Thoracic Outlet Syndrome (TOSS)

I play piano but also work in administration requiring long periods of time seated at a computer workstation. I am writing this post as a pianist to inform people about a condition I was diagnosed with last year after combined problems related to work and playing the piano. The condition is called Thoracic Outlet Syndrome (TOSS). I had symptoms including pain in the shoulder blade and pins and needles in the hand which thankfully have subsided, but only after intensive exercise program seeing a qualified phisiotherapist. I write this to instill the importance of seeing a professional should you be experiencing any muscular related pain esp related to using the computer AND piano. Google TOSS for more info. In spite of this at 40years of age, I am able to play again pain free although not tension free. Since last year I've refocused awarness on my technique which has improved significantly although I've noticed recently that the tricep muscle on my right arm is becoming sore after a practice session. I've tried to diagnose the problem given other aspects of the 'mechanism' are working fine. I'd appreciate any thoughts about what could be causing the problem which clearly isn't happening in my left arm. Body action for both sides feels the same but clearly something is going on. Cheers Andrew Melb Australia

Hello Andrew, Thanks for your post, it's informative and important. I had one student whose tendonitis came back even though we worked repeatedly to get her technique into good shape. At one point I gave her a Feldenkrais Functional Integration lesson (one of several actually) in which I literally could not move any part of her body, even incredibly gently, without evoking pain. It seemed her neuromotor system had amplified the localized pain and generalized it to her whole system. It had become a generalized neuropathic pain. There was nothing I could do in the lesson. She had to rest for a long time and still we have no real recovery. She is an exceptionally sensitive person in the physical sense - some of her tendons in the forearm nearly separated completely, not from playing piano but from some completely unrelated activity, I think she picked up a heavy garbage bag or something. Just to illustrate that there are situations where MEDICAL HELP is called for - even the best pianistic approach won't cure every last person. Now about your triceps muscle. When the hand works well, the triceps does increase its work as well, giving crucial supportive contractions. It might be the case that, because your right hand has had more technical challenges than the left, only your right tricep is feeling overworked, or at least worked more than usual. It could ALSO be that this pain is related to some neuropathic tingling-spreading physiological symptom, and therefore it is a medical problem. Sorry I can't really say for sure one way or the other from this distance. All the best, AFF