6 Exercises for Relieving Thoracic Outlet Syndrome Symptoms

Thoracic outlet syndrome (TOS)is a condition that develops when nerves or blood vessels are compressed in the thoracic outlet. This area is located between the collarbone and first rib. It contains important nerves and blood vessels. Neurogenic TOS is the most common type, and it results in arm pain, numbness, and weakness.

Fortunately, many cases of TOS can improve with exercise and other at-home treatments. Targeted exercises can increase flexibility and decrease muscle imbalances that contribute to symptoms. Learn more about exercises for TOS, including how to practice them safely, how they help, and which activities to avoid.

What are the best exercises for thoracic outlet syndrome? The best exercises for thoracic outlet syndrome include a combination of stretching and strengthening. That's because the condition is often due to narrowing of thethoracic outletfrom surrounding muscles that are tight, as well aspoor posture. Improvingboth these areascan help reduce symptoms and prevent TOS from coming back.

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1. Neck stretch A common area of compression in TOS is thescalene triangle. This is made up of the three scalene muscles at the base of the neck. When these muscles are tight or enlarged from overuse, they can narrow the thoracic outlet and compress nearby nerves and blood vessels.

Stretching the scalene musclescan help open up the thoracic outlet to reduce compression. Here's how to stretch these muscles:

• Step 1:Start in an upright sitting or standing position with your head aligned over your neck.
• Step 2:Bend your neck to one side, bringing your ear closer to your shoulder.
• Step 3:Keeping your neck bent to the side, extend your neck slightly backward. You should feel a stretch along the front of your neck.
• Step 4:Hold for 30 seconds, then relax.
• Step 5:Repeat 3 to 5 times on each side.

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2. Chest stretch Known as acorner stretch, this move helps open up your chest and stretch the pec muscles. The pectoralis minor, the smaller of the two pec muscles, borders part of the thoracic outlet. When tight, it can cause compression of the nerves and blood vessels that pass by.

Here's how to stretch your pec muscles:

• Step 1:Stand in front of the corner of a room, with one foot in front of the other. Or, you can perform this stretch through a doorway.
• Step 2:Keeping your elbows bent, lift both arms up and out to your sides and rest them along the walls of the corner (or edges of a doorframe). Your elbows should be level with your shoulders and your palms should be flat.
• Step 3:Keeping your arms along the walls, lean your body forward into the corner (or doorway). You should feel a stretch in the front of your chest.
• Step 4:Hold for 30 seconds, then relax.
• Step 5:Repeat 3 to 5 times.

3. Chin tucksChin tucksstrengthen your deep cervical flexor muscles. These muscles help maintain good neck posture. When these muscles are weak, other muscles - like the scalenes - can overcompensate. This leads to poor posture and can tighten the thoracic outlet.

Here's how to do chin tucks:

• Step 1:Start in an upright sitting or standing position with your head aligned over your neck.
• Step 2:Without bending or extending your neck, draw your head straight backwards, pulling in your head and neck to align over your spine.
• Step 3:Hold for 5 to 10 seconds, then relax.
• Step 4:Repeat 20 times.

4. Scapular rows Proper posture also involves good alignment of the shoulder blades. When the muscles that control the shoulder blades are weak, the shoulders tend to round forward. This can lead to compression in the front of the chest and shoulder, which can make thoracic outlet syndrome worse.

Scapular rowsstrengthen the muscles that control the shoulder blades. This exercise can help you keep a more upright posture to open up the thoracic outlet.

Here's how to do scapular rows:

• Step 1:Start in an upright standing position with a resistance band looped over or tied to a railing or sturdy object.
• Step 2:Grab one end of the resistance band in each hand and keep your elbows bent at 90 degrees.
• Step 3:Pull the band to draw your elbows back by your ribs. Squeeze your shoulder blades together.
• Step 4:Hold for 5 to 10 seconds, then relax.
• Step 5:Repeat 20 times.

5. Shoulder external rotation with resistance bandShoulder external rotation with a resistance bandis an exercise that works multiple muscles at the same time to maintain alignment of the shoulders and shoulder blades. This helps support good posture and opens up the thoracic outlet.

Here's how to do shoulder external rotation with a resistance band:

• Step 1:Start in an upright standing position. Hold a resistance band in both hands with your palms facing up, keeping your arms and elbows squeezed into your sides. Your elbows should be bent at approximately 90 degrees.
• Step 2:Keeping your elbows squeezed into your sides, pull the resistance band ends. Both shoulders will externally rotate while your arms stay squeezed into your sides. Squeeze your shoulder blades together. Do not straighten your elbows.
• Step 3:Hold for 5 to 10 seconds, then relax.
• Step 4:Repeat 20 times.

6. Wall slide with lift-offWall slide with lift-offis a move that involves sliding your forearms along a wall to form a Y shape, and then lifting your arms away from the wall. This combination of movements helps strengthen the lower trap muscle. This muscle is important formaintaining good alignmentof your shoulder blades.

Here's how to do a wall slide with lift-off:

• Step 1:Stand in front of a wall.
• Step 2:Place both forearms on the wall with your elbows bent. Your arms should be about shoulder-width apart. Your palms should be facing each other.
• Step 3:Slowly slide your arms up and out in a diagonal motion until your elbows are straight. Your arms should form a Y shape.
• Step 4:Keeping your arms straight, lift your arms away from the wall and move them back. Squeeze your shoulder blades together. Avoid arching your back.
• Step 5:Return your arms to the wall. Slide your arms down to the starting position.
• Step 6:Repeat 20 times.

What activities worsen thoracic outlet syndrome?Repeated overhead movementsincrease compression in the thoracic outlet and can make symptoms worse. These involve exercises like weightlifting, swimming, or tennis. Sports that involve throwing, as well asoverhead work duties, can also aggravate symptoms.

If you have symptoms of TOS, it's best to take a break from these activities. Starting treatment early can help manage symptoms and prevent thoracic outlet syndrome from getting worse. As your symptoms improve, you can gradually return to the activities you enjoy.

What other treatments can relieve thoracic outlet syndrome? The good news is that conservative treatment usually improves symptoms from TOS. In addition to the at-home exercises, you can also consider:

• Activity modification:It's important to limit physical activity that worsens your symptoms. This can prevent them from getting worse.
• Pain relievers:A short course of over-the-counter medication, like nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain and inflammation in the short term.
• Physical therapy:A physical therapist can provide you with hands-on treatment to help reduce tension within your thoracic outlet. They can also show you how to do exercises properly and make adjustments to your exercise plan when needed.

If your symptoms don't improve after a month or two of conservative treatment,surgery may be an option. It most often involves removing a section of the first rib and/or scalene muscle. This helps create more space in the thoracic outlet.

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" data-qa="ContentCalloutH2Title" The bottom line Thoracic outlet syndrome results from nerve or blood vessel compression within the thoracic outlet. This area at the front of the shoulder can become irritated from injuries, poor posture, or repeated upper-body movements. Fixing your posture and reducing muscle imbalances can help relieve symptoms. Stretch tight muscles in the neck and chest and strengthen muscles that control the shoulders and shoulder blades. This will help support your posture and keep your upper body in good alignment.

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