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Thoracic Outlet Syndrome - just diagnosed


Senior Member
I like to drive with my hands at 10 o'clock and 2 o'clock.

Do you know the old "10 and 2" hand position for driving is no longer recommended? It seems that it more likely to lead to injury if the airbags are deployed in a crash. I found the following on a "State Farm" (insurance) website:

"Two schools of thought are prevalent when talking about positioning of hands on the steering wheel. The old school wisdom was to position hands at 10 and 2 o’clock. As air bags became common, this led to the wrist and arm factures when air bags deployed and arms were flung into rearview mirrors or A-pillars. To avoid that occurrence, many safety advocates now recommend positioning hands at 9 and 3 o’clock on the steering wheel.

Hand-over-hand maneuvers during turning should be avoided to prevent arms from being in front of a deploying airbag in the event of a crash. Serious injuries may result during such occurrences."

So you're probably better off with your "5 & 7" hand position, anyway! I think that's what I usually do. I often drive 120 miles at a time.


Senior Member
New Zealand
Do you know the old "10 and 2" hand position for driving is no longer recommended?
Ha. ok, 9 and 3 it is then.

My daughter informed me that it is now frowned upon to hook your thumbs around the steering wheel as emergency departments are having to deal with too many thumb injuries when air bags activate. I see that Mythbusters dispute this.
Airbag Detonation Can Blow Your Thumbs Off
Finding: BUSTED

I'm looking forward to self-driving cars.

But I digress....
How are you feeling scott has your PEM gone . Our physician also suspects TOS reason of PEM and fatigue . Could let me know Canadian physicians contact details, I also need to rule out TOS as possible cause.


Stop the harm. Start the research and treatment.
Toronto, Canada
Personally, I suspect my TOS is a result of collagen degradation that may accompany ME - fwiw, I don't have the neuropathic (painful) version of TOS.

Yes, I still get PEM if I exert too much, especially my arms.

My GP is at St Michael's hospital in Toronto, so I saw somebody at St Mike's, sorry I don't recall his name, but it was something middle Eastern (like Al Kabar) -- I do remember asking him if TOS had anything to do with ME, and of course I got a blank stare, he didn't know what ME was and showed no interest.

I have a very low all around opinion of St Mike's so they are not a recommendation.


Senior Member
I hear the symptoms, the diagnosis(es) and I can't help but think of my own situation. In the 1970's after everything known was ruled out, I was told I had Carpal Tunnel Syndrome. True, I had pain into my arm, wrist and two fingers (still don't wear my wedding bands), and some of the other symptoms.

But not all....by a long shot. What explained the severe neck pain, the shoulder pain the fact that each Monday a.m. saw me sitting outside some Dr.'s office waiting for him so I could then go on to work?

I was finally sent to a neurologist who had worked in one of the poorest Latin American Countries (before graduating from Med School in the U.S.). He saw the very difficult to get (then) MRI and immediately saw that I had a "syndrome" called Syringomyelia. Very rare and doctors in the U.S. hadn't seen it, unless in an autopsy. One thing led to another....I implore you to see a neurologisit before you do anything else. Ask him to specifically look for Syringomyelia (SM) and Arnold-Chiari Malformation....the two often go hand in hand. There are so many neurological illnesses that can account for the exact same symptoms. Don't be led astray and have your Dr.'s actively look for other problems that can now be surgically repaired. I would have had unnecessary surgery that my body really couldn't have handled at the time. I wish you well....Yours, Lenora
In case it's useful for anyone, I'm part of a Facebook group in which the members aim to share experiences and educate each other on venous outflow issues.

Mostly looking at veins in and near the head, but TOS does come up, and some of the doctors well known to the group will know about it.


@ScottTriGuy sorry to hear about the lack of interest. If you're interested in finding a specialist or more info on TOS the group might be able to help


Senior Member
. I think that my now very poor posture and Ehler-Danlos symptoms are the cause.
I am now diagnosed with TOS as well (artery occlusion) and the specialist told me it is from a muscular conflict (one muscle too strong and the other too weak).
He ordered physiotherapy to change my posture.
I agree with this postural hypothesis. It is the same postural theory for loss of neck lordosis with poor extensor tone and excess flexor tone in the spineI found the extensor tone is under norepinephrine control so we can improve our posture with effort but if our norepinephrine tone doesn't raise, our chance to keep the gain is poor...
I asked the specialist if I could have microvascular dysfunction as well, and he answered the macrovascular and microvascular issues are often associated. He didn't explain why, but I think the norepinephrine muscle tone hypothesis may apply for mircrovascular dysfunction as well...