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A follow-up video detailing the anatomy of the scalene, subclavius and pectoralis minor muscles involved in thoracic outlet syndrome and giving specific stretches and provocation tests for each.
In the first video we covered the prevalence and symptoms of the thoracic outlet syndrome in more in detail. In this video we will take a closer look at very important anatomical factors and how they can be maintained. There are three important areas to recognize. The first is the scalenius muscle.
The second is the space under the clavicular. And the third is the area under the pectoralis minor. The scalenous muscle may pull the first and the second rib upwards causing the triangular space to tighten. Inside this triangle we find the arteries, veins and the nerves.
You will soon see the stretches for the scalenius muscles. The second area is the space under the clavicular. The subclavicular muscle can cause extra pressure on the structures there. If the muscle under the clavicular is overactive, the entire shoulder girdle may be rotated forward and downward.
The third area is the pectoralis minor which originates from the coracoid process of the shoulder and it attaches to third, fourth and fifth rib. When tightened it also affects the circulation of these three structures. The first scalenous muscle originates from the transversal process of the C3, C4, C5, C6 and it descends to attach the first rib. If you want to stretch this structure, place the fingers on the clavicle, rotate your head to the same side and then extend your neck backwards.
The middle scalenous muscle originates from the transversal process of C2, C3, C4, C5, C6 and C7 and it also attaches to the first rib. To stretch this structure place your fingers in the clavicle, bend your head to the opposite side and if needed add a slight neck extension. So backward bending. The posterior scalenius muscle originates from the transversal process of C4, C5, C6 and it attaches to second rib.
To stretch this muscle place the fingers on the clavicular notch of the side you want to stretch, rotate your head to the opposite side and tilt your chin downwards. If any of these stretches intensify your familiar symptoms, then that structure should be stretched regularly. And if you want to remember fun fact, the scalenous muscle number is 362746 and those are the origins. Indeed, under the clavicular there is a tiny muscle called subclavius and there's also tender structure, the costocoracoid ligament.
When these tighten the triangle under the clavicular starts to become compressed. If you are experiencing upper limb symptoms, try these movements first. Hold the position for 30 seconds and monitor if there is any increase in the symptoms. First, pull your shoulder blades back and hold it for 30 seconds.
Second, inhale and exhale while pulling your shoulder blades back and hold for 30 seconds. Third, pull your shoulder blades back, inhale, exhale and lift the chest and hold for 30 seconds. If some of the movement is causing your typical symptoms, then the most problematic place is the triangle or the pectoralis area. Pectoral minor originates from the coracoid process of the scapula and it attaches to the third, fourth and fifth rib.
This muscle can cause forward rotation of the shoulder girdle partially if it's active, like when pressing something down. Best stretching exercises involve pulling of the shoulder blade down and back. If you want to stretch the pectoralis minor muscle, get 90 degree angle to armpit and elbow. Then place the opposite side leg forward and then start rotating backwards when the hand is at the back.
You will going to feel the minor stretch. In most of the cases, thoracic outlet syndrome clients need some sort of manual therapy at the start of reducing the symptoms and after that exercises for surgical order is needed. Good posture of the upper body keeps the symptoms away in longer periods. If you want to see a video about nerve entrapments, click here and thank you for your time.
A follow-up video detailing the anatomy of the scalene, subclavius and pectoralis minor muscles involved in thoracic outlet syndrome and giving specific stretches and provocation tests for each.
The video demonstrates specific movement patterns and clinical exercise progressions: In the first video we covered the prevalence and symptoms of the thoracic outlet syndrome in more in detail. In this video we will take a closer look at very important anatomical factors and how they can be maintained. T...
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Get Free PDF Guides (Google Drive)Medical Disclaimer: The information presented in this article is strictly for educational purposes and does not replace a clinical physical therapy evaluation, medical diagnosis, or individualized treatment plan.