises and stretches outlined in this chapter not only serve to heal through active rehabilitation but to strengthen and therefore they prevent future injuries. I cannot guarantee you will not have an ache after a severe car, work, or sports accident, but I can tell you that this is the same routine we use to train our top amateur athletes for contact sports in boxing, tae kwon do, and MMA, where injuries to the neck are common.

The active rehabilitation involves the strengthening of the body’s lever and spring mechanisms in a two-step process.

Step 2—Strengthen Your Body’s Spring Suspension System to Suspend the Shoulder over the Thoracic Outlet and Tunnel with Resistance Exercises.

Step 3—Spring Train the Human Spring with Spring Training Drills and Plyometric Exercises to Enhance and Maintain the Body’s Human Spring Engineering.

Phase 2 and Phase 3 or the active rehabilitation phases are one of my favorite part of practice. In 1991, I designed, built, and opened one of the first active rehabilitation and strength training centers in the country. This is not personal training. You cannot compare the development and management of an exercise program for a healthy person to a patient who has just come out of extreme pain with proof of a severely herniated disc and a chronic thoracic outlet syndrome.

Patients loved graduating from passive care, consisting of manual therapy and physiotherapy, to active rehabilitation. Our practice was seeing 5,000 new patients per year. I have been rehabilitating thousands of patients since 1991. During that time, I developed innovative training approaches for not only actively rehabilitating patients but training top amateur and professional athletes. At Team Doctors®, we have managed the strength and conditioning programs assisting more than 20 athletes to fulfill their dreams of becoming either a national or world champion.

This active rehabilitation and training program did not come about from me copying anyone else’s approach, It came from what I learned from working with hundreds of national and world champions, working with top sports doctors at numerous national and world championships around the world, and my own experience determining what works with thousands of patients who were rehabilitated in our centers throughout the years.

I’m proud to say that I have finally been recognized, voted in by my peers into the National Fitness Hall of Fame and also the Personal Trainers Hall of Fame. In 2015, doctors from 35 nations recommended me for an honorary fellowship degree, which was presented by a member of the royal family, the Sultan of Pahang at the 2015 World Congress of Sports and Exercise Medicine. I hope this gives you the confidence that this active rehab program will help you reverse and prevent thoracic outlet syndrome from recurring.

Recently, I opened a new, exclusive, private treatment and training center in the River North neighborhood of downtown Chicago. I see far fewer patients, but patients are given more one-on- one care with me. The reason is because I think I have done everything I wanted to do with my medical career. At this time in my life, I would like to mostly work with cases that are extremely difficult to reverse or those patients who have been to many doctors and tried everything, yet have made no progress on their TOS or herniated discs. In this chapter, you will learn the active rehabilitation strategy I have developed for the treatment and prevention of thoracic outlet syndrome that has helped thousands of patients during the years avoid surgery and return to a more normal active, virtually pain-free lifestyle. With regard to conservative or surgical treatment, there is no agreement on how to classify, evaluate, and treat this syndrome, and whether or not treatment should be conservative or involve surgery (1).

Conservative treatments for thoracic outlet syndrome have been devised as far back as 1956 when Peet prepared a specific exercise program with the aim of correcting what he called morphodynamic problems that could affect the shoulder girdle and lead to thoracic outlet syndrome (2).

Peet outlined a treatment approach, which included

  • moist heat,
  • massage,
  • strengthening of the levator scapulae,
  • stretching of the pectoralis, and
  • posture correction exercises.

This is a general rehabilitation program, however, he was way ahead of his time (2).

I don’t use moist heat. If you are doing massage, a shiatsu or relaxation massage is not deep enough or specific enough to relax the 10 muscles that are compressing the outlet. The massage you do must be specifically designed to relax super contractions or trigger points in the 10 muscles that compress the outlet and the 2 muscles that open up the outlet. Because the upper trapezius muscles and levator scapulae muscles involve the same shoulder shrug exercise, it is true that this exercise would open up the thoracic outlet tunnel. The shoulder shrug is a necessary exercise to strengthen the thoracic outlet to reverse and prevent TOS from recurring. In the late 1980s, specialists developed more logical and comprehensive, rehabilitation-strengthening programs with the goal of restoring a balance of strength in the thoracic outlet area anatomy. They divided the muscles of the upper body into the muscles, which open up the thoracic outlet, and muscles, which closed down the thoracic outlet (3) (4) (5) (6).

The muscles, which opened up the thoracic outlet and specifically the costoclavicular space, were determined to be the upper trapezius muscles and the sternocleidomastoid muscles (3) (4) (5) (6). In the 1990s, Dr. Sucher, an osteopath, devised a similar treatment and rehabilitation approach I use, which involves myofascial trigger point release of the contracted muscles. He also determined that the pattern and perpetuation of these muscles spasms were programmed as an engram (bran pattern) in the brain. He focused on reprogramming the central engram for the particular muscle length with deep tissue treatments (7) (8). In the 1990s and 2000s, doctors also determined it was necessary to exercise the muscles that strengthen the thoracic outlet aerobically (9) (10) (11) (12) (13) (14). This makes sense because aerobic exercises help to reduce early fatigue of muscles. When muscles fatigue, they can no longer maintain the shoulder and neck posture necessary to maintain an open thoracic outlet.

You know your muscles are overly fatigued when you hold your head in your hands or prop up your head with your hands. If you cannot sit without having the chair back hold you up, and if you can’t stand very long without having to lean against a wall or a doorjamb. If you feel burning pain in your upper back with simple short-term computer use or work activities, you are suffering from early fatigue.

If you find these signs of early fatigue, you must incorporate aerobic strengthening in your active rehabilitation and fitness program. In the late 1990s, doctors decided that it was medically necessary to release the shoulder girdle joints, such as the acromioclavicular (AC joint of the joint between the collarbone and the shoulder blade), the sternoclavicular or the joint between the collarbone and the beast bone, and the costotransverse joints (the joints that attach the ribs to the spine) (15) (16) (17).

I agree and do check and release the joint “spring” play in these joints. A constant contraction of the muscles can compress these joints and limit their movements causing adhesions to develop, which would keep the thoracic outlet in a compressed state. It is not always medically necessary for a doctor or therapist to release these joints with hands-on adjustments. I use the training exercises to mobilize these joints, which works magnificently.

The frequency and duration of the rehabilitation exercises varied, however, one author recommended sessions of two to three days per week for 8–30 sessions (3) (18).

Another expert recommended a graduated increase in the number of exercises each week (19).

Week 1: 15–20 exercises Week 2: 10–20 exercises Week 3: 10–30 exercises Exercises x five daily Unless I’m working with a highly trained athlete, I start patients off with about five or six exercises, monitor their form and technique, and add exercises every few training sessions once I think they have mastered the first set of exercises I have taught them.

Each patient I see is evaluated for cardio fitness and strength tested before we begin active rehabilitation. When can you begin active rehabilitation?

Some experts recommend the obvious—that you would never begin rehabilitation exercises if you had

  • a thromboembolic phenomena (a blood clot that broke loose)
  • acute vascular insufficiency (where the flow of blood through the veins is inadequate)
  • symptoms of chronic vascular occlusion (pain, ache, cramp, or severe fatigue, pain when resting, especially at night, and ulcers of the skin distal to the occlusion) (10)
  • progressive neurologic deficit (weakness, loss of coordination, loss of muscle tone, tremor, or changes in sensation) (20) (21) (22)

I am even stricter starting my patients’ rehabilitation training when I have released all the super contractions or trigger points in all 10 muscles that compress the thoracic outlet and all joint play restrictions. I also make sure the first and second ribs are well adjusted out of the thoracic outlet before I start my patients on active rehabilitation. In my opinion, doctors and therapists start exercises before the super contractions have been relaxed in all muscles of the neck, upper back, chest, and shoulder. They don’t realize that exercise puts additional force on an already compressed outlet, risking additional exacerbation of the neck, shoulder, upper back, and ribs.

Before you add additional force and load on the neck, upper back, shoulder, and chest area with exercise, this is what has to be accomplished.

  1. You must be off all pain medication.
  2. All super contractions must be released in all muscles surrounding the outlet.
  3. All inflammation must be flushed out of the area.
  4. All joints must be freely moving and free from subluxations.
  5. You Must Be Off All Pain Medication.

If you are taking pain medication, then you won’t get the warning sign of pain when you are moving in a way that is causing tissue damage.

  1. All Super Contractions Must Be Released in All Muscles Surrounding the Outlet.

Protective reflexes that cause the muscle super contractions compress your joints and the thoracic tunnel. They are dominant reflexes that maintain compressive tension on your human spring system and specifically the thoracic outlet, regardless of your desire or attempt to release them. Therefore, you no longer have the ability to release the tension on your spring to make it more compliant or increase the tension to make it a stiffer spring.

The ability for you to increase or decrease the tension on your spring system is necessary to execute exercises, safely. In fact, these variations in the tension are necessary to safely execute any movements, including the simplest, from lifting your cell phone to your head or even simple walking.

It is a pathological tension that abnormally compresses your joints and the thoracic outlet, making it more vulnerable to injury if additional forces or stress are applied.

If your thoracic outlet is compressed, you might be able to still push blood through the constrictions in the artery, because you have a strong heart pumping the blood through. The veins don’t have a strong pump pushing the blood through, so you could end up with a stagnation of flow causing a clot in the veins. This would be called effort thrombosis or Paget-Schroetter syndrome. If you start too soon you might end up in the hospital.

I don’t allow any of my patients to start an exercise routine until I know every muscle fiber of the 10 muscles that can potentially compress the outlet are released. I also will not allow any patient to start exercise if I suspect there is abnormal tension in any muscles that might be causing abnormal compressive force on any area of the body.

If you start an exercise program before all compressive forces are removed from these super contractions, your healthcare professional has no idea what they are doing and is putting you at a high risk for reinjury, exacerbation, or an entirely new injury.

  1. All Inflammation Must Be Flushed Out of the Area.

This is because muscles compress when contracting. That can cause the inflammation to get pushed deeper into the nerves, muscles, and spindle cells, causing an exacerbation of the TOS. I always put the vibrating massager on every muscle that will be trained that day for at least 20–30 minutes prior to exercise as a warm-up, to flush any inflammation or lactic acid, and to stimulate the circulation of oxygen and nutrients into the area for improved performance of the training.

Also as a precaution, I do a hands-on deep tissue reexamination of all key 10 muscles that compress the outlet and the 2 muscles that lift the shoulder off the outlet to ensure there is no inflation. If there is, I do fine-tuning, deep tissue treatment and flush the inflammation out of the area with the Massage Assist vibrating massager.

  1. All Joints Must Be Freely Moving and Free from Subluxations.

If there is any locking of the joint spring or joint play, there will be strain on tissues when added force is applied to the joint throughout the movement. I always go through every joint that will be moving during the training to make adjustments to ensure joint play is as close to perfect as possible. If I find restrictions in joint movement, I make the necessary joint adjustments to restore movement.

Team Doctors® has been set up with a full training center since 1991. This way the treatment and training is done close together to make sure we have the maximum medical improvement with the combined positive effects of both disciplines.

The first goal of training is to strengthen the muscles that suspend the shoulder off the thoracic outlet tunnel. Patients with thoracic outlet syndrome have weakness in the muscles in the back of the shoulder, the muscles between the shoulder blades, and the rotator cuff muscles. This causes the shoulders to roll forward into the outlet resulting in forward head posture and rounded sagging shoulders (23). This is what causes the narrowing of the thoraco-coraco-pectoral space or compression of the outlet.

What you need to do is train the muscles that pull the head back and suspend the shoulder off the thoracic tunnel. You need to strengthen the anterior, middle, and lower trapezius muscles or muscles between the shoulder blades and top of the shoulders.

These are the muscles that are weak, causing the shoulder to fall into the outlet.

  • Posterior neck muscles
  • Upper trapezius muscle
  • Levator scapulae These are the muscles that rotate the arm and shoulder off the outlet.
  • Trapezius—elevates and depresses the scapula (depending on which part of the muscle contracts); rotates the scapula superiorly; retracts scapula.
  • Teres minor—rotates the arm laterally.
  • Supraspinatus—abducts the arm (initiates abduction).
  • Levator scapulae—elevates the scapula.
  • Serratus anterior—draws the scapula forward; the inferior fibers rotate the scapula superiorly.

These are the muscles that roll the shoulder blade up and back off the outlet.

  • Rhomboideus minor—retracts, elevates, and rotates the scapula inferiorly.
  • Rhomboideus major—retracts, elevates, and rotates the scapula inferiorly.

The second goal of retraining is to strengthen the 10 muscles that have been contracting 24 hours a day. If a muscle is contracting 24 hours a day, it is weak and cannot contract, because it is already contracted. Because it is contracting constantly, it is hard and stiff, thus choking the blood supply that replenishes the oxygen and nutrients to the area.

If you strengthen them, you will not make them contract into the outlet. That is because your exercise will be balanced. These are the muscle imbalances that occur in thoracic outlet patients.

These are the muscles that have been contracting constantly, compressing the outlet.

  1. Anterior scalene muscle
  2. Middle scalene muscle
  3. Posterior scalene muscle
  4. Anterior cervical (neck) muscles
  5. Subclavius muscle
  6. Biceps short head muscle
  7. Coracobrachialis muscle
  8. Pectoralis minor muscle
  9. Latissimus dorsi muscle
  10. Lower trapezius muscle What is vital is that you adhere to correct posture, form, technique, and timing of breathing. Each exercise in this book has a step-by-step guide to correct form and technique along with breathing instructions.

Breathing Instructions

The rule of thumb for breathing is to exhale during the exertion. This is to ensure you don’t have internal compression on your thorax or organs, while adding more force to the body when exerting force while pushing the weight. What I tell my patients and athletes is to count out the reps, as counting is done by exhaling. Ok, one, two, I can’t hear you!

This is what you can expect from your first few workouts.

  1. Clicking or cracking of the joints, because they are readjusting to changes in tension while they seek a balance or equilibrium tension across the body’s spring mechanism.
  2. On your first few weeks of exercise, you can expect what is called delayed onset muscle soreness (DOMS), which is the pain and stiffness felt several hours to days after new or strenuous exercise.
  3. Clicking or cracking—If there is locking or stiffness in the joint spring/play, you might hear clicking or cracking when exercising. If the clicking works out of the joint during the exercise and lessens after each workout, that could mean the exercise is resetting the movement pattern of the joint for you.
  4. Delayed onset muscle soreness—DOMS is thought to be caused by lengthening of the muscle when you are trying to get full range of motion. This is expected, because your muscles have been in a contracted state for so long.

The muscle soreness feels like a dull, achy pain in the muscles you just worked out with stiffness. The pain usually only happens when the muscles are stretched, contracted, during deep tissue pressure, or when using the vibrating therapy. The vibrating therapy is good at flushing out the soreness, so I highly recommend it to speed recovery from workouts. Because your muscles have been contracted constantly, choking off the flow of oxygen and nutrients into the muscle, the muscles will not have as many capillaries or blood pipes to remove the lactic acid and inflammation from mild muscle fiber microtrauma caused by the exercise. It’s like building a new subdivision without putting in an adequate sewer system to remove the waste. As you exercise, your system will adapt by growing more capillary systems to handle the need of additional circulation.

The difference between injuries to muscles from exercise and DOMS is acute muscle injury happens usually 4 hours after training and not 24 hours after. If you think you aggravated or reinjured your neck, shoulder, upper back, or ribs, then you should see your doctor for a workup. It can happen with an inexperienced therapist or trainer. In 1991, I was one of the first doctors to have a full active rehab and training center in the office.

Having a doctor or trainer with experience is vitally important to guide you through the first few training sessions. It’s important to know when soreness is due to an injury or just normal DOMS from your first few workouts.

Practice Makes Perfect

People say, “Practice makes perfect,” when it comes to proper form and technique of exercise. They talk about improving muscle memory. You learned that there is no such thing as muscle memory. The memory of the proper form and technique of walking, running, dancing, and exercising is stored in the nervous system, mainly in your brain. So, we are retraining your brain. As I mentioned in previous chapters, the form and technique of movements, like exercises, are stored as patterns of nerve activation, similar to programs in your computers software called engrams.

Engrams were first presented to the scientific community in 1904 by a well-known memory researcher, Richard Semon (24). This pattern created by repetition we call training or conditioning. Revealing the engram is one of the greatest challenges in neuroscience (25).

How long should you do routines three days a week after release?

You never stop training for prevention of an exacerbation of thoracic outlet syndrome. The answer is “for the rest of your life.” The more you repeat exercises of movements of any kind, the stronger the patterns in the brain become. That is why it is difficult to break the bad habits that cause thoracic outlet syndrome. People say, “I try.”

The brain appears to retain a memory by growing thicker, or more efficient, communication lines between these cells with movement pattern repetition. It is also thought that the strength of connections between nerves or neurons is one of the major mechanisms by which engrams are stored in the brain (26).

How frequently should I exercise?

I train my patients two days per week for the first week allowing three or four days between the first and second training session. I might extend the gap between the second and third session to three days, depending on how long the DOMS lasts. Usually, we can get that flushed out faster with the Massage Assist vibrating massage treatments, so we seldom see DOMS last more than 24 hours.

After the duration of the DOMS is reduced, we train the patients every other day, allowing a day for rest and recovery. This allows the oxygen and nutrients to be replenished and allows the lactic acid and inflammation to be flushed out as circulation improves.

Patients ask, “How long do I have to go to rehabilitation?” This is best answered by asking how long they have had the condition, how bad the imbalances are, or how weak the patient is. When I can see that the patient maintains near-perfect form and technique and is motivated to do the routines in their health club or at home three days a week, I release them from active rehabilitation.

Repetitions and Sets

We don’t have time or space in this book to go over all the theory on strength training and rehabilitation.

What I am going to recommend here is a simplified approach to strengthening the thoracic outlet, and you can learn some more advanced approaches from the www.thoracicoutletsyndrome.org site.

What you need to do is select a body part to work, like neck exercises, shoulder exercises, etc. Then select an exercise to start. Pick up a weight you feel you can do 10 repetitions with safely. If you can do 11 repetitions, then you should increase the weight. If you pick up a weight that is five pounds heavier and can only do nine repetitions, then that weight should put a sufficient amount of stress on your muscles to allow them to adapt and get stronger.

So, the rule of thumb is simply to attempt to do 10 repetitions. If you can do eleven repetitions, then increase the weight.

Am I too old for exercise?

Some of you might be thinking that you are too old to change. In this past century, neuroscientists determined that the brain structure could not change after a certain time during early childhood.

There have been many findings revealing that the brain remains ever-changing and moldable, even into adulthood (27). Research indicates that experience can change both the brain’s physical structure and how it functions physiologically (28). You are never too old to build a stronger, more efficient, and injury-resistant human spring.

With further training, strengthening of this area will help you better absorb impacts of collisions in sports or auto accidents, and fend off fatigue from constant strain from handheld devices and the use of the keyboard and mouse after hours in front of a computer. Now spring to action and do these exercises!

STRETCHES

Stretch - Back, Chest and Shoulder Stretch

Lay back on the ball extending your spine across the ball. Let your shoulders and chest slowly stretch as much as they can without pain.

Stay in this stretched out position, stretching the spine, hips, and abdomen. To get back to the start position, perform a sit up to end in the seated position again.

Repeat.

Caution: If you stay in the stretched position inverted with your head lower than your body the blood in your body will rush to your head, and expands the blood vessels throughout, including those in your brain and eyes. Your body is supposed to know how to adjust to the stress of changing blood pressures as you move around.

If you feel faint, faint or black out or have headaches after doing this stretch, this may indicate a medical problem such as high blood pressure, low blood pressure, infection or even something more serious. So if you faint or feel faint check with your doctor before doing anymore exercises or stretches with your head inverted below your body.

Stretch - Pectoralis Major and Pectoralis Minor

Stretch - Swissball Chest Stretch

  1. Grasp a bar or a door jam with your arm at your side.
  2. Rotate your body while maintaining your arm in a static position.
  3. You should feel the stretch in your shoulder, chest and rib cage.
  4. Stand so you have the Swiss ball positioned at the end of your outstretched arms.
  5. Slowly walk the swiss ball up the wall as you take small steps forward to maintain constant stretch on your chest, shoulders and arms.
  6. When you get to the top, push the ball as high up the wall as you can.
  7. Slowly walk the Swiss ball back down the wall to the original position.
  8. Repeat.

Stretch - Ribcage Lunge

Lateral Calf, Leg, Hip, Rib Cage and Shoulder Stretch #1

  1. Grasp the handles of the suspension system.
  2. Stand with your arms stretched out at 30 degrees.
  3. Lean forward until you feel a slight stretch in your arms, shoulders and chest.
  4. Slowly lunge forward and down feeling the stretch in your arms, shoulders and chest area.
  5. Step back while at the same time pull your body back to the original position.
  6. Repeat.

Lateral Calf, Leg, Hip, Rib Cage and Shoulder Stretch #2

Stretch - Upper Back

  1. Grasp the handles of the suspension system.
  2. Stand facing the wall with your arms stretched out 90 degrees to your body with a slight tension in your arms, shoulders and back.
  3. Lean backward and down until you feel a stretch in your arms, shoulders and back.
  4. When done, pull your body back to the original position.
  5. Repeat.

Stretch - Ribcage with Side Bending

Stretch - Rib Cage Stretch with Rotation

  1. Place the suspension cables at a 135 degree angle to your body.
  2. Grasp the handles of the suspension system.
  3. Stand facing the wall with your feet parallel to the wall.
  4. Stand with your arms stretched out 135 degrees to the wall your body with a slight tension in your arms, shoulders and back.
  5. Lean backward, rotate to the side and drop down until you feel a stretch in your arms, shoulders and back.
  6. When done, pull your body back to the original position.
  7. Repeat.
  8. Place the suspension cables at a 135 degree angle to your body.
  9. Grasp the handles of the suspension system.
  10. Stand facing the wall with your feet parallel to the wall.
  11. Stand with your arms stretched out 135 degrees to the wall your body with a slight tension in your arms, shoulders and back.
  12. Lean backward, rotate to the side and drop down until you feel a stretch in your arms, shoulders and back.
  13. When done, pull your body back to the original position.
  14. Repeat. Position the pulleys in a position at the level of your head or higher.

Grasp the handle.

Lean your body forward to get some body weight on the suspension cables.

The more you lean the more positive strain is on the chest and shoulder muscles.

Put a slight bend in the elbow.

Lower your body slowly into a press by bending at the elbows until you reach 90 degrees of elbow bending.

Stop when you get as low as you can Hold the stretch on your shoulders and chest at the bottom.

Press your body weight back to the fully extended elbow position.

Repeat.

CHEST

Suspension System Standing Bench Press

Suspension System Standing Bench Press (Poor Form)

She has a form break on this exercise because the rings are too high. The ring height should be at a height where your hands, arms, and chest line up when you have reached the bottom.

Chest - Dumbbell Bench Press

Grasp the dumbbells.

Sit on the bench with the dumbbells on your lap.

Slowly lay back down on the bench while simultaneously positioning the dumbbells directly over your head with your arms extended but slightly flexed.

Lower the dumbbells.

Push the dumbbells while maintaining the forearm perpendicular to the ground. Push the dumbbells up until you almost have your elbows fully extended. Do not fully extend your elbows. Repeat.

Cable Chest Fly or Cable Crossovers

Position the pulleys in a position at the level of your head or higher.

Select the weight you want to push.

Grasp the handle.

Bend forward a little bit at the waist.

Extend your arms to the side until you feel some tension on the chest and shoulders.

Put a slight bend in the elbow.

Press your arms to the midline with the largest arch possible.

Stop when your hands reach the middle.

Repeat.

Chest Dumbbell Flys

Lay fl at on the bench with the dumbbells in your hand and resting on your thighs.

Flip one dumbbell up to the starting position of the dumbbell held above your chest with your thigh. Your palms should be facing each other.

Bend your elbow slightly.

Lower the dumbbells. down to the side with a wide arc so it stretches your arms, shoulder and chest.

Breath in as the weight is lowered. When you get to the bottom get a healthy stretch of the chest, shoulders and arms.

The press the dumbbells up to the starting position along the same wide arc feeling a stretch and strain on your chest, shoulders and arms.

Repeat.

Straight Arm Pull Downs

Attach the straight bar to the pull down machine.

Grasp the bar with your arms overhead with hand position slightly greater than shoulder width.

Maintain the hands an arms width arc from the body as you push the bar down towards the thighs while exhaling. When the bar touches the thigh then let it raise back up to the original position.

Repeat

Chest Pullover

Lay the dumbbell on its side on the bench.

Lay perpendicular to the bench with your upper back and head resting across the bench with your feet fi rmly planted on the ground.

Grasp the dumbbell with both hands with the hands grasping the bar of the dumbbell. Position the dumbbell directly over the chest at arms length to the chest to start.

Keep your arms slightly bent at the elbows.

Lower the dumbbell in a wide arch over your head so it is hanging off the end of the bench while inhaling. When you have reached the lowest point, stretch your shoulders, rib cage and chest muscles for a few seconds. While exhaling, raise the dumbbell back to the original position in the widest arch away from your body as possible.

Repeat.

Upper Back – One Arm Rows

BACK

Lay the dumbbell you want to lift next to the bench.

Straddle your feet with the foot opposite the lifting arm positioned directly under you’re the chest.

Bend at the waist until your back is fl at or parallel to the ground.

Grasp the dumbbell.

While keeping your arm and elbow close to your body lift the dumbbell with the muscles between your shoulder blades fi rst.

Once the shoulder blades are at full rotation then bend at the elbow to complete the lift.

Roll your shoulder blades back and turn your head to the involved side.

Lower the weight back down on the same path.

Repeat.

Straight Arm Pull Downs

Attach the straight bar to the pull down machine.

Grasp the straight bar with a grip that is wider than shoulder width.

Grip the bar with an underhand grip (not an overhand grip)

Sit down while you maintain the tension on the pull down bar.

Lean back slightly.

Pull the bar down with by pulling with your muscles between your shoulder blades fi rst.

Then pull the bar down to touch the middle of your chest with your shoulder muscles.

Try to touch your shoulder blades together at the bottom.

Remember not to move your upper body through the entire exercise.

Next raise the bar back to the starting position and try to feel the pull of the bar lifting your shoulders off your chest or rib cage.

Use this exercise to open the thoracic outlet and tunnel.

Repeat.

Pull Downs (Poor Form)

Do not use a narrow grip as this can cause excessive twisting strain on your shoulders, elbows

and wrists Your entire upper extremity (wrist, forearm, arm and middle shoulder) must be in alignment from the front.

Hanging Half Pull up

Grasp the bar. Let your body hang down while you totally relax. Do a slight pull-up motion, tensing the muscles between your shoulder blades with your shoulders. You should feel your shoulder blades sliding inward toward your spine.

Shoulder - Dumbbell Front Raises

SHOULDERS

Stand and grasp the dumbbell with your thumb pointing up.

Lift the weight with a straight arm contracting the front deltoid shoulder muscles until your arm reaches a parallel position to the ground.

Use the stabilizing muscles of your legs, hips and core abdominals to keep your body completely still.

Do not swing your arms. Complete the lift up and down on one side before you lift the weight on the other side.

Repeat

Shoulders / Neck - Dumbbell Side Raises

Grasp the dumbbells.

While standing let the dumbbells hang at your side. While keeping your elbows bent, lift the dumbbells to the side until they are parallel to the fl oor.

Lower the dumbbells back to the side.

Repeat

Shoulder - Internal Rotation (Rotator Cuff) - Correct Form

Grasp the handle of the pulley.

Use your, lower body, hips and abdominal core muscles to maintain your body completely still throughout the exercise.

Make sure your humerus (long bone of the upper extremity) is directly perpendicular to the ground.

Bend your elbow to 90 degrees.

Rotate your shoulder inward until you reach your body.

Repeat

Shoulder - Internal Rotation (Rotator Cuff) - Poor Form

Her form break happens when her arm drifts off on an angle wish is not perpendicular to the ground.

Her second form break is when she rotates her arm across her body.

SHOULDERS (ROTATOR CUFF)

Shoulder - External Rotation (Rotator Cuff) - Correct Form

Grasp the handle of the pulley.

Use your, lower body, hips and abdominal core muscles to maintain your body completely still throughout the exercise.

Make sure your humerus (long bone of the upper extremity) is directly perpendicular to the ground.

Bend your elbow to 90 degrees.

Rotate your shoulder inward until you reach your body.

Repeat

Shoulder - External Rotation (Rotator Cuff) - Poor Form

Her form break happens when her humerus (upper arm) drifts off the perpendicular position on an angle.

Her second form break happens because her elbow is not at a 90 degree angle and her forearm is not parallel to the ground.

Her third form break is when she rotates her torso in an attempt to complete the lift.

Arms Biceps (Poor Form)

Grasp the dumbbell.

Stand with your arm hanging down slightly bent.

Align your wrist, forearm and arm to the dumbbell.

Lift the dumbbell to a position at the top which is between your coracoid process and your humerus bone (long bone of the upper arm).

Her form break happens when she lifts the dumbbell to a position at the top which is lateral to the humerus.

This causes a twisting strain on the wrist, elbow and shoulder.

Exhale or count out every repetition.

Arms Biceps (Proper Form)

ARMS

Grasp the dumbbell.

Stand with your arm hanging down slightly bent.

Align your wrist, forearm and arm to the dumbbell.

Lift the dumbbell to a position at the top which is between your coracoid process and your humerus bone (long bone of the upper arm).

Exhale or count out every repetition.

UPPER BACK/NECK

Upper Back / Neck – Incline Back Flys

Grasp the dumbbell.

Lay, face down on the incline bench.

Your palms should be facing each other.

Hang your arms down dangling the dumbbells directly below your shoulders.

Lift the dumbbells up to the side, in a wide arc above your head as high as you can without strain or pain while exhaling.

Squeeze your shoulder blades together like you are trying to touch them together.

Lower the weights back down to the starting position and repeat.

Upper Back / Neck - Dumbbell Shrugs

Grasp the dumbbells.

While standing let the dumbbells hang directly at your side.

Slowly raise your shoulders up as high as you can while exhaling.

Do not bend your arms or wrists during this lift.

Lower the dumbbells back to the original position.

Repeat

Neck - Flexion

NECK

Neck - Extension

Sit down at the machine and determine your seat height fi rst.

Set the seat height so the pad is positioned on your forehead just above the height of your eyebrow Keeping your body completely still, slowly forwardly flex your neck to no more than 45 degrees of flexion.

Caution, do not rotate your neck during the motion Slowly come back to a neutral position Repeat Sit down at the machine and determine your seat height fi rst.

Set the seat height so the pad is positioned on the back of your head just at the height of your eyes Keeping your body completely still, slowly forwardly extend your neck to no more than 45 degrees of flexion.

Caution, do not rotate your neck during the motion Slowly come back to a neutral position Repeat

Neck - Lateral Bending

Sit down at the machine and determine your seat height fi rst.

Set the seat height so the pad is positioned on your head just above your ear or just above the height of your eyebrow Keeping your body completely still, slowly side bend (laterally flex) your neck to no more than 45 degrees of side bending.

Caution, do not rotate your neck during the motion Slowly come back to a neutral position Repeat

Frequently Asked Questions

What exercises should I avoid with thoracic outlet syndrome (TOS)?

Patients with thoracic outlet syndrome (TOS) should avoid exercises that increase compression of the thoracic outlet, especially prolonged overhead lifting, heavy shoulder shrugs, upright rows, deep dips, and activities that reproduce symptoms. Before beginning an exercise program, tight muscles should first be treated with Vibeassage Therapy and self-help deep tissue techniques to reduce muscle guarding and restore Human Spring biomechanics.

Once compression has been reduced, exercises can be gradually reintroduced using proper movement mechanics. Throughout this book, you will learn which exercises to avoid and how to safely return to activity with thoracic outlet syndrome (TOS).

Can specific exercises improve thoracic outlet syndrome (TOS)?

Yes. Carefully selected exercises can improve thoracic outlet syndrome (TOS) after muscle restrictions have been reduced with Vibeassage Therapy and self-help deep tissue treatment.

The most effective exercises restore posture, shoulder blade control, spinal mobility, breathing mechanics, and Human Spring biomechanics without increasing compression of the brachial plexus. Exercise should reinforce normal movement rather than strengthen abnormal movement patterns.

Throughout this book, you will learn the safest exercises for improving thoracic outlet syndrome (TOS).

What physical therapy protocol should be followed for thoracic outlet syndrome (TOS)?

An effective physical therapy protocol for thoracic outlet syndrome (TOS) begins by reducing muscle guarding with Vibeassage Therapy, self-help deep tissue treatment, and manual therapy before progressing to stretching, mobility, stabilization, and strengthening exercises. The goal is to restore Human Spring biomechanics, normalize movement, and eliminate the mechanical compression responsible for symptoms.

Rehabilitation should progress only after symptoms improve rather than following a rigid timeline. Throughout this book, you will learn the proper sequence for successful physical therapy treatment of thoracic outlet syndrome (TOS).

What workplace modifications help thoracic outlet syndrome (TOS)?

Helpful workplace modifications for thoracic outlet syndrome (TOS) include improving desk ergonomics, keeping the keyboard and mouse close to the body, avoiding prolonged reaching, supporting the forearms, taking frequent movement breaks, and maintaining proper posture. Regular use of Vibeassage Therapy and self-help deep tissue treatment during the workday may help reduce muscle tension created by prolonged sitting and sustained muscle contraction.

Small ergonomic changes often produce significant improvements when combined with restoration of Human Spring biomechanics. Throughout this book, you will learn practical workplace strategies that reduce compression associated with thoracic outlet syndrome (TOS).

What prevention exercises work for thoracic outlet syndrome (TOS)?

The best prevention exercises for thoracic outlet syndrome (TOS) improve posture, shoulder blade stability, spinal mobility, breathing mechanics, and overall Human Spring biomechanics while avoiding excessive compression of the thoracic outlet. Performing Vibeassage Therapy and self-help deep tissue treatment before exercise helps prepare muscles for normal movement and reduces protective muscle guarding.

Prevention exercises should emphasize quality of movement rather than heavy resistance or high repetition. Throughout this book, you will learn how prevention exercises can reduce the risk of developing thoracic outlet syndrome (TOS).

How can thoracic outlet syndrome (TOS) be prevented?

Many cases of thoracic outlet syndrome (TOS) can be prevented by maintaining proper posture, avoiding prolonged sustained muscle contraction, optimizing workstation ergonomics, taking frequent movement breaks, and preserving healthy Human Spring biomechanics. Regular Vibeassage Therapy, self-help deep tissue treatment, and early correction of muscle tightness may help prevent chronic compression from developing.

Prevention focuses on eliminating the mechanical stresses that gradually narrow the thoracic outlet over time. Throughout this book, you will learn practical strategies to help prevent thoracic outlet syndrome (TOS) before symptoms begin.

Does thoracic outlet syndrome (TOS) go into remission?

Yes. Many patients experience long periods of remission from thoracic outlet syndrome (TOS) after the underlying biomechanical causes of compression have been corrected.

Continuing Vibeassage Therapy, self-help deep tissue treatment, posture correction, and healthy movement habits helps maintain Human Spring biomechanics and reduce the likelihood of symptom recurrence. Remission is more likely when patients eliminate the activities that originally caused chronic compression.

Throughout this book, you will learn how long-term self-care helps maintain remission from thoracic outlet syndrome (TOS).

How do you prevent recurrence of thoracic outlet syndrome (TOS)?

Preventing recurrence of thoracic outlet syndrome (TOS) requires maintaining proper posture, avoiding prolonged compression, continuing Vibeassage Therapy, performing regular self-help deep tissue treatment, and preserving healthy Human Spring biomechanics. Patients should also identify and modify the daily habits that originally contributed to their condition, including prolonged computer work, poor sleeping positions, and sustained muscle contraction.

Long-term maintenance is often the key to preventing symptoms from returning. Throughout this book, you will learn how to develop a maintenance program that helps prevent recurrence of thoracic outlet syndrome (TOS).

How do you reduce flare-ups of thoracic outlet syndrome (TOS)?

Flare-ups of thoracic outlet syndrome (TOS) can often be reduced by identifying aggravating activities early, correcting posture, decreasing sustained muscle contraction, and using Vibeassage Therapy with self-help deep tissue treatment to relax tight muscles before severe symptoms develop. Temporary activity modification, heat or ice when appropriate, and restoring Human Spring biomechanics may also shorten the duration of symptom flare-ups.

The earlier treatment begins, the easier it is to control symptoms. Throughout this book, you will learn practical techniques for reducing flare-ups of thoracic outlet syndrome (TOS).

When can athletes return to sport after thoracic outlet syndrome (TOS)?

Athletes may return to sport after thoracic outlet syndrome (TOS) once pain, numbness, weakness, and movement restrictions have resolved and normal Human Spring biomechanics have been restored. Continuing Vibeassage Therapy and self-help deep tissue treatment during rehabilitation helps maintain soft tissue mobility and prepares muscles for progressive training.

Return to sport should occur gradually without reproducing symptoms during practice or competition. Throughout this book, you will learn how athletes can safely return to sport after recovering from thoracic outlet syndrome (TOS).

Can exercise restore shoulder mechanics in thoracic outlet syndrome (TOS)?

Yes. Appropriate exercise can restore normal shoulder mechanics in thoracic outlet syndrome (TOS) after muscle restrictions have been reduced with Vibeassage Therapy and self-help deep tissue treatment.

Rehabilitation should improve shoulder blade movement, posture, spinal mobility, breathing mechanics, and Human Spring biomechanics while avoiding positions that recreate compression. Proper movement patterns are more important than simply increasing strength.

Throughout this book, you will learn how exercise restores healthy shoulder mechanics in patients with thoracic outlet syndrome (TOS).

How should rehabilitation progress for thoracic outlet syndrome (TOS)?

Rehabilitation for thoracic outlet syndrome (TOS) should progress from pain reduction and muscle relaxation to mobility restoration, movement retraining, stabilization, strengthening, and finally return to full activity. Vibeassage Therapy and self-help deep tissue treatment help prepare tissues for each stage of rehabilitation by reducing muscle guarding and improving soft tissue mobility while restoring Human Spring biomechanics.

Progression should always be based on symptom improvement and movement quality rather than following a fixed schedule. Throughout this book, you will learn the proper progression for successful rehabilitation from thoracic outlet syndrome (TOS).

References

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Glossary

Browse important terms used in this chapter. Select a letter or search by keyword.

A Acromioclavicular (AC) Joint
The synovial joint between the acromion of the scapula and the clavicle. Restoring normal AC joint mobility is presented as an important component of thoracic outlet rehabilitation and shoulder biomechanics.
A Active Rehabilitation
The phase of recovery emphasizing strengthening exercises, corrective exercise, neuromuscular retraining, and functional movement after compression has been relieved. Chapter 14 centers on active rehabilitation as Step 2 of the Human Spring Approach.
A Aerobic Capacity
The body's ability to sustain prolonged physical activity using oxygen-dependent metabolism. Patients are evaluated for aerobic capacity before beginning active rehabilitation.
A Aerobic Conditioning
Exercise designed to improve muscular endurance and cardiovascular fitness. The chapter explains that aerobic conditioning helps reduce early muscle fatigue and maintain thoracic outlet posture.
A Aerobic Exercise
Exercise performed primarily through aerobic metabolism to improve endurance, postural stability, and long-term thoracic outlet function.
A Aerobic Metabolism
Energy production using oxygen. Efficient aerobic metabolism reduces lactic acid accumulation and improves muscular endurance.
A Achilles Tendon
The large tendon connecting the calf muscles to the heel bone. The chapter uses the Achilles tendon as an example of an important spring component within the Human Spring System.
A ACL Injury (Anterior Cruciate Ligament Injury)
A common sports injury frequently occurring during landing rather than takeoff. The chapter uses ACL injury to illustrate the importance of training the body's landing mechanics.
A Active Recovery
Low-intensity movement performed between training sessions to promote circulation, tissue healing, and removal of metabolic waste while minimizing stiffness.
A Adaptive Deformation
A temporary, healthy change in tissue shape allowing the body to absorb forces without injury. Adaptive deformation is a fundamental concept within the Human Spring Model.
A Agility Training
Exercises emphasizing rapid changes in direction, coordination, balance, and reactive movement. Advanced spring training incorporates agility exercises after adequate rehabilitation.
A Angiogenesis
The formation of new blood vessels and capillaries within tissues. The chapter explains that regular exercise promotes angiogenesis to improve circulation and muscle recovery.
A Ankle Stability
The ability of the ankle to maintain controlled alignment during standing, walking, running, and landing. Barefoot training strengthens ankle stability as part of the Human Spring System.
A Arch Support
Support of the foot's longitudinal arch. The chapter argues that strengthening the body's natural arch support is preferable to long-term dependence on external devices.
A Arthrokinematics
The small accessory joint movements occurring during normal motion. Restoring normal arthrokinematics is considered essential before beginning strengthening exercises.
A Athletic Performance
The ability to perform efficiently during sports through optimal strength, speed, balance, power, and Human Spring biomechanics.
B Balance
The ability to maintain body stability during static and dynamic movement. Human Spring training improves balance through enhanced proprioception and neuromuscular control.
B Balance Muscles
Muscles responsible for maintaining postural stability during movement and landing. The chapter emphasizes that these muscles are often neglected during conventional strength training.
B Barefoot Running
Running without shoes or with minimalist footwear to promote natural foot biomechanics, strengthen intrinsic foot muscles, and restore Human Spring function.
B Barefoot Training
Exercise performed without shoes to improve foot strength, proprioception, mobility, balance, and natural movement mechanics.
B Biomechanical Conditioning
Training directed toward improving the body's ability to tolerate mechanical loading while maintaining healthy Human Spring function.
B Biomechanics
The study of movement and mechanical function of the human body. Chapter 14 applies biomechanics through the Human Spring Model rather than a traditional lever-only model.
B Blood Flow
The circulation of blood through tissues supplying oxygen and nutrients while removing waste products. Improved blood flow supports recovery and spring performance.
C Cadence
The number of steps taken per minute during walking or running. Proper cadence improves Human Spring efficiency and reduces unnecessary impact forces.
C Capillary Growth
The development of additional capillaries within exercising muscles. Increased capillary density improves oxygen delivery and recovery.
C Capillary System
The microscopic blood vessel network supplying tissues with oxygen and nutrients. Exercise strengthens this system through physiological adaptation.
C Cartilage Degeneration
Progressive deterioration of joint cartilage caused by repetitive mechanical overload and inadequate shock absorption. A strong Human Spring helps reduce cartilage degeneration.
C Cellular Biomechanics
The mechanical behavior of individual cells under loading and deformation. The chapter notes that even cells possess measurable stiffness contributing to Human Spring function.
C Cellular Stiffness
The resistance of individual cells to deformation under mechanical load. Cellular stiffness contributes to overall spring mechanics.
C Chronic Fatigue
Persistent muscular fatigue resulting from an inefficient or weakened Human Spring System that cannot effectively recycle elastic energy.
C Chronic Pain
Long-standing pain resulting from repeated mechanical overload, poor biomechanics, and failure of the Human Spring System to adequately absorb forces.
C Collision Sports
Sports involving repeated body impacts such as football, boxing, rugby, wrestling, and mixed martial arts. The Human Spring Approach emphasizes preparing the body to tolerate collision forces safely.
C Compliance (Spring Compliance)
The ability of a spring to deform easily under load, increasing shock absorption and reducing impact forces. The chapter contrasts spring compliance with spring stiffness.
C Compression Spring
A spring designed to shorten under load while storing elastic energy. The chapter compares intervertebral discs to biological compression springs.
C Connective Tissue
The fibrous tissues—including tendons, ligaments, fascia, and cartilage—that contribute to the Human Spring System by storing and transmitting mechanical forces.
D Deep Stabilizing Muscles
Small muscles located close to joints that provide postural stability and control rather than producing large movements. The chapter emphasizes that these muscles are frequently neglected in conventional training but are essential components of the Human Spring System.
D Delayed Onset Muscle Soreness (DOMS)
Muscle soreness that develops several hours to days after unfamiliar or strenuous exercise because of microscopic muscle fiber damage and normal tissue adaptation. The chapter explains how to distinguish DOMS from acute muscle injury and recommends vibration therapy to speed recovery.
D Deformation
A change in the shape or size of a material or biological tissue under mechanical load. The Human Spring Model distinguishes healthy elastic deformation from pathological plastic deformation.
D Degenerative Joint Disease (DJD)
Progressive deterioration of joint cartilage and supporting tissues resulting from chronic mechanical overload, poor shock absorption, and impaired Human Spring function.
D Diaphragmatic Breathing
Breathing that emphasizes expansion of the diaphragm rather than excessive upper chest movement. Proper diaphragmatic breathing reduces unnecessary thoracic compression during exercise.
D Disc Degeneration
Progressive deterioration of the intervertebral discs resulting from repeated mechanical overload and impaired shock absorption. The chapter presents strong Human Spring mechanics as protective against disc degeneration.
D Dynamic Stability
The body's ability to maintain joint alignment and balance while moving. Dynamic stability depends on coordinated muscle activation, proprioception, and Human Spring function.
E Eccentric Muscle Control
Controlled muscle lengthening during movement, particularly during landing. Eccentric control is essential for safely absorbing impact forces.
E Eccentric Strength
The strength generated while muscles lengthen under load. The chapter identifies eccentric strength as a key determinant of injury prevention during landing.
E Elastic Deformation
A reversible change in tissue shape that stores mechanical energy and returns completely to its original form after the load is removed. Elastic deformation is the foundation of healthy Human Spring function.
E Elastic Energy
Mechanical energy stored temporarily within muscles, tendons, ligaments, fascia, and other connective tissues during deformation. Elastic energy is later released to improve movement efficiency.
E Elastic Recoil
The rapid return of stretched tissues to their original shape, releasing stored elastic energy to improve movement efficiency and reduce muscular effort.
E Elasticity
The ability of tissues to deform under load and return completely to their original shape. Healthy elasticity allows the Human Spring System to absorb impacts safely.
E Engram
A neurological memory pattern stored within the central nervous system that controls learned movement patterns. The chapter explains that exercise strengthens healthy engrams through repetition.
E Energy Conservation
Reduction in muscular effort through efficient storage and release of elastic energy. A properly functioning Human Spring improves energy conservation during movement.
E Energy Recycling
The repeated storage and release of elastic energy during walking, running, jumping, and other movements. Energy recycling is one of the three primary functions of the Human Spring System.
E Exercise Progression
The gradual advancement of rehabilitation exercises based on movement quality, symptom improvement, and neuromuscular adaptation rather than a fixed schedule.
E Exercise Recovery
The physiological repair process following physical training. The chapter recommends vibration therapy to accelerate exercise recovery by improving circulation and reducing inflammation.
E Explosive Movement
Rapid force production requiring efficient storage and release of elastic energy. Plyometric exercises develop explosive movement through Human Spring training.
F Fascia
The continuous connective tissue network that stores mechanical energy, transmits forces, and contributes significantly to the Human Spring System.
F Fatigue Resistance
The ability of muscles and connective tissues to maintain performance over prolonged activity. Human Spring training improves fatigue resistance by enhancing spring function.
F Foot Biomechanics
The coordinated mechanical function of the foot during standing, walking, running, and jumping. The chapter emphasizes restoring natural foot biomechanics through barefoot training.
F Foot Eversion
Movement of the sole of the foot outward. Barefoot eversion exercises strengthen muscles supporting the Human Spring System.
F Foot Inversion
Movement of the sole of the foot inward. Barefoot inversion exercises improve foot stability and spring mechanics.
F Foot Strike Pattern
The manner in which the foot contacts the ground during walking or running. Proper foot strike improves force absorption and Human Spring efficiency.
F Force Absorption
The body's ability to safely dissipate mechanical energy during impact. Human Spring training is designed to maximize force absorption while minimizing tissue injury.
F Force Distribution
The spreading of mechanical loads across multiple tissues to reduce stress on any single structure. Healthy Human Spring mechanics improve force distribution.
F Functional Movement
Efficient, coordinated movement used during daily activities and athletic performance. The Human Spring Approach seeks to restore normal functional movement through rehabilitation.
F Functional Strengthening
Strength training emphasizing coordinated whole-body movement rather than isolated muscle development. Functional strengthening is a major objective of spring training.
G Gait Mechanics
The coordinated biomechanical pattern of walking or running. Proper gait mechanics depend upon efficient Human Spring function and natural foot movement.
G Golgi Tendon Organ
A sensory receptor within tendons that detects muscle tension and contributes to neuromuscular control. The Human Spring System relies upon Golgi tendon organs to regulate muscle function during movement.
G Ground Contact Time
The duration that the foot remains on the ground during walking or running. Efficient Human Spring mechanics reduce unnecessary ground contact time while improving elastic energy return.
G Ground Reaction Force (GRF)
The force exerted by the ground against the body during standing, walking, running, landing, or jumping. Human Spring training is specifically designed to improve the body's ability to absorb and safely manage ground reaction forces.
H Healthy Aging
The preservation of physical function, mobility, joint health, and musculoskeletal resilience throughout life. The chapter proposes that maintaining a strong Human Spring System contributes to healthier aging and reduced degenerative disease.
H Healthy Deformation
A normal, reversible change in tissue shape during loading that completely returns to its original form after the force is removed. Healthy deformation allows efficient shock absorption without tissue injury.
H Herniated Disc
Displacement of intervertebral disc material that may compress spinal nerves and reduce normal spring function. The chapter repeatedly identifies a strong Human Spring as protective against disc injury.
H Human Movement
The coordinated interaction of muscles, joints, fascia, connective tissues, and the nervous system to produce efficient movement. Chapter 14 explains human movement through the Human Spring Model rather than a lever-only model.
H Human Spring
The author's biomechanical model describing the body as an integrated elastic spring system capable of absorbing shock, storing elastic energy, maintaining joint spacing, and recycling mechanical energy during movement.
H Human Spring Approach
The comprehensive rehabilitation philosophy combining decompression, deep tissue therapy, movement retraining, resistance exercise, spring training, and long-term maintenance to restore normal biomechanics.
H Human Spring Engineering
The application of engineering principles governing springs, materials science, elasticity, and force transmission to understand human biomechanics and injury prevention.
H Human Spring Model
The theoretical framework proposing that the human body functions primarily as a living spring system rather than simply a collection of levers.
H Human Spring System
The integrated network of muscles, tendons, fascia, ligaments, connective tissues, and joints working together to absorb impacts, store elastic energy, and maintain biomechanical integrity.
I Impact Absorption
The ability of the body to dissipate mechanical forces during walking, running, jumping, collisions, and landings without tissue injury.
I Impact Attenuation
The reduction of impact forces transmitted through the body by elastic tissues and coordinated Human Spring mechanics.
I Impact Loading
Mechanical forces applied to tissues during landing, jumping, running, or collisions. Proper Human Spring function minimizes tissue damage from repeated impact loading.
I Injury Prevention
Strategies designed to reduce the risk of musculoskeletal injury through improved biomechanics, strength, proprioception, neuromuscular control, and Human Spring training. Injury prevention is a primary objective of Chapter 14.
I Intervertebral Disc
A fibrocartilaginous structure between adjacent vertebrae that functions as a biological compression spring, storing and releasing mechanical energy during movement.
I Intrinsic Foot Muscles
Small muscles located entirely within the foot that stabilize the arches and contribute to normal Human Spring function. Barefoot training strengthens these muscles.
I Isometric Exercise
Exercise in which muscles generate force without changing length. Isometric exercises are included as part of progressive spring strengthening.
J Joint Alignment
The normal anatomical relationship between adjacent bones within a joint. Human Spring training improves joint alignment through balanced muscle function and coordinated biomechanics.
J Joint Compression
Excessive loading of opposing joint surfaces caused by poor biomechanics or muscle imbalance. A properly functioning Human Spring reduces abnormal joint compression.
J Joint Mobility
The normal range and quality of movement within a joint. Restoring joint mobility is a prerequisite before beginning strengthening exercises.
J Joint Play
Small passive accessory movements occurring within healthy joints. The chapter emphasizes restoring normal joint play before initiating active rehabilitation.
J Joint Stability
The ability of joints to remain properly aligned while resisting abnormal movement during loading. Strong Human Spring mechanics enhance joint stability throughout the body.
K Kinetic Chain
The interconnected system of joints, muscles, fascia, tendons, and ligaments transmitting forces throughout the body during movement. Dysfunction anywhere within the kinetic chain affects Human Spring performance.
K Kinetic Energy
The energy possessed by a moving body. The Human Spring System stores and recycles portions of kinetic energy during walking, running, and jumping to improve efficiency.
L Landing Mechanics
The coordinated neuromuscular strategy used to safely absorb forces during ground contact. The chapter emphasizes that most injuries occur during landing rather than takeoff.
L Landing Muscles
Muscles primarily responsible for eccentric control, impact absorption, and stabilization during landing. These muscles are frequently neglected in traditional strength programs.
L Lateral Stability
The ability to resist excessive side-to-side movement during walking, running, cutting, and landing. Improved lateral stability contributes to injury prevention and efficient Human Spring mechanics.
L Lever Mechanics
The traditional biomechanical model explaining movement primarily through rigid levers and pivot points. The Human Spring Model expands beyond lever mechanics by incorporating elastic deformation and energy storage.
L Ligaments
Strong bands of connective tissue connecting bones across joints. Ligaments function as elastic components of the Human Spring System by contributing to joint stability and force transmission.
L Loading Cycles
Repeated applications of mechanical force experienced during walking, running, jumping, work, and daily activities. A healthy Human Spring withstands millions of loading cycles without permanent damage.
L Longitudinal Arch
The primary arch running from the heel to the forefoot. It functions as one of the body's most important biological springs by storing and releasing elastic energy during gait.
M Materials Science
The scientific study of how materials respond to mechanical forces such as tension, compression, bending, torsion, and impact. The chapter applies principles of materials science to explain the behavior of the Human Spring System.
M Mechanical Compliance
The ability of biological tissues to deform under load while absorbing mechanical energy. Greater compliance improves shock absorption but may reduce movement efficiency if excessive.
M Mechanical Deformation
Temporary or permanent changes in tissue shape resulting from external mechanical forces. Healthy mechanical deformation allows the body to absorb impacts without injury.
M Mechanical Efficiency
The ability to produce movement with minimal energy expenditure by efficiently storing and recycling elastic energy. Mechanical efficiency is a major benefit of a healthy Human Spring System.
M Mechanical Loading
The forces placed upon muscles, tendons, ligaments, fascia, cartilage, and bone during movement and exercise. Appropriate progressive loading strengthens the Human Spring System.
M Mechanics
The branch of physics studying forces and motion. The Human Spring Model applies mechanical principles to explain movement, injury prevention, and rehabilitation.
M Mechanotransduction
The biological process by which cells detect and respond to mechanical forces. The chapter notes that cellular stiffness and mechanotransduction influence Human Spring function.
M Metabolic Waste
Byproducts of cellular metabolism, including lactic acid and inflammatory chemicals, that accumulate within working muscles. Vibration therapy and improved circulation help remove metabolic waste before and after exercise.
M Microcirculation
Blood flow through capillaries and the smallest blood vessels supplying muscles and connective tissues. Enhanced microcirculation improves oxygen delivery, nutrient transport, and recovery.
M Minimalist Footwear
Shoes with little cushioning or structural support designed to encourage natural foot movement and Human Spring function.
M Mobility
The ability of joints and soft tissues to move freely through their full physiological range of motion. Mobility is essential for proper Human Spring mechanics and injury prevention.
M Motor Control
The neurological regulation of coordinated movement through precise activation of muscles. Human Spring training enhances motor control during walking, running, and athletic performance.
M Motor Learning
The process by which repeated movement permanently improves neuromuscular performance. The chapter explains that repetition strengthens movement engrams within the brain.
M Movement Efficiency
The ability to move with minimal wasted energy while maximizing speed, power, and endurance. Efficient Human Spring function greatly improves movement efficiency.
M Movement Mechanics
The biomechanical principles governing human movement. Proper movement mechanics minimize injury risk while maximizing Human Spring performance.
M Movement Quality
The accuracy, coordination, and efficiency of movement patterns during rehabilitation and athletic performance. Exercise progression should be based on movement quality rather than time alone.
M Muscle Guarding
An involuntary protective increase in muscle tension following injury. The chapter distinguishes pathological muscle guarding from healthy spring stiffness.
M Muscle Memory
A commonly used but technically inaccurate term referring to learned movement patterns. The chapter explains that movement patterns are actually stored within the central nervous system as engrams rather than within muscles.
M Muscle Spasm
An involuntary muscle contraction that may compress joints, nerves, blood vessels, and the thoracic outlet. Muscle spasms should be relieved before beginning strengthening exercises.
M Muscle Spindle Cells
Stretch-sensitive sensory receptors located within skeletal muscles that regulate muscle tone and protective reflexes. The chapter discusses reducing abnormal spindle activity before rehabilitation.
M Muscle Stiffness
Protective tightness occurring after injury or excessive loading. The chapter repeatedly emphasizes that muscle stiffness should not be confused with healthy spring stiffness.
M Muscle-Tendon Unit
The functional combination of muscle and tendon acting together as an elastic spring that stores and releases mechanical energy during movement.
M Musculoskeletal System
The integrated system of bones, joints, muscles, tendons, ligaments, fascia, and connective tissues responsible for movement and support. The Human Spring System functions throughout the musculoskeletal system.
M Myofascial Restriction
Abnormal tightening of muscles and fascia that limits mobility and contributes to compression syndromes. Myofascial restrictions should be released before beginning active rehabilitation.
N Natural Movement
Movement performed according to the body's inherent biomechanical design without unnecessary external restriction. Barefoot training seeks to restore natural movement patterns.
N Neuroplasticity
The lifelong ability of the brain to reorganize and strengthen neural pathways through learning and repetition. The chapter explains that neuroplasticity allows patients of any age to improve movement patterns.
N Neuromuscular Adaptation
Physiological changes within the nervous system and muscles resulting from repeated training. These adaptations improve Human Spring function and movement efficiency.
N Neuromuscular Control
The coordinated interaction between the nervous system and muscles that produces stable, efficient movement. It is one of the primary goals of spring training.
N Newtonian Mechanics
The branch of classical physics describing the relationship between forces, mass, and motion. The Human Spring Model applies Newtonian mechanics to explain impact loading and movement.
O Orthotics
External devices placed inside shoes to support the foot. The chapter argues that long-term dependence on orthotics may weaken the body's natural Human Spring rather than restoring it.
O Overuse Injury
An injury resulting from repeated mechanical stress exceeding the body's capacity to recover. Proper Human Spring function helps reduce the risk of overuse injuries.
O Oxygen Delivery
Transport of oxygen through the circulation to muscles and connective tissues. Improved oxygen delivery supports muscle performance, recovery, and tissue healing.
P Periodization
The systematic organization of training into progressive phases to optimize adaptation, recovery, and athletic performance. The chapter discusses incorporating spring training into a periodized training model.
P Physiological Adaptation
The body's structural and functional response to repeated exercise, resulting in stronger muscles, tendons, connective tissues, and Human Spring mechanics.
P Plastic Deformation
A permanent change in tissue shape caused by excessive mechanical loading or injury. Unlike elastic deformation, plastic deformation does not return completely to its original form.
P Plantar Fascia
The thick band of connective tissue supporting the foot arch. It functions as one of the body's most important biological springs by storing and releasing elastic energy.
P Plyometric Training
Explosive exercise utilizing rapid stretch-shortening cycles to improve elastic energy storage, power, speed, and Human Spring performance. Plyometric training represents Phase III of the rehabilitation program.
P Plyometrics
A category of explosive exercises that teach the body to absorb, store, and rapidly release elastic energy. Plyometrics develop the integrated Human Spring System rather than isolated muscles.
P Postural Muscles
Deep stabilizing muscles responsible for maintaining upright posture during standing, sitting, and movement. These muscles are essential components of the Human Spring System.
P Postural Stability
The ability to maintain proper body alignment against gravity during movement and sustained activities. Human Spring training improves postural stability and reduces fatigue.
P Progressive Overload
The gradual increase in training demands necessary to stimulate physiological adaptation. The chapter recommends progressive overload while maintaining perfect exercise technique.
P Progressive Resistance Exercise
Strength training that progressively increases resistance as muscles adapt. Progressive resistance forms the foundation of Phase II Human Spring strengthening.
P Proprioception
The body's awareness of joint position and movement. Barefoot training and Human Spring exercises enhance proprioception, improving balance, stability, and movement quality.
R Reactive Force Development
The ability to rapidly transition from force absorption to force production during movement. Reactive force development is enhanced through plyometric training and Human Spring conditioning.
R Reactive Strength
The capacity to rapidly absorb impact forces and immediately produce powerful movement using stored elastic energy. Reactive strength is one of the principal goals of Human Spring training.
R Rehabilitation
A structured process of restoring normal biomechanics, movement, strength, mobility, stability, and Human Spring function after injury. Chapter 14 focuses on the active rehabilitation phases of recovery.
R Rehabilitation Progression
The systematic advancement from pain reduction and decompression to strengthening, spring training, and return to activity. Progression is based on movement quality rather than a fixed timeline.
R Repetitive Loading
Repeated application of mechanical stress during walking, running, work, sports, and daily activities. A healthy Human Spring System tolerates repetitive loading while minimizing tissue damage.
R Resistance Exercise
Exercise performed against an external load to increase muscle strength, connective tissue resilience, and Human Spring support. Resistance exercises make up Phase II of the rehabilitation program.
R Resilience
The ability of tissues to withstand repeated mechanical loading without permanent damage. The Human Spring System improves overall musculoskeletal resilience.
R Restorative Biomechanics
The process of restoring normal movement mechanics, joint spacing, force distribution, and Human Spring function through rehabilitation.
R Running Biomechanics
The mechanical principles governing efficient running, including foot strike, cadence, spring stiffness, elastic recoil, and force absorption. Human Spring training seeks to optimize running biomechanics.
R Running Economy
The amount of energy required to maintain a given running speed. Efficient Human Spring function improves running economy by recycling elastic energy.
S Scapular Biomechanics
The coordinated movement of the scapula during upper extremity motion. Proper scapular biomechanics help maintain thoracic outlet space and shoulder stability.
S Scapular Stabilization
Strengthening and neuromuscular control of the muscles supporting the shoulder blade. Scapular stabilization is a major objective of thoracic outlet rehabilitation.
S Scapular Stability
The ability of the scapula to remain properly positioned while moving. Stable scapular mechanics reduce compression within the thoracic outlet.
S Shock Absorption
The process of reducing impact forces through controlled deformation of muscles, tendons, ligaments, fascia, intervertebral discs, and joints. Shock absorption is one of the primary functions of the Human Spring System.
S Single-Joint Stiffness
The mechanical stiffness of an individual joint, such as the ankle, knee, hip, spine, or cervical spine. Single-joint stiffness contributes to overall Human Spring performance.
S Soft Tissue
Collective term for muscles, tendons, fascia, ligaments, and connective tissues. Healthy soft tissue mobility is essential for normal Human Spring mechanics.
S Sports Biomechanics
The scientific study of movement mechanics during athletic performance. Chapter 14 applies sports biomechanics through the Human Spring Model to improve both performance and injury prevention.
S Sports Medicine
The medical specialty devoted to injury prevention, rehabilitation, and optimization of athletic performance. The Human Spring Approach integrates sports medicine with biomechanics and engineering principles.
S Spring Compliance
The ability of the Human Spring to deform more easily under load, allowing greater shock absorption and impact attenuation. Increased compliance improves protection from impacts but may reduce movement efficiency if excessive.
S Spring Deformation
The temporary change in shape of the Human Spring during loading. Healthy spring deformation stores elastic energy that is released during movement.
S Spring Engineering
The engineering principles governing the behavior of springs, including stiffness, compliance, elasticity, deformation, and energy storage. These principles form the scientific foundation of the Human Spring Model.
S Spring Function
The combined ability of biological tissues to absorb impacts, store elastic energy, recycle energy, and protect joints from mechanical overload.
S Spring Mechanics
The mechanical behavior of elastic biological tissues during loading and unloading. Spring mechanics explain how the body absorbs impact and generates efficient movement.
S Spring Stiffness
The controlled increase in elastic tension within the Human Spring System that improves speed, power, joint stability, and movement efficiency without producing pathological muscle tightness. The chapter emphasizes that spring stiffness is fundamentally different from muscle stiffness.
S Spring Strength
The overall capacity of the Human Spring System to tolerate repeated loading while maintaining elasticity, resilience, stability, and energy recycling.
S Spring Suspension System
The integrated muscles, tendons, fascia, and connective tissues that suspend body segments while maintaining joint spacing and biomechanical alignment. Strengthening this suspension system is one of the primary objectives of Chapter 14.
S Spring Training
The specialized training method developed within the Human Spring Approach that strengthens the body's elastic system through progressive resistance exercises, plyometrics, movement retraining, and biomechanical conditioning. It represents Step 2 and Step 3 of long-term rehabilitation and injury prevention.
S Stabilizer Muscles
Deep muscles responsible for maintaining joint alignment and postural control during movement. Conventional bodybuilding often neglects these muscles despite their critical role in Human Spring function.
S Stretch-Shortening Cycle (SSC)
A rapid sequence of eccentric muscle loading immediately followed by concentric contraction. The stretch-shortening cycle enables efficient storage and release of elastic energy during plyometric movements.
S Structural Integrity
The ability of biological tissues to maintain normal shape and function while resisting repeated mechanical loading. Strong structural integrity reduces injury risk and supports long-term Human Spring performance.
S Synaptic Plasticity
The strengthening or weakening of communication between neurons through repeated activity. The chapter cites synaptic plasticity as one of the mechanisms underlying motor learning and long-term movement retraining.
T Takeoff Muscles
The large primary muscles responsible for propulsion during walking, running, jumping, and athletic movement. The chapter contrasts these with the equally important landing muscles, emphasizing that training only the takeoff muscles increases injury risk.
T Tendon
A dense connective tissue that attaches muscle to bone and functions as a major elastic component of the Human Spring System by storing and releasing mechanical energy.
T Tendon Elasticity
The ability of tendons to stretch under load and recoil to their original length while returning stored elastic energy. Healthy tendon elasticity improves movement efficiency and reduces injury risk.
T Tissue Elasticity
The capacity of biological tissues to temporarily deform under mechanical loading and recover their original shape. Tissue elasticity is fundamental to healthy Human Spring function.
T Tissue Resilience
The ability of muscles, tendons, fascia, ligaments, cartilage, and bone to tolerate repeated loading without permanent damage. Spring training enhances tissue resilience through progressive adaptation.
T Thoracic Outlet
The anatomical passage through which the brachial plexus, subclavian artery, and subclavian vein pass between the neck and upper extremity. Chapter 14 focuses on strengthening the body to keep this space open after decompression.
T Thoracic Outlet Syndrome (TOS)
A neurovascular compression disorder involving narrowing of the thoracic outlet. The chapter presents spring training as the second phase of long-term rehabilitation and recurrence prevention.
T Thoracic Spine
The twelve vertebrae associated with the rib cage. Proper thoracic spine mobility contributes to healthy posture, spring mechanics, and thoracic outlet function.
T Training Progression
The planned advancement of exercise intensity, complexity, and loading throughout rehabilitation while maintaining proper biomechanics and movement quality.
T Trigger Point
A hyperirritable area within skeletal muscle producing pain, tenderness, and abnormal muscle contraction. Trigger points should be released before beginning active strengthening.
T Trigger Point Therapy
A manual treatment technique directed toward releasing myofascial trigger points, reducing abnormal muscle tension, and restoring normal Human Spring mechanics.
U Upper Crossed Syndrome
A common postural imbalance characterized by forward head posture, rounded shoulders, and muscle imbalance around the neck and shoulder girdle. The chapter identifies it as a frequent contributor to thoracic outlet syndrome.
V Vascular Compression
Mechanical compression of arteries or veins resulting in impaired blood flow. The Human Spring Approach aims to eliminate vascular compression by restoring normal biomechanics.
V Venous Congestion
Pooling of blood within veins due to impaired venous return. Premature exercise before thoracic outlet decompression may increase the risk of venous congestion.
V Venous Return
The flow of blood back to the heart through the venous system. Healthy thoracic outlet biomechanics improve venous return from the upper extremity.
V Venous Stasis
Slowing or stagnation of venous blood flow. Persistent thoracic outlet compression can produce venous stasis and increase the risk of thrombosis.
V Vibeassage
The author's therapeutic vibrating massage device used before and after exercise to improve circulation, remove inflammatory byproducts, reduce muscle guarding, enhance recovery, and prepare tissues for Human Spring training.
V Vibration Therapy
The therapeutic application of controlled mechanical vibration to improve circulation, lymphatic drainage, muscle recovery, and tissue healing. Chapter 14 recommends vibration therapy before exercise to prepare muscles for training.
W Walking Biomechanics
The coordinated mechanical function of the body during walking, including foot mechanics, spring stiffness, energy recycling, and force absorption. Efficient walking biomechanics depend upon a healthy Human Spring System.
W Whiplash Injury
An injury resulting from rapid acceleration-deceleration forces acting upon the cervical spine. The chapter proposes that a well-trained Human Spring may improve resistance to whiplash injuries.
W Workstation Ergonomics
The arrangement of desks, computers, keyboards, monitors, and workstations to minimize prolonged thoracic outlet compression and postural strain. No major glossary terms beginning with X appear in Chapter 14. No major glossary terms beginning with Y appear in Chapter 14. No major glossary terms beginning with Z appear in Chapter 14.
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