Botox yes! In TOS 1 Superior trapezius usually spastic/hyperdynamic; inducing same-side Pectoralis minor muscle to be spastic/hyperdynamic. These muscles control directional shift of distal clavicle; which, as drawn inferior, closes Thoracic Outlet (1 cm vs. clavicle & 1st rib).
The physical exam should note shoulder asymmetry; one shoulder lower with head usually tilted toward lower shoulder. The tilted 10# head often induces spasm & hypertrophy of Superior trapezius associated with opposite & higher shoulder.
Superior trapezius hyperdynamic function then induces spasm/hypertrophy within same-side opposing (shoulder lift & draw-down are complementary functions) Pectoralis minor (PM) muscle. It is PM hyperdynamic function that draws distal clavicle excessively inferior in TOS disorder.
The clavicle is about 18 cm long & 1 cm of excess inferior shift can close the Thoracic Outlet (TO) by ~30%; impinging brachial neurovascular bundle contents of the TO.
That part of the brachial neural plexus that gives rise to the ulnar nerve is the first part of the brachial neural plexus impinged as Thoracic Outlet closes; anatomical explanation why ulnar paresthesias are most common dysesthesia aroused by arm-shoulder abduction with TOS.
After surgeons failed to cure TOS with flayed/excision of Scalenes (~1980’s theory of TOS etiology), they discovered that Pectoralis muscle release (off corocoid process) & tie-down of first rib to 2nd (axilla surgical entrance) was therapeutic; opened up the Thoracic Outlet.
Yet this surgical approach seems somewhat butchery. Better to reduce “crossed muscle” asymmetry of Superior trapezium (strengthen weaker Superior trapezius with isometric & shrug exercises) & induce muscle relaxation of spastic shoulder muscles with massage, Botox & biofeedback.
The theories and practices referenced in this thread are my own novel insights and inventions; gained from years toiling in the clinical trenches. I have created several other threadreaders about TOS.
This is Dr. Krause, Neurosurgeon, of an El Salvador healing center he set up contemporaneously. Dr. Delgado, Neurosurgeon he mentions, was one of my Professors at Yale Medical School in 1966 & famous then for implanting radio frequency controlled electrode in a bull’s brain.
MIND CONTROL WITH EMF & LIGHT: Dr. Delgado, or surrogate, got into bull ring. As bull charged for the kill a flick of a switch stopped him in his tracks. ‘‘Twas a powerful demonstration. Dr. Delgado was an handsome Surgeon & the coeds, my own same-time fancy, swooned.
IBS IN VETERANS: As a medical doctor I have clinically studied this disorder. My clinical impressions are as follows:
My prediction is that this disorder will be found in more female veterans than males. My Threadreader to follows explains why …
VETERANS WITH IBS, PREFACE TO THIS THREAD: Over >2 decades, I have studied pathophysiology/etiology of IBS. Amongst my >300 threadreaders on Twitter/X, I have discussed IBS issues.
VETERANS WITH IBS, MY AUTHORITY: Since 2007, I have published clinical data internationally in “Proceedings of Interdisciplinary World Congress on Low Back & Pelvic Pain”, which Congress meets every three years.
HYPERMOBILITY SYNDROME (~15% women) predisposes ▶️ Dysmenorrhea due to Relaxin hormone each menses ▶️ Abdominal Endoscopy whereby 100% women ▶️ intestinal adhesion from #2-3 Scopes ▶️ IBS symptoms of partial obstruction = “Endometriosis” …
After several endoscopic procedures iatrogenic-caused bowel adhesions induce dysfunctional bowel manifest as IBS. Now the time for widespread ablation of peritoneal tissue. I am curious about the long term effects of this mutilating procedure.
FIBROMYALGIA SLEEP SOLUTION? Very simply, the solution is increased REM sleep. FM sufferers are surface sleepers aroused, by musculoskeletal pain, from deeper levels of sleep. Ask them if they regularly dream, and most admit they don’t.
FIBROMYALGIA & SLEEP: A sine qua non of Fibromyalgia (FM) is chronic low back pain. Commonly, etiology of FM low back pain is unilateral sacroiliac (SIJ) dysfunction/subluxation, whereat integrity of the SIJ capsule has been compromised.
DAMAGED LIGAMENTS HURT, as the Spanish Inquisition’s use of “The Rack” taught us. Each sacroiliac is 17 cm sq., largest joint in axial spine, & has a large ligament capsule. Torsion of this capsule occurs at night …
DYSAUTONOMIAS: etiologic via major joint subluxations (shoulder/pelvic girdles) proximate autonomic tracts/plexi become impinged, due to titled upright body tower, due to ⏬️ musculoskeletal tone, due to prolonged (>2 wks) bedrest, due to significant viral illness. GRAVITY RULES
FIBROMYALGIA BEGETS ITSELF: Once chronic widespread muscle spasms begin, chronic pain & restless sleep induce sedentary life, reclusiveness, daytime fatigue and depression. These changes lead to inadequate sunlight, low Vit D, weaker spastic muscles, & greater sedentariness.
FIBROMYALGIA BEGETS ITSELF: weak spastic muscles in persons with Hypermobility Syndrome (~15% of women) induce joint subluxations. These subluxations impinge the Autonomic Nervous System plexi at shoulder & pelvic girdle joints….
DYSAUTONOMIAS: etiologic via major joint subluxations (shoulder/pelvic girdles) proximate autonomic tracts/plexi become impinged, due to titled upright body tower, due to ⏬️ musculoskeletal tone, due to prolonged (>2 wks) bedrest, due to significant viral illness. GRAVITY RULES
DYSAUTONOMIAS: THORACIC OUTLET SYNDROME & CRPS (RSV) of arms aroused via autonomic dysfunctions as neural tract impingements are effected within asymmetric shoulder girdles, secondary to functional scoliosis in hypermobile women with faulty muscle tone & unstable pelvic girdles.
DYSAUTONOMIAS: IRRITABLE BOWEL SYNDROME & INTERSTITIAL CYSTITIS are aroused d/t autonomic dysfunctions as neural tracts impinged within presacral plexi overlaying ventral sulci of sacroiliac joints in hypermobile women w. SIJ subluxation, d/t mundane slips/falls/ childbirths.