Educate the patient
• Teach posture correction
• Teach how to modify provoking stresses
• Teach safe exercises for home exercise program
Correct impaired posture
Mobilize restricted neurological tissue
• Nerve mobilization techniques if testing is positive for restricted mobility
Mobilize restricted joints, connective tissue, and muscle
• Tissue-specific manual techniques to restricted structures if testing is positive for restricted mobility
• Self-stretching exercises […]

• Intermittent brachial plexus and vascular symptoms of pain, paresthesia, numbness, weakness, discoloration, and swelling
• Muscle length-strength imbalance in the shoulder girdle with tightness in anterior and medial structures and weakness in posterior and lateral structures
• Faulty postural awareness in the upper quarter
• Poor endurance in the postural muscles
• Shallow respiratory pattern characterized by upper […]

There are three primary sites for compression or entrapment of the neurovascular structures that lead to tension or compression signs.
• Interscalene triangle: bordered by the scalenus anterior and medius muscles and the first rib. If these muscles are hypertrophied, tight, or have anatomical variations, they may compress the proximal portion of the brachial plexus normal […]

Walsh has identified three causative factors for TOS that could be interrelated or exist separately: compressive neuropathy, faulty posture, and entrapment.
• Compressive neuropathy. Compression of the neurovascular structures can occur if there is a decrease in the size of the area through which the brachial plexus and subclavian vessels pass. Compression can result from muscle […]

Thoracic Outlet Syndrome
The thoracic outlet is the region along the pathway of the brachial plexus from just distal to the nerve roots exiting the intervertebral foramen to the lower border of the axilla.. The outlet is bordered medially by the scalenus anterior, medius, and posterior and the first rib; posteriorly by the upper trapezius and […]