Thoracic Outlet Syndrome AKA TOS

Friday, February 25th, 2011 At 3:15 pm

The thoracic outlet is the area immediately next to the neck, more precisely the area between the 1st rib and clavicle. When this opening becomes reduced, pressure can be placed on the blood vessels and/or nerves. Cervical ribs, clavicle injuries, muscle spasms, head forward posture, and repetitive stress injuries are usually the cause. Pain, numbness, tingling, weakness in the forearm, are typically experienced in the elbow and the fourth and fifth finger.

In my office we start with a good physical exam along with a thorough history that usually confirms the diagnosis. Sometimes imaging may be a warranted. These tests may include X-Ray, MRI, and CT. Many times treatment such as mobilization of the cervical and thoracic vertebrae as well as strengthening of the neck, upper back, and the shoulder musculature are very helpful.   At Capitol Rehab we have a multi-discipline approach.  We utilize the best in Chiropractic, Physical Therapy, and exercise to help with the symptoms of TOS.  

In our office we find mobilization of the cervical and thoracic vertebrae as well as strengthening of the neck, upper back, and the shoulder musculature are very helpful. If conservative care does not resolve the symptoms, a referral to a surgeon will be made. 

Dr. Jack Ricci DC

Top 3 Exercises for TOS

20 Seconds for 3 Repetitions

5 Repetitions 10 Seconds

10 Repetitions 5 Seconds

Top 5 Runners Injuries AKA The Big 5

Monday, March 15th, 2010 At 2:17 pm

The days are warmer and the birds are back.  It is actually light when I get home from work.  What does this mean? For me it means running season.  The 5ks, 10ks, and marathons are all scheduled.

Don’t let the possibilities of running injuries stop you from all the fun! Here are the 5 most common runners injuries  AKA *The Big 5* to watch for:

1. Runners Knee/Chondromalacia Patella
   This is pain under and around the knee cap due to improper tracking  between the condyles of the knee.  It causes wearing of the underside of the knee cap and often leads to disorders of the knee such as tendonitis and other inflammatory disorders.
2. Plantar Fascitis
   This is an inflammatory disorder of the plantar fascia.  The plantar fascia is a band of tissue, much like a tendon, that runs from your heel to the ball of your foot.  A common complaint is pain upon waking in the morning.  Patients report the first few steps are very painful. It is also aggravated after running, walking, or standing for long times.
3. IT Band Syndrome
   This is also an inflammatory disorder of the a tendon that runs from your hip to your knee. It commonly cause hip and knee pain. If you’ve had this one you know how painful it can be.
4. Achilles Tendonitis
   This is inflammation of the achilles tendon.  The achilles tendon connects the calf to the heel. I commonly find this Inflammatory disorder with plantar fascitis.  Inflammation weakens connective tissue and can lead to achilles rupture.  Not good!
5. Shin Splints
   Generally it is inflammation of the posterior muscles behind the shin bone. It is caused by improper foot mechanics. Other muscles around the shin may also be affected such as the anterior tibialis muscles.

Do you notice a pattern here?

The common denominator is inflammation. Commonly Doctors are quite familiar with this pattern and treat the inflammation through rest, immobilization and NSAIDs ( non-steroidal anti-inflammatories).  If this does not work many times they do use cortisone through injections.

Why is this not enough?

That is because every condition that was described above is simply an explanation of the symptoms.  They are all describing the result of injury and the course of treatment only addressed the symptoms.  Little or no attention was put into the “cause” of the problem.

If the doctor or patient are pro-active they may seek out physical therapy.  A successful plan of therapy will address the actual cause of the symptoms not just the resultant symptoms.