Audrey Spangler, LMT

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07/20/2022

🔈THORACIC OUTLET SYNDROME

Thoracic outlet syndrome is a disorder characterized by pain and paresthesias in a hand, the neck, a shoulder, or an arm.
Pathogenesis often involves compression of the lower trunk of the brachial plexus (and perhaps the subclavian vessels) as these structures traverse the thoracic outlet below the scalene muscles and over the 1st rib, before they enter the axilla.

Compression may be caused by:
• A cervical rib
• An abnormal 1st thoracic rib
• Abnormal insertion or position of the scalene muscles
• A malunited clavicle fracture
• Thoracic outlet syndromes are more common among women and usually develop between age 35 and 55.

Symptoms and Signs of TOS
Pain and paresthesias usually begin in the neck or shoulder and extend to the medial aspect of the arm and hand and sometimes to the adjacent anterior chest wall. Many patients have mild to moderate sensory impairment in the C8 to T1 distribution on the painful side; a few have prominent vascular-autonomic changes in the hand (e.g., cyanosis, swelling). In even fewer, the entire affected hand is weak.

Rare complications of thoracic outlet compression syndromes include Raynaud syndrome localized to the affected arm and distal gangrene.

Exercise:
• Pectoralis stretch: Stand in a doorway or corner with both arms on the wall slightly above your head. Slowly lean forward until you feel a stretch in the front of your shoulders. Hold 15 to 30 seconds. Repeat 3 times.

• Thoracic extension: While sitting in a chair, clasp both arms behind your head. Gently arch backward and look up toward the ceiling. Repeat 10 times. Do this several times per day.

• Arm slide on wall: Sit or stand with your back against a wall and your elbows and wrists against the wall. Slowly slide your arms upward as high as you can while keeping your elbows and wrists against the wall. Do 3 sets of 10.

• Rowing exercise: Tie a piece of elastic tubing around an immovable object and grasp the ends in each hand. Keep your forearms vertical and your elbows at shoulder level and bent to 90 degrees. Pull backward on the band and squeeze your shoulder blades together. Repeat 10 times. Do 3 sets.

07/19/2022

🔈 TIBIALIS ANTERIOR TENDONITIS - SYMPTOMS, CAUSES, TREATMENT OPTIONS

▶️ WHAT IS TIBIALIS ANTERIOR TENDONITIS?

The tibialis anterior is a muscle which lies at the front of the shin and attaches to several bones in the foot via the tibialis anterior tendon. The tibialis anterior is primarily responsible for moving the foot and ankle towards the head (dorsiflexion – figure 1), and, controlling the foot as it lowers to the ground during walking or running.

Whenever the tibialis anterior muscle contracts or is stretched, tension is placed through the tibialis anterior tendon. If this tension is excessive due to too much repetition or high force, damage to the tendon can occur. Tibialis anterior tendonitis is a condition whereby there is damage to the tibialis anterior tendon with subsequent inflammation and degeneration.

▶️ SIGNS AND SYMPTOMS OF TIBIALIS ANTERIOR TENDONITIS

Patients with tibialis anterior tendonitis usually experience pain at the front of the shin, ankle or foot during activities which place large amounts of stress on the tibialis anterior tendon (or after these activities with rest, especially upon waking in the morning). These activities may include walking or running excessively (especially up or down hills or on hard or uneven surfaces), kicking an object with toes pointed (e.g. a football), wearing excessively tight shoes or kneeling. The pain associated with this condition tends to be of gradual onset which progressively worsens over weeks or months with continuation of aggravating activities. Patients with this condition may also experience pain on firmly touching the tibialis anterior tendon.

▶️ CAUSES OF TIBIALIS ANTERIOR TENDONITIS

Tibialis anterior tendonitis typically occurs due to activities placing large amounts of stress through the tibialis anterior muscle. These activities may include fast walking or running (especially up or downhill or on hard or uneven surfaces) or sporting activity (such as running or kicking sports). Patients may also develop this condition following direct rubbing on the tibialis anterior tendon. This may occur due to excessive tightness of strapping or shoelaces over the tendon.

▶️ TREATMENT OPTIONS

Treatment for patients with tibialis anterior tendonitis is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of injury recurrence. Treatment may comprise:

- soft tissue massage
- electrotherapy (e.g. ultrasound)
- anti-inflammatory advice
- stretches
- joint mobilization
- dry needling
- ankle taping
- bracing
- the use of crutches
- ice or heat treatment
- exercises to improve strength, flexibility and balance
- education
- activity modification advice
- biomechanical correction
- footwear advice
- a gradual return to activity program

▶️ EXERCISES

The following exercises are commonly prescribed to patients with this condition. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally, they should be performed 3 times daily and only provided they do not cause or increase symptoms.

Your physiotherapist can advise when it is appropriate to begin the initial exercises and eventually progress to the advanced and self massage exercises. As a general rule, addition of exercises or progression to more advanced exercises should take place provided there is no increase in symptoms.

🔑 Foot and Ankle Up and Down

Move your foot and ankle up and down as far as possible and comfortable without pain (figure 2). Repeat 10 – 20 times provided there is no increase in symptoms.

🔑 Foot and Ankle In and Out

Move your foot and ankle in and out as far as possible and comfortable without pain (figure 3). Repeat 10 -20 times provided there is no increase in symptoms.

Reference: Physio Advisor

Address

2193 Park Avenue W
Mansfield, OH
44906

Opening Hours

Tuesday 9am - 3:30pm
Thursday 9am - 3:30pm

Telephone

+14199342013

Website

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