What are Scalenes?
Scalene muscles are a group of three muscles that originates from the cervical spine and attaches to 1st two ribs. They are located on the lateral side of the neck bilaterally. They have a significant role in the side bending and the anterior bending of the neck. Scalene muscles also act as accessory muscles of respiration. They increase the intrathoracic volume by elevating the 1st two ribs. Scalene muscles also help in the stabilization of the neck.
How Do Scalenes Get affected?
When the deep flexors of the neck are not working, scalenes compensate for them. But being non-postural muscles, they tire easily, tighten, and develop stress and trigger points. The brachial plexus and subclavian artery pass between the anterior and middle scalene muscles. Any condition that tightens scalenes muscles may compromise the arterial and neural structures passing through. Forward head posture, labored breathing, and carrying heavy backpacks stress the scalene muscles and activate the trigger points in these muscles. When the scalene muscles are affected, pain is not only in the neck but also in the shoulder, arm, chest, and upper back. The clinical presentation of scalenes involvement often resembles that of cervical radiculopathy. That’s why scalene muscles involvement is often underdiagnosed. Screening of the scalenes muscles is crucial in neck pain.
- Diaphragmatic Breathing- Learning the correct breathing technique is crucial for shallow breathers. It helps to reduce the stress on the scalenes. Lie down on your back with your knees bent. Keep your shoulders relaxed. Place hands on your abdomen, one on top of the other, just below your rib cage. Breathe in slowly and deeply through your nose and feel your belly rise into your hands. Then slowly breathe out through pursed lips and feel your belly falling back to the starting position. Repeat ten times.
- Stretching of Scalenes- For stretching the right side scalenes, tilt your head on the left to touch your shoulder with the ear. Hold for ten seconds. Then rotate your neck to look up over the right shoulder. Hold for ten seconds. Lastly, from the last posture, look up slightly and hold for ten seconds again. This sequence of movement will stretch all the fibers of the scalenes.
- Neck isometrics to strengthen the scalenes-Sit straight and place one hand on the right side of your head just above the ear. Push your hand with your head, and your hand should be pressing back against your head. There should be no resultant movement. Hold for five seconds. Repeat by placing your hand on the forehead first and then on the left side of your head. Do five reps in each direction.
- Chest opening stretch– Clasp your hands behind your back. Now, pull your elbows out to the side and slightly bend your head backward. Hold for 10 seconds, and you will feel a nice stretch in your neck, arms, and upper back. Repeat five times.
- Shoulder blade squeeze-Stand with arms by your side and pull your shoulders back by squeezing your shoulder blades together. Hold this stretch for five seconds and repeat five times.
Trigger point therapy is also helpful to release tightness in the scalene muscle.
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