Massage and Thoracic Outlet Syndrome

The right brachial plexus with its short branc...

Thoracic Outlet Syndrome (TOS) comprises a variety of symptoms caused by abnormal pressure on the neurovascular bundle between the neck and the lower end of the armpit – the thoracic outlet area. The neurovascular bundle refers to a group of nerves (the brachial plexus) and blood supply (subclavian artery and vein). This bundle supplies the fingers, hand, arm, shoulder girdle and some regions of the head and neck with circulation. Nerve compression is more frequently involved than restriction of the blood supply. The most common symptoms are swelling or puffiness of the hand and fingers, dull achiness in the neck and shoulder region (especially at night), sense of fatigue in the arm, pain in the hand (especially in the fourth and fifth fingers), muscle weakness with difficulty in gripping things and when doing fine motor activities and tingling and numbness in the neck, shoulder, arm and hand. Doing activities with the arm elevated, such as combing or blow-drying hair or driving a car, also causes the above symptoms. And finally, it is not common, but some people may be born with an extra rib above their first rib, creating compression in the area.

Aggravating Factors. TOS often results from poor or strenuous postures, trauma or static muscle tension in the shoulder area. Occupations affected most are those requiring repetitive movement and posture such as cashiers, assembly line workers, plasterers and electricians. It can also occur in people who stock shelves or do needle work. Athletes who play volleyball, swimmers, tennis players or baseball pitchers can all be affected. Musicians, particularly violinists, are also susceptible to this condition. Carrying heavy loads, children, briefcases, purses and daypacks over one shoulder can aggravate TOS as well.

Self-health Measures. It is important when someone experiences discomfort that suggests nerve involvement such as numbness, tingling, puffiness or other similar symptoms in the arms or legs, that he seek medical attention for an accurate diagnosis. With that said, treatment for TOS responds well to manual therapy such as massage or physical therapy and stretching exercises. It is also necessary for the person to look at his activities of daily life, occupation and athletics to determine which postures or biomechanics need to be modified in order to alleviate the symptoms and make a more permanent change.

Overall, TOS can be well managed by doing the following:

  • Sitting erect with lumbar support. This keeps the shoulders back.
  • Avoid sleeping on the affected side.
  • Avoid folding or crossing your arms.
  • Taking breaks every 15 to 30 minutes from repetitive work which has you bent slightly forward.
  • Avoid lifting things above shoulder level.


365 Days Project - Day 151 - Pain in the neck!


Headaches are commonly categorized as tension, migraine or sinus in origin. They may also be caused by a pathological disease process that is far less common than the other three causes.

Tension headaches are typically caused by physical or emotional stress. This includes factors such as eyestrain, poor posture, a neck injury like whiplash, or even conditions such as temporomandibular joint dysfunction. Migraine headaches, while vascular in origin, are often triggered or exacerbated by hypertonic soft tissue in the cervical region. Sinus headaches arise from increased pressure in the sinus cavities around the nose and eyes. It is not uncommon to find myofascial trigger points in the suboccipital and posterior scalenes region that refer to the sinuses and either initiate or aggravate a sinus headache.

Tension headaches are the most common type of headaches. Quite simply, tightness in the neck and shoulder muscles seems to be the most direct cause. In our experience, myofascial trigger points in any of the muscles of the neck and shoulders can “trigger” pain in the head, whether it is behind the eyes, at the base of the skull, toward the back or side of the head or that “tight band” around the head. Deactivating these trigger points and relieving tension in the muscles through therapeutic massage can frequently decrease the frequency and intensity of tension headaches.

Aggravating factors.  Headaches can also be initiated by certain foods and food additives (chocolate, nitrates, aspartame, etc.), medication interactions, lack of adequate water intake, skipping meals, smoking and drinking alcohol.

Self-health Measures.  The most obvious, yet the most difficult measure to decrease or eliminate headaches is to slow down and have regular periods of rest and relaxation. Quite simply, try to eliminate one of the elements in the stress-tension-pain cycle.

Tension headaches also can be decreased or eliminated through a number of methods:

  • Implementing a regular and moderate exercise program
  • Utilizing meditation
  • Reducing caffeine intake
  • Eating more whole foods and fewer fast or processed foods
  • Sitting quietly to eat meals, avoid eating on the run
  • Increasing flexibility in the neck and shoulder muscles
  • Cessation of smoking and tobacco use
  • Improving workplace ergonomics
  • Establishing regular sleep and wake patterns
  • Making time for relaxation, hobbies and varied recreational activities
  • Receiving periodic therapeutic massage or bodywork
  • Developing a trusting, emotional support outlet with friends, family or a therapist

A frequent complaint, neck pain can result from a variety of factors. It can be acute or chronic. The most predominant cause of pain is damage to the soft tissue of the neck and can occur because of overuse, or injuries such as whiplash. Pain can also be due to abnormalities such as birth defects, structural trauma (i.e. fractures), degenerative and inflammatory diseases, or prolonged wear and tear resulting in cervical disc degeneration or protrusion (herniated disc). With various postural stresses, the disc degenerates as we grow older (typically age 40 and up), creating less space between the bones and more friction. Less frequently, neck pain can be caused by tumors or infection. Emotional stress is also an important contributing factor. Neck pain often causes, or is a major contributor to headaches, shoulder, arm and back pain. The longer a person has pain, the more effort is needed to correct it.

Aggravating Factors.  Inactivity is one of several aggravating factors for neck pain. As soft tissue becomes more stiff and inflexible through lack of activity, the circulation to the area is decreased. Dysfunctional biomechanics is another factor, with the prime contributor being the head-forward, rounded-shoulder posture. Fatigue directly affects our sense of well-being and is a contributor to pain. We are less prone to continuing our supportive postural habits and more inclined to slouch and have contracted posture when we’re tired. Further tightness in the soft tissues can be caused by emotional stress. Stress can also worsen existing neck tension. Environment is something many of us forget when assessing pain. Consider this — a cool draft on the neck can cause stiffness and discomfort, just as allergies, fumes or odors from smoke, paint or some household cleaning products can irritate the respiratory system and eyes, thereby causing surrounding soft tissue to tense as a defensive mechanism. Other elements, such as fibromyalgia and temporomandibular dysfunction, can also be aggravating factors in neck pain.

Self-health Measures.  Neck pain can be decreased or eliminated through a number of methods.  If the pain does not subside or you experience tingling, numbness or sharp, shooting pain referrals to other areas of your body, then schedule an appointment to see a medical professional.

  • Maintain supportive postural habits. Practice bringing your sternum up and contracting your lower abdominal muscles to bring your head and neck into better alignment while sitting or standing.
  • If you wear eyeglasses, be sure your prescription is current or is adequate for your needs. If you spend large amounts of time at the computer, you may need special computer glasses.
  • Computer monitors should be 18″ to 24″ away and the top line should be approximately at eye level
  • Strategically use pillows to adequately support your neck while sleeping
  • When reading, be sure to keep your light well-positioned to avoid undue neck rotation or strain
  • Keep your neck warm. In cooler weather this may mean wearing a turtleneck shirt, even to bed
  • Use of ice or heat or both to alleviate the pain and discomfort
  • Maintain gentle movements of the neck. Modify any stretching or other activities involving the neck to stay within your tolerance
  • Get some exercise, even if it is just a walk around the block. The increased circulation and endorphin level will help reduce the pain and bring much-needed nutrients and oxygen to the area. Consult with a qualified professional for appropriate strengthening exercises when you are ready
  • Find ways to manage stress. Mental and physical flexibility is a key factor here
  • If your pain is related to conditions such as arthritis or fibromyalgia, there are support groups which may have information and tips on how to manage your pain

Stretching Suggestions.  Doing the neck and shoulder routines daily can create considerable relaxation and flexibility in the neck muscles, thereby producing an improvement in frequency, duration and intensity of headaches.

Plan to do stretching exercises two times each day for about 20 minutes per session. Do stretches slowly so you feel a normal sensation of stretching, but not pain. Hold the stretch for five seconds, relax for five seconds, and then repeat each stretch about three to five times. You can do many stretching exercises while standing or sitting. You can use them as stress-releasers when sitting in a long meeting and in the car, or while waiting in line at the store or standing in the shower. Many people include stretching exercises with their favorite daily TV show to make sure they keep these exercises as part of their daily routine. Other people do stretching exercises before bedtime to help them sleep.

Stretches that help relieve headaches are listed below. Add these to a whole body stretching program and use them when headaches first start:

  • Neck range of motion: Tip your chin forward to your chest, upward to the ceiling, and then turn your chin to touch each shoulder.
  • Shoulder shrugs: Shrug shoulders up, then up and forward, and then up and back.
  • Neck isometrics: Place your palm on your forehead and press your head against it. Be very still and don’t move your head or hand as you press one against the other. Repeat with your hand on each side of the head.
  • Head lift: Link the fingers of your hands together and hold then behind your neck at the base of your head. Pull your elbows forward and up so you can feel your head lifting up slightly from your neck.

Tips for Successful Stretching

Stretch twice daily, in the morning and before bed

  • Begin stretches after taking a warm shower or using a heating pad over your most painful area for 15 minutes
  • Listen to music or watch your favorite TV show while you do your exercises
  • Do each stretch slowly. Stretch until the first sensation of stretching is reached, then hold the stretch for five seconds. Relax and repeat three to 10 times.
  • If you feel more pain after stretching, wrap ice in a towel and place it on your most painful area for 10 minutes
  • If your pain is usually aggravated by stretches, reduce the amount of stretch and talk to your therapist about your exercise program

And of course, massage therapy can greatly relieve soft tissue tension. If pain is due to disc degeneration or herniation, decreasing muscle tightness will help alleviate pain caused by the pain-spasm-pain cycle.

By Jill Bielawski and Jerry Weinert

Originally published in Massage & Bodywork magazine, February/March 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.

Ancient Wisdom on Massage Therapy

Considered a father of Western medicine, Hippo...

The physician must be experienced in many things, but most assuredly in rubbing.

Hippocrates, The “Father of Modern Medicine”

For rubbing can bind a joint that is too loose, and loosen a joint that is too rigid.

-Hippocrates, The “Father of Modern Medicine”

The object of massage is to disperse the effete matters found in the muscles and not expelled by exercise.

-Avicenna, Arab philosopher and physician wrote this in his Canon

The Healing Power of Words!

Help us help you . . . What Your Massage Therapist Needs to Know

Massage in Frankfurt, Germany

What Your Massage Therapist Needs To Know

One of the benefits of regular massage is the sense of camaraderie and familiarity you develop with your therapist. You know your way around the office and your therapist knows that certain spot that holds your tension, so you may not have to complete the customary intake procedure most first-timers go through. However, sometimes it is best to pause from your typical routine, take a minute to talk with your therapist, and revisit the intake process.

Whenever you feel the need to speak with your therapist about a medical change, physical concern, or other issue, it is helpful to mention this when you schedule the appointment. If that isn’t possible, just ask to talk when you first arrive. Your therapist can better concentrate on your question before the session instead of during your session.

Even a simple, “I had a long car ride this weekend and have noticed a particularly tight place in my hips,” can be helpful for your therapist. More serious concerns may take a little longer to work through, but being honest with your massage therapist about any changes will help you get your needs met.

Following are a few specific items your massage therapist should know:

A Doctor’s Visit or New Medications
Even though you probably filled out a medical history form when you first came in for a treatment, there are certain things that make it necessary to revisit your medical information. For example, if you have seen the doctor for a routine checkup and have been diagnosed with a particular illness or medical condition, you should let your therapist know. You should also speak up if you are taking any new medications.

Some medical circumstances would preclude you from receiving massage, while others might just change the way your practitioner approaches your session. For example, if you are pregnant, you can still get a massage or spa treatments, but your therapist might change the techniques. Other medical conditions you should mention include high blood pressure, heart disease, diabetes, chronic autoimmune diseases, or skin allergies. All of these, and many other medical conditions, can affect your sessions.

A New or Acute Injury
Maybe you spent hours driving to a destination getaway and your shoulders ache. Or you walked off the porch step and sprained your ankle. Any time you have a new ache, pain, sprain, twist, or muscle pull, you should be sure to mention it to your therapist.

When an injury is in the acute stage, your massage therapist will probably avoid direct pressure on the site. Depending on the location and extent of your injury, the treatment session may have to be postponed altogether, or the injury site may have to be avoided. For example, if you have twisted your ankle, your massage therapist may avoid working on the foot area until it is healed, but could continue to massage your back and shoulders as usual.

Sometimes it isn’t about a new injury, but rather just an ache or pain. Maybe you strained your back gardening or spent more time than usual on the computer. Perhaps a tension headache struck this week. All of these little complaints are clues that your therapist can use to make sure that your session is personalized for your specific needs that day.

Personal Preferences
This is the third, less obvious category, but it is equally important. Everyone has unique preferences and sometimes there may be something you would like to change at your next massage. A colleague summed it up when she said, “A massage session is about the client. If they would like something changed I am happy to do so, but I have to know what they want.” Most therapists would quickly agree with her. Whether you want to bring your own music, or find the room chilly and want an extra blanket, your therapist will quickly adapt if you mention your preferences.

Even in our set routines, change can occur. The key to keeping a successful and positive relationship with your massage therapist is communication. Any time your physical health changes, even temporarily, a simple mention when you first arrive can help your therapist make the session the most effective it can be for you.

By Angela England

Originally published in Body Sense, Autumn/Winter 2009. Copyright 2009. Associated Bodywork and Massage Professionals. All rights reserved.

Cultivating Wellness – How Does Your Garden Grow?

Earth laughs in flowers.  ~Ralph Waldo Emerson

Cultivating Wellness – How Does Your Garden Grow?

When I go into my garden with a spade, and dig a bed, I feel such an exhilaration and health, that I discover I have been defrauding myself all this time in letting others do for me what I should have done with my own hands.
Ralph Waldo Emerson, 1849

It’s difficult to find a gardener who doesn’t agree with Emerson. The reward, avid gardeners say, of cultivating the earth is nothing short of sublime. So what exactly is going on in the backyard plot that has captivated more than 85 million Americans? Well, in a word, healing.

Getting your hands dirty and letting your cares fall away can be a meditative experience for the gardener, explains Charlie Nardozzi, horticulturist for the National Gardening Association (NGA) in Burlington, Vt.

“It’s a place to get lost in,” he says. “When people go out to garden, it’s often the first time that day they’ve slowed down and relaxed a little bit.”

On a physiological level, this calming effect lowers stress hormones that may ease a variety of conditions such as heart disease, hypertension, gastrointestinal disorders and insomnia. “I encourage people to visit their garden everyday, even if they’re not working on it,” Nardozzi says. “When you reconnect with the weather, temperature, butterflies and other animals, you get a better sense of the cycle and rhythm of life.”

Of course, many gardeners also welcome the physical workout. Planting, watering, weeding, raking, digging, spading, tilling and trimming increase flexibility, strengthen joints and work all the major muscle groups. “The key with gardening,” Nardozzi says, “is to vary the type of work you’re doing, for example doing three different activities for 10 minutes each.”

As with any exercise regimen, the key is to start at a comfortable pace and gradually work your way up to longer, more difficult activities. Ideally, your heart rate while gardening should be the same as when you’re at a brisk walk, but not so high you can’t complete sentences between breaths. Overdoing it can result in sore joints and muscles, or worse, increased heart attack risk. As the summer heats up, make sure you drink plenty of water to avoid dehydration, which can contribute to headaches
and muscle cramping.

Cultivating your own fruits, vegetables and herbs gives you control over the produce on your plate. Conventional crops are sometimes genetically modified and may contain chemicals that can’t be easily washed away. But in your own garden, for example, you can counter aphids with ladybug larvae rather than pesticide.

Finally, have at the bounty. Fruits and vegetables are full of important nutrients and antioxidants that remain key in preventing disease and maintaining wellness. And biting into a fresh, ripe strawberry never tasted so good.

By Lara Evans Bracciante – Originally published in Body Sense magazine, Spring 2003.

Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.

Taking Time Out for Yourself: The Only Way to Conquer Stress and Its Effects

In today’s world, we all have countless demands on our time and energy. Obligations from work, education, family, church, and countless other outside factors all pile up and lead to never-ending stress.

This burden of stress creates imbalances in our bodies which manifest themselves in different ways. Acne breakouts, digestive irregularity, aches and pains, tension headaches, and insomnia are just a few signs that your body may be overwhelmed by the demands on your physical, mental, and emotional energy.

If you sense that you are overworked and overtired, here are a few tips on how to manage the physical signs of excess pressure so that you can return to your busy life refreshed and prepared to handle whatever comes your way.

First of all, the key to unraveling stress of any kind lies in one thing that too few of do: take time for ourselves. Whether it is because we feel guilty or we are just so preoccupied that it never occurs to us, we just don’t do it! That needs to change, starting today!

Even if it is only five minutes, you need to work it into your routine–pencil it into your day planner or put it on the to-do list–whatever works for you, just make sure it gets done.

Nurturing yourself doesn’t have to be time-consuming or expensive. What you need to be concerned with first is creating a little niche for yourself where you know you can relax. Ideally, it should be a spot in your home–whether it’s a favorite chair in the den or a whole spare room, designate a space that is exclusively devoted to your leisure.

In that space, you cannot deal with “business,” of any kind. If your spouse approaches you to talk about the bills or the children, then it must wait until you exit your special space. This is to preserve the association in your mind: the place you choose should always remain practically sacred to you.

Next, think about how you can treat yourself to sensory stimulation of all kinds. Enjoy new scents, sounds, and tastes. When you settle into your little area, enjoy a bowl of fresh fruit. Turn on whatever type of music you consider the best to help you unwind. If you are the type of person that can release stress through aromatherapy, then try candles, scented oil, or even incense.

You don’t necessarily have to go into complete meditation mode, but we are so exposed to the clatter and chatter of everyday life that it can help to replace it all with things of our choosing.

It’s also vital to take time out to nourish your relationships. You could think about taking a couples’ massage class with your spouse; if you do, practice often! Just like your private relaxation space, try to turn the bedroom into a “no business or conflict,” zone. This will foster greater intimacy between you as a couple.

Ultimately, you have to figure out what works best for you when it comes to releasing the stress and pressures of day-to-day life, but you do actually have to do it at some point. Otherwise, you will overwork your body, and eventually, it will burn out. So do something kind to yourself starting today.

Three simple tips – How to live a longer life with less stress Tuesday, April 12, 2011 by: James Schreiber

(NaturalNews) Sometimes it may seem like the strains and demands of modern society exceed human abilities. However, that is usually far from the truth. This article outlines how you can take things down a notch with three simple tips that will help you shrug off stress and anxiety, induce deep relaxation, and make harmful levels of cortisol plummet.

The way we respond to stress has a bigger impact on our health than we previously thought. In 2009, the Nobel Prize in Medicine went to Elizabeth Blackburn, Carol Greider and Jack Szostak, who discovered a link between chronic emotional stress and telomerase (an enzyme responsible for repairing telomeres – the protective caps at the ends of chromosomes in cells that control aging). What they found was that people who feel more stressed are more likely to have shorter telomeres and lower levels of telomerase, which suggests that prolonged stress may actually shorten our lifespan.

If that wasn’t enough, chronic stress has also been associated with a host of health problems – ranging from inflammation, heart disease and rashes to headaches, insomnia, hemorrhoids, varicose veins and loss of concentration. The following relaxation techniques for dealing with stress and anxiety will allow you to grab the reins, indulge in positive thoughts and inhibit sympathetic nervous activity.

#1 Tip: Sauna and steam-baths

Sauna and steam-baths cleanse the body and relax the mind by generating abundant sweat. This is achieved with a 10-20 minute session in a room warmed to 180+ degrees Fahrenheit.

However, relaxation and contentment are not the only health benefits sauna is offering. The heat releases poisons so that your body is able to get rid of them via perspiration. During a sauna session, we go through artificial fever state, which stimulates the immune system and supports the body’s natural healing process. Plus, the increased blood flow to subcutaneous and surface tissue gradually improves the quality of the skin.

#2 Tip: Deep breathing

In modern society, the impact of breathing on our health goes largely unnoticed. It’s a shame because when you breathe correctly, your body reacts in many positive ways.

Deep breathing reduces high blood pressure, raises our energy levels, relaxes muscles and improves athletic performance. It also helps us release tension and reverse the body’s fight & flight reaction to stressful situations – no health club membership required.

#3 Tip: Massage therapy

Many people view massages as luxury splurges with no real health benefit. That is, however, far from the truth. This hands-on healing is terrific for removing blockages as well as for dealing with stress, migraines and neck pain. Another wonderful side benefit of massage is improved quality of sleep.

Both everyday experience and scientific research suggest that there are few things you can do to impact your life more powerfully and profoundly than learning how to cope with everyday stress. All you need to do is take the first step by taking enough time to slow down and relax.
Learn more:

HOF’s BLOG . . . Healing Mind, Body & Spirit

Welcome to our Blog where you will find articles that may challenge your current ideas about healthy thinking, living and being; where you will be the first to learn about upcoming specials and/or workshops; where you can read reviews about us or leave us one of your own.

Our intention with this Blog is to help you learn more about Traditional Naturopathy, Digestive Health/Enzyme therapy, Massage therapy, Energy Healing/Chakra Balancing, and all that encompasses Holistic Healing – Mind, Body & Spirit.


%d bloggers like this: