Thoracic Outlet Syndrome Stretches & Exercises – Ask Doctor Jo

Thoracic Outlet Syndrome Stretches & Exercises – Ask Doctor Jo

Hey everybody, it’s Doctor Jo, and today I’m
gonna show you some stretches and exercises for thoracic outlet syndrome. Let’s get started. Like my T-shirt? I do. That represents Miss Kali. And yes, yes I would. If you like this t-shirt, or you want to check
out some other cool stuff, go to Alright, let’s get started. What I like to do with thoracic outlet syndrome
is stretch your pec muscles, that’s really important get that correct posture. Do nerve glides or stretching kind of get
those nerves loosened up and moving around in there, and then also doing some first rib
mobilization. So let’s start off with some pec stretches. The first one is a pretty easy one, you can
just take your hands and clasp them CLASP them behind you. Try and keep your palms together if you can,
and you’re really just pushing your chest outwards. So it really opens up the chest, gets the
stretch in there. Hold it for about 30 seconds. Then relax it, and do that 3 times. So that really kind of opens everything up
in there and the reason you want to get those pec muscles stretched out is cause usually
that’s where all the stuff gets trapped in that area right there. So if you loosen those up, that’s gonna help
get that movement and get everything nice and loose and get that irritation out of there. So the next thing I’m gonna show you is a
first rib mobilization. You can do that a couple of different ways,
but what I think is probably the easiest way is just grab a ball. A massage ball, lacrosse ball, anything that’s
kind of firm. You can use a tennis ball, but you want it
to be enough where it puts pressure on that first rib. And the first rib kind of lies underneath
that clavicle or the collar bone. So what you want to do is take that ball and
just set it in that little pocket. You can kind of feel a little pocket in there,
and if you push hard enough you can feel that first rib. And a lot of times that first rib has come
up a little bit. So you want to put it right there. What I like to do is relax this arm kind of
down. Take your neck and bend it over cause that
relaxes some of those neck muscles in there. And then take a deep breath in, and as you’re
letting it out, push down as hard as you comfortably can on the ball. So you go. And come back up and do that about 4 or 5
times. So big breath in. And push down. And sometimes, people do feel a little pop
where it’s popping back into place. So as long as it’s not painful, that’s a good
thing, that’s not necessarily a bad thing. And a lot of time that pressure gets off of
those nerves and those vessels and veins and arteries in there, and then it feels a lot
better after that. So now, we’re gonna lie down a little bit
and Im gonna show you some more pec stretches. I like to use a foam roller, this is probably
the best way that I like to stretch the pecs. Put it vertically, and you’re gonna lie on
top of it. So come down close to the edge because you
want to be able to be nice and relaxed and put your head on it. So then you’re not stressing out your neck
muscles. And then just bring your arms out to the side
and let them drop down. So as you can see here, I’m stretching out
those pec muscles and that’s a really, really nice stretch. And if you want more of a stretch, if this
is just a medium stretch for you, then straighten your arms out a little bit. And then do the same thing. Just try and relax and let them go down. If you need a little bit more, you can have
somebody kind of push down on your arms a little bit and get a really good pec stretch
there. But again, just holding it for about 30 seconds,
give it a little break, and then doing that again. Just really stretching it out. Then you’re gonna do some scapular squeezes,
shoulder squeezes, this is again just to help get that correct posture. Cause a lot of times when you roll forward
like that with those tight pec muscles, that’s what ends up causing all the problems. So getting your chest open is what really
helps. So a scapular squeeze is just really, imagine
that somebody is placing their hand in the middle of your back on your spine. And you’re trying to squeeze that hand with
your shoulder blades. So just coming, squeeze back. Hold it for about 3 – 5 seconds, and then
come forward. So really nice, squeeze, and then come back. I like to use my elbows while I’m pushing
back cause I feel like it helps me squeeze a little bit more. Some people just kind of squeeze this way,
but I feel like you get a little bit more of a squeeze if you actually use your elbows
a little bit. So just hold that squeeze for about 3 – 5
seconds and then relax. And do about 5 to 10 of those and that should
really help loosen it up a little bit. And then finally is the nerve glides or the
nerve stretches. You can do both ways. Sometimes with the stretches, people get a
little bit irritated with them, so there’s a modified way to do it which is kind of the
glide, and then there’s the stretch glide as well. Some people call it a little bit differently,
different ways. But the first one is gonna be the little bit
of modified, more of a glide. So if it’s on my right side, I’m gonna start
with my elbow up, my head up, and then I’m gonna put my arm out, but take my head, almost
like I have a string connected to my head. So I’m gonna go out like that and then come
up. So what I’m doing is I’m kind of gliding that
nerve, flossing that nerve, as I go. So out, come back in. This is the one that’s not quite as stressful
on the nerves, so you might want to start off with this one. With nerve glides, I only like to do about
10 of them because if you do a whole lot, then you’re gonna end up just irritating that
nerve even more. So especially with the stretches, the big
glides, really only stick with 10 just once a day. Don’t do a whole lot more than that. But then what you’re gonna do put your arm
straight out with your palm up. And this time you’re gonna take your head
to the opposite way as you pull your palm downward. So it’s gonna be this movement. Now you might want to just start off doing
the palm part first. Cause some people feel it there. I can feel a little bit of tingle in my middle
finger just right there doing that. But if you want even more, then you go out
this way and come back in. That really stretches out that nerve in there. If it’s kind of scarred up in that area, that’s
gonna help loosen everything up a little bit. And again, like I said, only just do about
10 of those. Don’t do any more of those especially in the
beginning. And then the last one is gonna be a stretch
for those scalene muscles right here. And the reason you really want to stretch
those out is these attach to that first rib down there. So if they’re tight, they’re pulling up on
that first rib. So what you want to do is, again kind of put
your hands behind you, you can clasp them. You don’t have to be so tight with them, but
put your hands behind you. And then you’re gonna turn your head a little
bit to an angle and then side bend. So it’s not just side bend this way, and it’s
not just rotating, it’s that kind of combination so you feel that stretch right in there where
those scalene muscles are. And then hold that stretch for about 30 seconds
and then relax. And do that 3 times. So there you have it. Those are your stretches and exercises for
thoracic outlet syndrome, or people call it TOS. If you have any questions, leave them in the
comments section. If you’d like to check out some other videos,
go to Don’t forget to like us. And remember, be safe, have fun (don’t let
the zombies get you), and I hope you feel better soon.

95 Replies to “Thoracic Outlet Syndrome Stretches & Exercises – Ask Doctor Jo”

  1. Doc thanks again for this video.

    But my question if a off topic, I can't do those lotus/Indian sit position. I used to but nowadays I can't do it any longer than five minutes. There's pain on the butt and on the hip. Any exercise or stretches I can do with it?

  2. Not sure if I have this or not but my forearms, hands, neck and shoulders are always sore and fatigued. My doc is clueless so maybe I'll ask her about this disorder. She wants to send me for an MRI on my neck. Which I'm not looking forward to and would like to avoid if at all possible. I had a nerve conduction test for carpal tunnel that was negative. Would that test have shown TOS? Or do I have to do that damn MRI?

  3. Thanks so much for this video. Really good and exceptional attention to understanding the diversity of nerve response. Too much nerve stretching can irritate. Thank you so much

  4. Thank you ,
    this really helped.
    Have had this for over 3 years now. You are the first to come up with
    an explanation and how to get rid of it.
    Do you know what to do with an impingement from a shoulder ?

  5. Doctor could you please tell me what is long term prognosis of cervical bulging discs causing pain in neck and shoulder blade .? Thanks

  6. Thank you so much for your humble help. Okay tell me please that do these intervertebral discs repair themselves to go back to normal shape and size ?😃

  7. I was stretching my pec minor and started getting a tingle in the tip of my thumb that wont go away. I think i aggravated a nerve. Any recommendations?

  8. THANK YOU so much for this FREE advice and help. You are amazing. I am totally grateful and thankful I have found your channel.

  9. i have been suffering with this for about 5 yrs, i need to know how much i need to stretch and exercise these muscles and how much is to much? i have been to several physical therapist and i now see a chiropractor but still have a lot of pain in shoulder and arm.
    also would strengthening my core help to relieve some of the pressure on my neck?

  10. Hey thank you so much! I want to ask you how much stretching is too much? I exercise with bodyweight exercises, 4 days a week, an my symptoms have aggravated. But i really ydont want to stop. What should i do? Thanks

  11. I can' t thank you enough how much your videos are helpful….thank you so much…my pt told me that she thinks i do have TOS. Can you have numbness on all five fingers when you have TOS?

  12. About two months ago I got a left shoulder arthroscopic bankart repair and posterior capsular plication. Since the time of surgery my right hand came into a lot of use. Cross body movements to reach out my left hand biceps by bringing my right hand infront of my chest. Sideward elevation and forward elevation therapy for left shoulder rehab, required my right shoulder joint to compress its pec minor, major, scalene muscles a lot. Initially I had right AC joint irritation and shoulder joint click-click sounds. And more prominantly, any everytime I reach my left shoulder with my rght hand, I felt a sever pinch on my pec minors. Slowly the right shoulder pain started to worse from Nov 16th and now since a week I feel burning sensation, tingling on my right throcic area spread through my right arm and fiingers. The right scalene, left upper traps, left scalene and right and left upper back (near the shoulder blades and inbetween the spinal chord) have become very tight. What do I do? lot of discomfort and pain if I sleep either on my right pecs or on my stomach. Mornings are cold and tingling on my right side and since two days the left traps have become super tight.

  13. Thanks for the video. I have numbness and tingling in all 5 fingers on both hands. Could TOS be the cause? I'm going for a EMG test next week just thought this sounded allot like what is going on.

  14. hey Jo….my right arm is not growing…even I can't lift my arm …just because of that syndrome …if anything happen please tell me

  15. Hi Dr Joe,
    I always get help from your videos, so thank you again.
    I just need to know that, one of my patient, misdiagnosed with cervical spondylosis by Ortho Physician,, I assessed her today and found out TOS.
    But the problem with this patient is when I am stretching or even trying to release her Scaleni, she is popping up due to severe pain radiates on her right upper limb.
    She is maintaining her Cx spine in flexion, which helps her to reduce pain.
    Today I prescribed her Cx Soft collar.
    Is there any other treatment I can start with her?
    I will be looking forward for your suggestion.
    Thank you in advance.

  16. I had a severe brain injury, from a car accident with hypoxic encephalopathy 23 years ago. My left arm and hand do not work the same anymore. My left hand was completely contracted at one time, and it still tingles some, especially my thumb. Still I've been going to the gym 3 times a week, and am getting a lot stronger. I primarily use machine weights, and started to do pull-ups about 6 months ago. I have the most trouble doing the extra wide pull-ups (where your hands are placed wide apart). Although I can do other kinds of pull-ups w/o assistance, wt the extra wide, I still need 70 lb. of help. Soon after starting these pull-ups, I noticed a lot of discomfort in my triceps. I realized that my brain wasn't sending the proper messages to my nerves in my left arm, for many years. Since doing exercises I have found on youtube including yours, my arm has started feeling a lot better, and both lifting, and doing dips has become much easier. Still can't even get close to doing the bird man stretch, but small steps. Thank you Doctor Jo 🙂

  17. These are providing a lot of relief for me! I had to wait a month between diagnosis and starting physical therapy, since everybody was booked out, and I thought I would go nuts from the pain!! But these helped a lot, thank you so much! Laying on that roller– or in my case, a rolled up towel–really helped open things up, but my back is pretty unhappy about it! I guess that's what happens when you're trying to correct years of bad posture 😛 I'm sure it will get easier with time!

  18. I've been through two years of this getting worse and worse. 5 PTs 3 surgeons, one pointless opening of my shoulder laparoscopic because he 100% guaranteed i had a torn labrum that I did not have once he cut into my left shoulder.

    Been trying to figure out what is wrong with my shoulders and nerve pain for a year. Started when i got a new job where i was typing 7 hours straight a day. Lifting every morning.

    Left shoulder always snapping popping, raises higher, goes back much further and foward much further. Painful to externally rotate. Cannot do wall slides. Tapping the pec minor, post and ant delt all cause tingling down my arm. Scalene are tight but don't do the same. Been to pts who only give same rotator cuff and chest stretch that do not work. Could be sub scap? left side has no trigger points or cant get to it under my armpit, right side i can get to it.

    Need help to stabilize left scapula so that can fix rounded shoulders. Experiencing muscle wasting please help.

    Videos on my channel.

    Been putting off but now the nerve pain is crazy. Thank you

  19. All my ribs have loosed up but the first rib near the neck is very tight and is giving me vertigo whenever i look left

  20. Does anything about this video change if you have a cervical rib on each side? The tennis ball one looks like it might not be a good thing for that. Thanks.

  21. Firsr want to preface by saying that i did the exercises under pt's supervision originally. I developed scary odd symptoms in my hands that my pt never explained to me so i figured i ask :

    1) is it possible to overdo nerve flossing/stretches and cause serious injury

    2)should i be worried that i can feel the nerves/vessels pumping.

  22. I tried them all and they felt really good, especially the clasping the hands behind the back and pulling back/down, but the very last one instantly gave me a very tight, painful charley horse in the back of my neck.

  23. Hey, first day on this exercise I sure hope this works for me. I've had thoracic for almost 3 yrs now just found out I had it 4 months ago so now rehab process has been going, been in a lot of pain for 3 yrs just couldn't ever figure out what it was.. been in and out on physical therapy and Drs..finally found the issue. My question is do I stretch both sides and workout both sides?or just the side that hurts all the time?? And 1 more question I bought a posture brace to help try and relieve pressure would you recommend using this? Or should I just try and rely on my own body to get a good posture again? Thank you

  24. Oh god thank you, I had three slipped discs in my Thoracic spine , plus tmj & this helps so much & one low slipped disc from trauma my senior year in college! This helped thank you. I've been doing your videos since 2015 through my recovery! : )

  25. I had a discectomy about 4 years ago and the scaring has now caused me to have TOS on my left side. These exercises really help with the tightness I get and I'm slowly getting strength and power back.

  26. Dr. Joe, a continued report on my progress. I am in the process of water titrating my SSRI, and will be finished by June. The only problem I am experiencing with the reduction, is upper and mid arm pain, that I'm quite sure is related to the nerves. I'm not exactly sure what nerves are effected, by my brain, but I think its all three, the medial, radial, and ulner nerves. After my TBI I had severe tingling in my left hand, and at one point my hand was completely contracted. It is now open, but I still have difficulty wt my thumb, and the hand still tingles.I have done some QiDong, that helps my flexibility and pain temporarily (a couple of hours.) Although this isn't exactly Thoracic Outlet Syndrome, because the problem originates in the brain, both my injury and medication masked the problem for so long, it may have formed. I've noticed a ton of videos on YouTube for correcting this, but other then healing QiDong exercises, none have ever for more then a couple of minutes of pain relief. Although these exercises do help temporarily, the problem soon returns (minutes.) . I am completely unable, to get my arm, and hand into the palm up position, in that nerve glide. Still when I do a longer & slower QiDong exercise getting my arm into that position is possible.Do you have any other suggestions about exercises that could help remove the pain for longer. Although QiDong literally works wonders, I do not always have the 45 minutes needed to do the full healing exercise.

  27. Hello Doctor Jo, excellent video as always! quick question, the nerve glide you showed in this video regarding T.O.S, does that glide all 3 nerves or just one in particular?

  28. hey, would it be a bad idea to do exercises like bench press and so on if there no pain im pre sure my shoulders feel better afterwards. over head stuff doesnt feel good tho.

  29. I lived with this pain around 8 months. I was trying a lot of things to be healthy again, acupuncture, physiotherapists, doctors, lost too much time and too much money. Luckly i found your video, and thought why not to try this, and i couldn't believe but it works. Now is the 6th day when I'm doing these exercises, I don't feel pain, I feel a desire to live again !! THANKS YOU 🙂
    Only one question, how long should I keep doing this to be sure this won't back?

  30. I'm 69 years old and have been (from a very active life) relatively inactive for the past year and a 1/2. I'm pretty sure my problem stems from my neck area (lying on my side propping my head up), but I've developed what feels like shingles (armpit, back of arm excruciating burning sensation) on this side. Could this be related? Would massage help?

  31. Thank you so much .. im an Amaesthetist… suffering from this intense pain day and night … it affects my work too… got an immediate relief with this … amaizing …

  32. Hi Doctor Jo, would these exercises also apply to costoclavicular syndrome (or "bra strap" syndrome)? I'm having a hard time finding anything that addresses dealing with this specific issue.

  33. is TOC can be caused by overuse the retraction and depression of scapula and week upper trapezious muscle? Cause when I started to strenghten my upper traps the symptom what i had before ( cold one hand) go away.

  34. Thanks so much for the exercises. I just found out I have TOS, I’m not sure what kind yet. I need to have testing done. Besides the numbness and pain I have a very strange and unsettling issue. When I wake up in the morning, my arms are throbbing, like a heartbeat, but it’s not. If I move my neck in a certain position, it will stop. Does this sound like it could be the venous type? I’m seeing a venous doctor soon. Sleeping is very difficult because of my arms. Thanks again. The exercises feel so good.

  35. Thank you for this! I have a dual career involving computer work and music performance so I am starting to struggle with TOS, but I will try these!

  36. doc Jo, can build upper traps help with TOS as well? I read somewhere that it can open up the costoclavicular space and release pinched nerves there?

  37. What do you recommend for those of us with extra cervical ribs?
    I did PT and it made me so much worse.

  38. I have tos, your exercises helped me but that one with the hands behind your back is way yo painful at the beggining, Just couldn't do it.

  39. It gets worse when I stretch like this. maybe its not TOS. I have a tingle in my (front side) neck 🙁 this is so annoying. any tips? maybe I stretched too much and a muscle fiber crack? I think its the Sternocleidomastoideus and directly over the clavicula. I stretch it and try to relax the muscle with warmth and moderate massage but its getting worse and worse :/

  40. I've been doing these stretches for a couple months and my original (incredibly terrible) symptoms are under control, but now I am dealing with new, similar symptoms that just won't go away. So I find myself stretching 24/7 because I am not sure what else to do.

  41. Hi dr Jo
    I’m a nail technician, my job sit all day long . And I’m having tos now. Can you teach me some stretch that I could do in between client?? Thanks

  42. Can my PT diagnose TOS or is that under a different type of doctor? I've had on and off shoulder pain for months and neck and upper back pain for over a year now. I was seeing PT for the neck and back when the shoulder started in again. Today my PT did some motions with my arm (lifting it up caused my hand to fall asleep) and pushed on the first rib area which caused a burning feeling there. She said it may be TOS and told me to start the first rib mobilizations. I am just curious if she says it might be that and it does end up being correct, do I get the diagnosis from her or do I have to go talk to my primary doctor?

  43. Hi Dr. Jo, I have been having pain on my right upper arm for about 8 months and was finally diagnosed with TOS due to being born with an extra rib. I am 52 now and have been active gyming with weights for the past 3 years. I have finally received more information regarding TOS after I visited a Hand and Upper Arm Specialist.
    I will start my physio soon but my Doctor suggested that i stop upper body exercises in the gym. I am confused because I read that one should strengthen Deltoids, Rhomboid and Triceps while being diagnosed with TOS. Please advise.
    Between I am a Secretary. I also find relief from my symptoms while doing Yoga which I just started 3 months ago.
    I am happy to find your video and hope to hear from you soon!

  44. I have suspected subclavian artery  blockage,CTA the16th[blood pressure 50points higher on unaffected arm systolical, hadpt last oct/nov for neck shoulder pain with dry needle.  Are these  exercizes safe for me?

  45. Hey, can you do ball exercise even if you don't have TOS and want to just improve your posture and make sure the scalenes/first rib stays down so you avoid TOS?

  46. Dr Jo- just got my dominant hand rib removed.

    Not sure where to go from here 🙁

    I’ll use this for my left side but curious what you think I

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