Hey Forumites! Is there an orthopaedic specialist out there who swims and is familiar with thoracic outlet syndrome? I have a theory regarding TOS and swimming 200 breaststroke, and would like to know if I'm on to something here. I don't need a consultation; I would just like to ask a question to another Forumite who is familiar with both angles; TOS and breaststroke technique. If you will send me a PM, I would most appreciate bouncing this off you!
Thanks!
:agree:
Hey Forumites! Is there an orthopaedic specialist out there who swims and is familiar with thoracic outlet syndrome? I have a theory regarding TOC and swimming 200 breaststroke, and would like to know if I'm on to something here. I don't need a consultation; I would just like to ask a question to another Forumite who is familiar with both angles; TOS and breaststroke technique. If you will send me a PM, I would most appreciate bouncing this off you!
Thanks!
:agree:
P.S. I just noticed (6/10/12) that I made a typo in the title. It should read, "T.O.S."
For those who don't have TOS, think about trying to swim an event as a blood pressure cuff gets inflated way too much very high on your arm and someone takes a cattle prod to your upper trap and neck. Not fun. I'm not an orthopedic doc, just a 54 yo doc with TOS who tries to swim butterfly and IM. Don't construe this as medical advice (you wouldn't want me with a scalpel in my hand),:cane: just advice from a mutual sufferer trying to enjoy Masters swimming.
It's interesting that you have more trouble with breaststroke than fly. I came back from Greensboro having swum the three fly events, 100 back, and the 100 and 200 IM with my typically worse (for post-meet) TOS pain determined to improve my breaststroke this summer for my IM. For about 2 months, I swam about twice as much breaststroke (and long course, too), only to find it made my TOS so much worse that I had to skip Omaha and am now to the point of surgery.
You're right that *** is the only stroke where the thoracic outlet is compressed continuously because your arms are always overhead. To the extent that you shrug your shoulders and round them forward with a neutral spine as you breathe, you do give your thoracic outlet a break by creating space (by lifting your collarbone off of the first rib). And, unfortunately, the most important part of breaststroke --- the streamline glide --- is the most compressive position for the thoracic outlet. Even fly, which eventually makes my involved arm go numb, gives your thoracic outlet a break as you pull through and recover.
My theory would be that in the 200 ***, with a slower turnover and trying to "ride the glide," you are continuously narrowing the thoracic outlet compared to a shorter, more rapid turnover, *** event, and certainly more than fly. That's why you're having so much trouble. It's not a conditioning issue, it's a nerve/vascular compression issue.
The things you might want to experiment with are the trade-offs between efficiency/speed (all the things like neutral spine/head position, ride the glide, hitting streamline early for the kick) and duration of symptom-free distance. Over a 200, "perfect" breaststroke might actually leave you worse off for the last 50 because it aggravates your TOS more, much like taking it out too fast in a race. For me, the streamline and "press to the Y" outsweep are absolute killers for my TOS. I've been trying to experiment with a narrower outsweep and/or with trying to really round my shoulders forward to move my collarbone as far forward as I can as I shrug during the breath, keeping my spine neutral (and neck relaxed). This trick gives my thoracic outlet a brief break before going into the God awful streamline again.
You may also want to try turning your head slightly away from your more involved side as you go to streamline. It would leave you with a weird looking breaststroke, but it might give you a bit of a break to make you hold up for a 200 better. One of the tests for TOS has the doc measuring to see if your wrist pulse on the TOS side is more faint when you turn your head toward him versus looking away. I've noticed that in fly, as I go into my catch, I unconsciously tilt my head away from my TOS side to relieve the strain on my thoracic outlet. You may also want to concentrate more as you get tired on keeping your chin closer to your chest (neutral spine), because if you're like me, I'm usually lifting my head (hyperextending my neck) to gasp for air by the end of a 200. You can test the relationship of your head position (completely neutral vs chin slightly more tucked; head tilted away versus dead center) and your TOS symptoms in front of a mirror doing a streamline for 3 minutes and clenching/unclenching your fists. You might find a variation that lets you go longer without symptoms.
Anyway, short answer to your question is, yes I think *** is worse than even fly for TOS. You have to look for places in your stroke to "cheat" to give your thoracic outlet a temporary reprieve. Since anatomy varies, finding your own "sweet spots" of arm/neck/head position where you can give your thoracic outlet a break will take some experimentation. You may end up with a less than textbook stroke carrying you further faster than a perfect one.
Good luck! I feel your pain.
Hey Forumites! Is there an orthopaedic specialist out there who swims and is familiar with thoracic outlet syndrome? I have a theory regarding TOC and swimming 200 breaststroke, and would like to know if I'm on to something here. I don't need a consultation; I would just like to ask a question to another Forumite who is familiar with both angles; TOS and breaststroke technique. If you will send me a PM, I would most appreciate bouncing this off you!
Thanks!
:agree:
P.S. I just noticed (6/10/12) that I made a typo in the title. It should read, "T.O.S."
For those who don't have TOS, think about trying to swim an event as a blood pressure cuff gets inflated way too much very high on your arm and someone takes a cattle prod to your upper trap and neck. Not fun. I'm not an orthopedic doc, just a 54 yo doc with TOS who tries to swim butterfly and IM. Don't construe this as medical advice (you wouldn't want me with a scalpel in my hand),:cane: just advice from a mutual sufferer trying to enjoy Masters swimming.
It's interesting that you have more trouble with breaststroke than fly. I came back from Greensboro having swum the three fly events, 100 back, and the 100 and 200 IM with my typically worse (for post-meet) TOS pain determined to improve my breaststroke this summer for my IM. For about 2 months, I swam about twice as much breaststroke (and long course, too), only to find it made my TOS so much worse that I had to skip Omaha and am now to the point of surgery.
You're right that *** is the only stroke where the thoracic outlet is compressed continuously because your arms are always overhead. To the extent that you shrug your shoulders and round them forward with a neutral spine as you breathe, you do give your thoracic outlet a break by creating space (by lifting your collarbone off of the first rib). And, unfortunately, the most important part of breaststroke --- the streamline glide --- is the most compressive position for the thoracic outlet. Even fly, which eventually makes my involved arm go numb, gives your thoracic outlet a break as you pull through and recover.
My theory would be that in the 200 ***, with a slower turnover and trying to "ride the glide," you are continuously narrowing the thoracic outlet compared to a shorter, more rapid turnover, *** event, and certainly more than fly. That's why you're having so much trouble. It's not a conditioning issue, it's a nerve/vascular compression issue.
The things you might want to experiment with are the trade-offs between efficiency/speed (all the things like neutral spine/head position, ride the glide, hitting streamline early for the kick) and duration of symptom-free distance. Over a 200, "perfect" breaststroke might actually leave you worse off for the last 50 because it aggravates your TOS more, much like taking it out too fast in a race. For me, the streamline and "press to the Y" outsweep are absolute killers for my TOS. I've been trying to experiment with a narrower outsweep and/or with trying to really round my shoulders forward to move my collarbone as far forward as I can as I shrug during the breath, keeping my spine neutral (and neck relaxed). This trick gives my thoracic outlet a brief break before going into the God awful streamline again.
You may also want to try turning your head slightly away from your more involved side as you go to streamline. It would leave you with a weird looking breaststroke, but it might give you a bit of a break to make you hold up for a 200 better. One of the tests for TOS has the doc measuring to see if your wrist pulse on the TOS side is more faint when you turn your head toward him versus looking away. I've noticed that in fly, as I go into my catch, I unconsciously tilt my head away from my TOS side to relieve the strain on my thoracic outlet. You may also want to concentrate more as you get tired on keeping your chin closer to your chest (neutral spine), because if you're like me, I'm usually lifting my head (hyperextending my neck) to gasp for air by the end of a 200. You can test the relationship of your head position (completely neutral vs chin slightly more tucked; head tilted away versus dead center) and your TOS symptoms in front of a mirror doing a streamline for 3 minutes and clenching/unclenching your fists. You might find a variation that lets you go longer without symptoms.
Anyway, short answer to your question is, yes I think *** is worse than even fly for TOS. You have to look for places in your stroke to "cheat" to give your thoracic outlet a temporary reprieve. Since anatomy varies, finding your own "sweet spots" of arm/neck/head position where you can give your thoracic outlet a break will take some experimentation. You may end up with a less than textbook stroke carrying you further faster than a perfect one.
Good luck! I feel your pain.
