Thoracic Outlet Syndrome (TOS) in a condition which can cause pain, numbness, and weakness in the upper body. It occurs when the nerves or blood vessels in the thoracic outlet—the space between the collarbone and first rib—become compressed. This can happen after trauma such as a car accident, or slowly develop over time. While treatment for TOS often focuses on the affected area directly, there's an aspect that is sometimes overlooked but can be immensely beneficial: core strength and stability. So let's chat about why developing a strong and stable core is vital in managing and treating Thoracic Outlet Syndrome.
Understanding Thoracic Outlet Syndrome:
Before delving into the role of core strength in managing TOS, let's briefly understand the condition itself (we all know this is one of my fav things to treat and talk about!). TOS can present itself in various ways, including pain, numbness, tingling, and weakness in the shoulder, arm, and hand. These symptoms often arise due to compression of nerves, blood vessels, or both, as they pass through the thoracic outlet. There are 3 kinds of TOS which are given their name based on what structures are compressed- arterial, venous or neurogenic. The causes of TOS can range from poor posture and muscle imbalances to anatomical variations or trauma. Patients have often been treated for a variety of other conditions, like carpal tunnel, cubital tunnel, or tennis elbow, with no relief- although these nerves are usually effected in TOS, these treatments don't help because the problem is starting up higher near the shoulder and neck. Treatment for TOS requires the therapist to treat the whole body to improve alignment, movement patterns and strength to prevent future compression.
The Importance of Core Strength and Stability:
While TOS primarily affects the upper body, the role of the core—comprising muscles in the abdomen, lower back, and pelvis—should not be underestimated. Here's why:
Postural Alignment: A strong core helps maintain proper posture, which is crucial in relieving pressure on the thoracic outlet. Poor posture can exacerbate TOS symptoms by causing misalignment and increasing compression on nerves and blood vessels. (think of when we are hunched over our screens and computers- we can cause pinching of these structures near our pecs) Strengthening the core muscles can correct imbalances and promote better alignment, reducing strain on the thoracic outlet.
Upper Body Support: Core stability is essential for providing a solid foundation for the upper body. When the core muscles are weak or imbalanced, the shoulders and arms may bear more weight than they should, leading to increased stress on the thoracic outlet. The shoulder blade also wont have a strong base of support to move the arm on! This is like building a house on a weak foundation, we wouldn't expect it to hold the load it needs to for years to come. By strengthening the core, individuals with TOS can better support their upper body, alleviating strain on the affected area.
Enhanced Movement Patterns: A strong and stable core contributes to improved movement efficiency and coordination. This is particularly important for individuals with TOS, as certain movements or activities can aggravate symptoms. By enhancing core strength and stability, individuals can move more efficiently, reducing the risk of exacerbating TOS symptoms during daily tasks or physical activities. We want bigger muscles like those is the hips (hello, gluts!), back and core to help us move so that the poor shoulder is not stuck doing it all on its own.
Pain Management: Core strengthening exercises can help alleviate pain associated with TOS. By targeting the core muscles, these exercises promote better body mechanics and alignment, reducing the strain on the thoracic outlet and alleviating discomfort. Additionally, a strong core can provide better support to the spine, which may indirectly alleviate referred pain often associated with TOS.
Incorporating Core Strengthening into TOS Treatment:
Integrating core strengthening exercises into the treatment plan for TOS can significantly improve outcomes. Physical therapists, occupational therapists and healthcare providers can prescribe targeted exercises tailored to individual needs and limitations. These may include:
Planks and side planks to engage the entire core.
Bird-dog exercises to improve core stability and balance.
Pelvic tilts to strengthen the lower back and pelvis.
Bridging exercises to activate the glutes and lower back muscles.
Lunges with reaching in all directions to work balance and core
Single leg exercises to activate glutes and stability muscles
It's essential for individuals with TOS to work closely with healthcare professionals to ensure that core strengthening exercises are performed correctly and target the proper areas- each person is different and should have a customized program tailored to them! Additionally, maintaining consistency with these exercises is key to managing your TOS for years to come.
While Thoracic Outlet Syndrome can present significant challenges, the incorporation of core strengthening exercises into the treatment regimen offers a promising avenue for relief. By addressing core strength and stability, individuals with TOS can improve posture, support the upper body, enhance movement patterns, and manage pain more effectively. As part of a comprehensive treatment approach, strengthening the core can play a pivotal role in restoring function and improving quality of life for those affected by TOS.