Thoracic outlet syndrome - a patient with questions

Hi all,

I've unfortunately been dealing with the rigour of TOS for 4 years with surgery looking very likely. I wanted to collate all your thoughts as I embark on better understanding my own body and finding the relevant expert(s) to help me through this truly horrendous ordeal.

I have vascular symptoms in both forearms, more so on the left than the right. After many year of football, cycling and 5 days of heavy weightlifting my body began to see development muscular imbalances:

• Firstly, my right shoulder sloped forwards - two years later tos symptoms
• Two years later, left shoulder sloped forwards - tos symptoms followed two months later
• Flared ribs
• Anterior pevlic tilt - this is so bad that both hips have worn out and I've had arthroscopy

Recently, symptoms are so bad I cannot leave the house as all movements are so sensitive. It seems that the narrowing of the costoclavicular space is causing the compression as symptoms were in tune with rounding of shoulders. However, when I pull shoulder back to 'correct' position, my symptoms increase. Could this signal tight scalenes?

I have tried the following to reduced symptoms:

• Stretching pecs, strengthening lower traps
• Massage/acupuncture
• Postural restoration; ballon/diaphragmatic breathing
• I have also had a mouth splint fitted to help improve airflow. This is related to PRI

My symptoms seem to be a result of terrible posture but any attempt to reallign this causes further pain.

I've yet to properly try first rib mobilisation and will doing some further reading on this in the coming days.

TOS is a very difficult condition to diagnose due to it's complexity and there's a lack of understanding - or so it seems - from the people I've been working with. I've now reached a stage where I'm hoping to build up the best understanding possible and use all the necessary skills to help alleviate or manage my symptoms. But I'm looking for advise in the meantime because I'm running out of ideas.

Thanks,
Dan