12 Thoracic Outlet Syndrome Exercises for Lasting Relief

 Thoracic outlet syndrome  occurs when nerves or blood vessels become compressed in the area between the clavicle (collarbone) and first rib. This space is known as the thoracic outlet. Symptoms of  thoracic outlet syndrome  can include the following:

Once TOS has been diagnosed by a healthcare professional and any acute pain is under control, exercises and stretches are the  next step  in treatment. Certain exercises can  help alleviate  those suffering from TOS.

Is stretching good for thoracic outlet syndrome?  Stretching is good  for TOS. Many of the exercises below are stretches. You’ll want to visit a physical therapist or chiropractor before trying strenuous movements. They  can help you build an exercise program based on your specific needs.

While the  majority  find stretching and strengthening helpful, symptoms  may worsen  for those who have other conditions. That’s another reason it’s important to discuss new exercises with a professional.

TOS exercises focus on 3 areas: the neck, the upper back, and the chest. Stretching muscle groups in these areas should help relieve the tension and pressure causing impingement in the thoracic outlet.

We’ve compiled a list of stretches and exercises that both strengthen and improve range of motion.

This stretch exercises the muscles around the scapula, or the shoulder blade.

Starting position : Stand with the arm of the affected side outstretched in front of you.

The goal is basically to make circles with your shoulder.

Reps:  5

Sets:  3

Frontal and lateral raises require small weights, such as 1-5 lb dumbbells. Frontal raises work the shoulders (anterior deltoids), the upper back (trapezius muscle), and parts of the pectorals.

Starting position:  Stand with knees slightly bent and with hands gripping the individual dumbbells. Your knuckles should face away from you.

Lateral raises also work the shoulders and upper back. This latter exercise is quite similar to the former, except your arms raise from the sides rather than the front. Starting position is taking a dumbbell in each hand, with knuckles facing out, and standing with your arms by your sides.

Reps:  5-10

Sets:  3

One study  found nerve gliding crucial to conservative and surgical forms of treatment for TOS. Nerve gliding is the gentle technique of stretching nerves, as you might sore muscles, to reduce irritation.

The ulnar nerve running down the arm is often responsible for tingling sensations. The ulnar nerve glide should help relieve this TOS symptom. Starting position is standing while making the “O.K.” sign with the fingers of the affected arm.

Reps:  15

Sets:  2

This exercise works the infraspinatus muscles. It requires a band and a towel. Anchor the band to a doorknob and place the towel between your side and the affected arm. Starting position is gripping the band with your arm at a 90 degree angle.

Reps:  10

Sets:  3

This exercise activates the serratus muscles which cover the sides of the ribs. When is action, this exercise appears to be mini push-ups. Starting position is on hands and knees as though you were performing a modified push-up.

Reps:  8

Sets:  2

The first rib is an atypical (shorter and structured differently) rib that can become elevated out of place. Mobilizing it or getting into its original position can relieve compression of the nerves and blood vessels in the thoracic outlet.

Starting position is sitting in a chair with the back straight. A strap lies over the affected side’s shoulder.

Reps:  4-5

Another way to free up your first rib requires a massage or lacrosse ball. Find the space or “pocket” just beneath the collarbone where the first rib lies. Take the ball and press down on the first rib. Feel free to apply quite a bit of pressure, but not so much that it’s painful. Breathe in deeply then release that breath.5

This exercise stretches scapular musculature. A stretchy band is required for this exercise. Starting position is a relaxed standing position with both hands gripping the band.

Reps:  4

Sets:  3

The pectoralis minor stretch is meant to open up the chest muscles and the rib cage. A foam roller is required for this particular exercise. Starting position is lying on your back on top of the foam roller. Be sure your neck and head are supported by the foam roller. Feet are flat on the ground with knees bent.

When you find a good stretch position, hold it for about 30 seconds, then give yourself a break.

Reps:  4

An additional, simple pec exercise that you can do standing or sitting is clasping your hands behind your back and pushing your chest out. Try to keep your palms touching. Hold for 30 seconds 3 times.

This may be the easiest exercise in our list. It stretches muscles that connect to the cervical spine.

Think about it like you’re trying to create a double chin. We avoid that look at all costs; however, it’s the goal for this exercise.

Reps:  6-8

This stretch is great for helping to correct poor posture and aid thoracic extension. A foam roller is required. Starting position is sitting on the ground with the foam roller situated perpendicular to the spine. The foam roller should be placed at the base of the thoracic spine.

Reps:  3

This exercise stretches the shoulder muscles and requires a stick or cane. Starting position is standing while both hands grip the stick behind you.

Reps:  10

This neck stretch aims to alleviate stress on the blood vessels and nerves located in the interscalene triangle (the first rib forms the base and the anterior and middle scalenes form the sides). Starting position is sitting in a chair with the back straight. A strap lies over the affected side’s shoulder.

Reps:  5

The 3 types of TOS include

Sometimes venous and arterial TOS are together referred to as vascular TOS. While neurogenic TOS symptoms can be addressed with exercises and sometimes medication, vascular TOS is more serious and may require surgery to correct.

Several things could cause neurogenic thoracic outlet syndrome including

What aggravates thoracic outlet syndrome?  Overuse or incorrect use of muscles surrounding the thoracic outlet or a poor sleeping position could aggravate thoracic outlet syndrome.

If you’re uncertain about whether or not you can safely do these exercises or if your symptoms are more severe in nature, don’t hesitate to seek medical advice from a trusted healthcare provider.