In this video you will learn an exercise routine to relieve the symptoms caused by Thoracic Outlet Syndrome. Hello friends, welcome back to physiotherapy at your fingertips, Thoracic Outlet Syndrome, or TDS, is a condition in which both the nerves and blood vessels that originate in the neck and end in the arm become irritated in the thoracic outlet region. This region is located between the neck and the upper chest, near the collarbone and first rib. The irritation can present itself in the form of generalized pain, but in more severe cases it can lead to changes in limb sensitivity (numbness/tingling) or even weakness in the hand with potential loss of grip strength. Unfortunately, the exact cause of Thoracic Outlet Syndrome is unknown, however it has been discovered that it is useful to treat the surrounding structures and soft tissues to mitigate the signs and symptoms. If you want to know more about this condition, you can access the video dedicated to the pathology by clicking on the top right corner of the screen. Okay, back to the main topic of the video, I'm going to suggest six exercises that will help you relieve its symptoms. NEURAL SLIDING. The first exercise looks like a ballet step. Sit on a stool and lean your back straight against the wall. Raise your arm straight, in a neutral position as high as possible. Then perform a dorsal flexion of the wrist and lower the arm to the horizontal. Then internally rotate your shoulder and wrist so that the palm of the hand is vertically facing outwards. Finally, bend the elbow as much as possible, as if you wanted to touch your ear. It is very important that in the last elbow movement, the arm is completely straight. You can try to do it well, and do it badly so that you can notice the difference in tension in your arm. This exercise will help you improve the sliding of the nerve within its own path. The second exercise is similar to the previous one, the only thing we have to do is change the final movement of the wrist. Let's go step by step again. Raise your arm straight, in a neutral position, as high as possible. Next, dorsiflex your wrist and lower your arm to horizontal. Then, internally rotate your shoulder and wrist until your palm is facing downwards. Finally, bend your elbow as much as possible, flexing your wrist, as if you wanted to bring it towards your ear. Perform two sets of 10 repetitions of each of the two movements. UPPER TRAPEZIUS STRETCH. Bring the painful arm behind you, catch and pull the forearm with the other hand behind your back. You should feel tension and stretching on the side of your neck. Maintaining the traction of the arm, lateralize your head to the opposite side and then rotate your neck to end up looking towards the ceiling. It seems complicated, but it is quite obvious. If you look at the example on the screen, it will be much clearer. Perform 3 or 4 sets of 45 seconds. THE ANGEL. Lying on your back with your legs bent, place your arms on either side of your body. Keeping your elbows and hands flat on the floor, slowly slide your arms up and down in a range of motion that allows you to maintain contact with the floor. Perform 2 sets of 10 repetitions. SCAPULAR RETRACTION. Sit in a chair with your elbows bent and your palms facing up. Push your chest out, squeezing your shoulder blades together behind you while turning your palms outward. You should feel a good muscle contraction between your shoulder blades. Hold the contraction for 5 seconds and relax. Perform 3 sets of 10 repetitions each. SPINAL MOBILITY. To finish off a movement that will help you improve mobility in your lower cervical spine, lie face down with your arms in a diamond shape. Keeping your cervical area neutral, raise your chest as high as possible. From this position with your chest raised, bring your head towards your hands, as if you wanted to touch them with your forehead. Hold the position for 5 seconds and then raise your head back up until it is aligned with your spine. Complete the routine with 2 sets of 10 reps. You can choose 3 or 4 exercises from the routine to do 3 to 4 times a week. You should notice improvement in your symptoms within seven days. If you have the time and all the exercises feel good to you, you can easily include them in a routine every day, as long as you don't feel any more pain the next day. Okay, folks, that's all I hope these exercises help you alleviate the unpleasant symptoms of Thoracic Outlet Syndrome.