Can't find Stretch for Nerve Impingement from Neck Down Arm

[Adley]

Hi wonderful St community. 

For about 3 months, I've been having some nerve sensations which seems to originate at the lower part of the left side of my cervix/upper thoracic, and then travels down my left arm to my fingers. There is not really pain as I typically think of it, but the numbing sensation increases until it becomes unbearable.

I can often relive the sensation by raising my left arm above my head momentarily.

I have looked through other posts on this forum regarding neck nerve impingement, and see that one of the recommended stretches for what may be TOS is the scallion stretch that Kit demonstrates.  However, when I get into this position and grab my left ankle with my left arm, the numbing sensation intensifies unbearably before I even inch my foot down. I have the same experience of intensity when I attempt to do the solo shoulder raise demonstrated by Kit, regardless of how gently I enter into it.

I have done some exploration with a massage tool laying on my back with the tool under my shoulder blades, upper thoracic, and have found some nice spots to explore. But it does not prevent the numbing sensations from coming on with a variety of movements. 

I also do the ST neck sequence without bringing on the numbing sensations, except when I tilt my head back which brings on the sensation.

The pec stretch with the arm against the wall also seems to bring momentary relief, or at least not additional numbness. But again, the numbness comes on again with many movements after. 

If I lay down on my back and lengthen my neck along the floor, the numbness comes. If I tilt my head back, or raise it with a pillow the numbness goes away. 

I'm not sure where the impingement is, and I'm a bit discouraged that I have not been able to resolve it as of yet. I have had the thought recently that I need to try to bring more relaxation to the area, as opposed to tension. 

I would so welcome any thoughts or suggestions. 

Thanks for your thoughts. 

Adley

[Nathan]

Hi Adley,

@Kit_L will likely have better advice, but in the meantime, just something to try:

• Use a ball to roll along the underside of the collarbone, starting near the center/sternum and moving outward. Move slowly and stop on any lumps or tender spots, allowing them to release. Once you get close to the arm/deltoid, move downward and back in to roll the whole pec minor area (example image). Take your time.
• After you've rolled the area, do the pec minor stretch (palm down = no fascial demension) on the floor. Take your time and be gentle.
• Finally, give the scalenes stretch a try. Don't let your head hang back, which is an advanced version of this stretch. See if you can just get into the starting position and chill out there for a while. Focus on feeling the tension and allowing it to relax. Don't worry about inching the foot away until you can feel comfortable here.

Even better if you can do all of this in a warm room after a nice, hot bath. If you still can't get into the scalenes stretch starting position, there is a first rib mobilization you can do with a ball that might help, but it's fairly difficult to find a good position and do it well. I don't see any great videos, but this one should give you an idea.

[Adley]

Hi Nathan. 

Thanks so much for these thoughts. I will give it a go and report back in a day or so. 

With much appreciation. 

Adley

[Adley]

Hi Nathan et al,

So after a nice hot bath, I gently and as relaxedly as I know how followed Nathan's suggestions. 

I used a ball to rollout the area under the collarbone. At first I didn't think I had any tender spots there, but did find a few. Then did the pec minor stretch on the floor. 

However, didn't seem to be any change in the attempt at the scalenes stretch. In fact, just laying on my back with my head on the floor brings on the numbness down the left arm. If I put a pillow under my head it goes away, but wasn't sure I should attempt the scalenes stretch with a pillow under my head. 

I then used the video link Nathan sent and used a ball to try to get some rib mobilization. While this felt fantastic, I wasn't sure I was doing it right. In any case, it did not change the onset of the numbness. 

I plan to try it all again, but would appreciate other thoughts as well.

Best,

Adley

[Kit_L]

@Adley: check this one out:

If you search on "scalenes" and "brachial plexus" here, the nexus will become clear (sorry: could not resist the pun—how often do you get to rhyme with something that ends in '–exus'?). Very likely this could be the source of that pain/discomfort.

[Nathan]

@Kit_L I'm from Texas, and I assumed the same nexus... Yes, horrible, I know 

@Adley For what it's worth, I dealt with a similar issue. It took a long time to return to normal. Be careful about trying too much, but it will take gentle daily attention. I did a lot of the rolling as I described, and I did the pec minor and scalene stretches regularly, being careful not to push too hard. As you hinted at in your initial post, a little bit of relaxation can always help too. Consider adding some lying relaxation into your routine, if you can. See the ST Relaxation Wiki or search around the forums for details.

Edit:

7 hours ago, Adley said:

wasn't sure I should attempt the scalenes stretch with a pillow under my head

Go ahead and try. Personally, I would use something more stable to lift the head. You're basically reducing the stretch on the scalenes. If this is what allows you to start working on them, then it's a starting point.

[Adley]

Hi Kit and Nathan, 

I see that you've made a rhyme, about my spine, and with that I am fine. 

Kit the scalene stretch video you sent is the one I had been using and was excited about.  

Unfortunately, as soon as I reach down and grab my ankle, I get incredible numbness from the neck down my left arm and into my fingers. 

The numbness will go away if I put my head on a pillow in the same position, but returns as I again reach for my ankle. 

Nathan, thanks for sharing that about your own journey. I can tell there is still more for me to learn here, and I think always good to slow down and be gentle. So appreciate your suggestion of doing some of the lying relaxation routines (which I do only from time to time), and in general to not push too hard or too much (which is my tendency). 

I can tell it would be good for me to be hopeful here, but the discouragement wants to take over. Perhaps that's also part of my journey. 

I'll update if I have anything else to report. 

Adley

[Kit_L]

@Adley: So, use a loop around the ankle so that you do not have to reach so far. 

Quote

Unfortunately, as soon as I reach down and grab my ankle, I get incredible numbness from the neck down my left arm and into my fingers. 

And that's all the evidence you need to be certain that the scalenes and brachial plexus are involved. Reduce the intensity, and persevere. Best of luck!

[Adley]

Interesting update. 

I set out to do a lying relaxation tonight. First thing I noticed was that the numbing sensation running down my arm while lying with my head flat on the floor was too intense for me. So I put a small yoga blanket under my head, and that decreased the sensations somewhat. But soon into the routine, the sensations returned and I didn't think I could get through the whole thing. (Prior to this "injury" I have in the past thoroughly enjoyed Kit's relaxation routines).  I decided to hang in there and see if I could relax more in my neck, head and shoulder area. I noticed that I brought my neck in towards my chest a bit in response to my own cue. And to my surprise, the numbing sensation decreased dramatically, but not completely. But enough so that I could finish the routine and enter a state of deep relaxation. I am pleased with this update. 

[Kit_L]

Can you hang from a bar or rings? This activity too will help these same nerves.  

There's a number here; the third one's the most intense. Work up to timed hangs slowly, too.

https://www.youtube.com/c/KitLaughlin/search?query=hanging

[Adley]

Thanks for that suggestion Kit. 

I have a pull up bar and while I can't hang with one arm, I will try hanging with both and using one arm to assist the other. 

Adley

[Kit_L]

This might sound a bit extreme, but I recommend handing by two arms for ~3:00 minutes (and being able to do that for at least once or twice a week for a month) before trying one arm work. The reason is that tendons and ligaments have about 1/10th the nutrient supply of muscles—and muscles get stronger faster (so it's easy to hurt yourself). Build up slowly, and especially with that impingement. In time, try to relax fully in the hang position, apart from the grip, of course. Do please report back.

[Adley]

Ok. I will try and report back. 

[Adley]

So I've been incorporating the suggestions from Kit and Nathan.

I'm pleased to report that I think there are some subtle positive changes occurring.

The numbness is feeling less intense, and there are longer periods where I don't have any symptoms. Also easier to sleep through the night without waking up in discomfort. In particular, I like hanging with both arms arms as you suggested Kit. Although I can only do it for about 30 seconds because my hands can't hold the grip longer. 

I had the image of my situation (injury?) being like an upset child that needs some extra loving attention at the moment, which I'm able to offer it. 

I will send further updates as changes occur. Am feeling a bit more hopeful. 

Adley

[Adley]

My symptoms continue. Yesterday I tried using a percussion massage gun on my shoulders, traps, and scalenes. My body didn't like this too much and couldn't get the nerve to settle down. 

I tried doing some stretching and was able to come up with something that seems to reliably get my symptoms to go away for a bit. It's a combination of the seated side stretch and solo shoulder pull down. I'm doing contractions as in the solo shoulder. While I'm not sure what's being stretched, I'm assuming it's stretching of the scalenes that's making a difference. 

Below is a link to a recording of me doing it. My right arm is grabbing the front left of the chair and my left arm is grabbing the back leg of the chair. My symptoms go down my left arm. When I attempt the lying down scalene stretch, my symptoms intensify too much. 

 

[Kit_L]

This is a more gentle version of the shoulder pulldown, and yes, it is stretching scalenes. (I'm not sure if I explained this before, but I am a massive fan of distort in the shape of the rib cage using the whole shoulder girdle to press the first rib directly down towards the pelvis – and you don't even need to take the head to the side, and that avoids a potential cramping on the inside of the curve that The neck makes if you do take the next to the side.)

Keep going!

[Adley]

Hi Kit. 

Not sure I know what you mean by "distort in the shape of the rib cage using the whole shoulder girdle to press the first rib directly down towards the pelvis". 

Any video of having demo'ed that avail somewhere?

[Kit_L]

Yes:

 

Do please be gentle the first time you try this.