Those Sneaky Scalenes

By Sharon Truelove

Is there a knot between your shoulder blade & spine that just won’t go away no matter how much you work on it? How about carpal tunnel symptoms that don’t seem to go away with common treatment. It may be those sneaky scalenes. The knots can’t go away until the scalene muscles are released. The knot is a symptom, the scalenes the cause.

Some things that can cause scalene problems are: whiplash injuries, excessive coughing, Gasping for air (people who suffer with asthma, emphysema, or have bronchitis or pneumonia are especially susceptible to problematic scalene muscles), pulling or lifting with arms level with the waist, working for long-periods with head turned to one side (“word-processor headache”), sleeping on your stomach with your head turned  to one side, carrying a heavy backpack or purse, wearing a tight collar or tie…..

Nerves make a path from your neck through the upper body, then run down the arms to the fingers. Compression of those nerves can cause unpleasant sensations in the areas that they enervate. Many times knotted up scalenes are misdiagnosed as carpal tunnel or Thoracic Outlet Syndrome.

The scalenes are made up of the anterior, medial and posterior portions on either side of the neck. Orignating on transverse processes of C2  through C7 (lateral neck bones)they then insert on the top side of the first and second ribs.

There actions are elevation of the 1st & 2nd ribs & lateral flexion of the neck. They also, help sternocleidomastoid when inhaling. Because of all the various structures packed so tightly in this area it’s nickname, Neurovascular Entrapper (also shared with pectoralis minor) is well deserved. Blood vessels and nerves (subclavian artery and brachial plexus) going to the arm travel between these muscles and can be a setup for trigger points which can produce a wide variety of symptoms.

Some of the symptoms include pain, numbness, tingling, swelling, and weakness  of the arms and hands. Referral points can be felt at the medial border of the scapula, upper anterior arm, upper anterior chest, and down the the forearm to the thumb and index finger. Sometimes because of the similar symptoms, they can be misdiagnosed as carpal tunnel syndrome. They can also produce pain similar to angina in the chest. They may even produce upper back pain.

If this sounds familiar, what can be done to alleviate the symptoms if it is trigger points? Try this stretch:

Hold your hand behind your back while standing

Lower the left shoulder
Tilt your head to the right

Slowly, and gently, roll head back until a stretch is felt

Hold for 15 seconds
Besure to repeat on the other side

If there are already existing neck issues, be sure to go slow and do BOTH sides.

Try these techniques and tell me what you think!

20 thoughts on “Those Sneaky Scalenes”

  1. Be sure to read to the end of this where it mentions REPEAT OTHER SIDE. I worked on owner of day spa yesterday, on the PROBLEM side. I knew better but forgot,,, about 10 minutes later she was hold opposite side in pain. I got her in the chair to finish left side. BOTH sides in any treatment, has always kept the balance.

  2. I found the information extremely helpful and very informative. I will try the technique the next time I experience that type of problem.

  3. This is a good exercise to do when you are tight and you need to stretch. I will remember this one! Thanks!

    1. My neck actually feels longer! When I stretched the muscles, I felt the scalenes loosen in my neck.This is an exercise I will do when I’m done using the computer- staring at the computer,and using bad posture is a weakness.

  4. Good one Sharon! I was just thinking about this today. My neck was bothering me so I did some of the other neck stretches you taught us. It helped. Thanks again.

  5. Crazy to think only a couple of muscles could do so much damage. I work alot overhead and my neck becomes very tense since i have to look up for eight hours a day. The release of the scalenes is crucial to have a normal less painful day for me and this routine works. Thanks Sharon

  6. This is always a great stretch to remember. I always have lots of tension in this area so when I did the stretches it really helped. Thanks.

  7. The neck exercises are always one of my favorites. This one was very helpful, I did feel release after doing this a few times, was very tight. This one might take a little more time to be able to get the clients to be able to remember, just a little more to figure out how to make it stick with them. And no changes in my mind, as I am just learning all the tricks of this trade I am very grateful to be able to get all the extra knowledge and training.

  8. This is a good stretch, just because. However, I was working on my son on Friday, he had large knots on both sides between scapula and spine. I worked for as long as I knew (20 minutes) but could not get it to release. I will have him do the exercises and work on scalenes as well next time!

  9. I am having trouble especially on left side of my body.I tried the stretches on both sides. On the right its felt really good and losen me up. On my left side it was very stiff and sent a warm tingling sensation down from my ear to my hip. As I did it to both sides several times it did losen it up some.

  10. When I tried this exercise last night before I went to bed, I felt my neck loosen up some, I carry a lot of tension in my neck and shoulders. As I got out of bed this morning, my neck and my mid nback area did’t feel tight like it normally does in the morning. I will probobly conyinue to do this at night before I go to bed.

  11. I love this exercise. My physical therapist showed me how to do this years ago and every time I feel the pull in my neck I do this exercise. It releases my leveator scapula also. I especially love this if I have fallen asleep on the sofa.

  12. This is wonderful advice. I found this stretch to be very helpful. I did not realize how tense I was. I will be sure to keep this stretch in mind in the future. Thanks

  13. This is a really good blog… I have had people come to me and ask to work on it but I sometimes can’t get it to release. I hadn’t thou7ght about the scalenes. Thanks forr the suggestion and stretches!

  14. I have spent two years and lots of $$ trying to figure out what was going on with my neck/upper back/chest on my right side and when I saw this page i said “THAT’S ME!!!”. Thank you for getting me on the right track!

  15. Stretching can almost never release trigger points alone. You need manual pressure which is often very painful to unlock a trigger point and loosen surrounding facia.

  16. As a massage therapist, I love it when people come in with carpal tunnel symptoms. Most of the time (maybe 60-70{dd4fd4792e0eb33cfcd896730531ad5ee27f408bd2ce28da7f8125f8188131a8}) I can give them instant relief without even going near the wrist. It continues to amaze me how often these people go for months/years with symptoms and expensive, unsuccessful treatments, when relief can be as easy (and cheap) as massage on the anterior scalenes.