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 1^st & 2^nd 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!