The scalenes are a grouping of a pair of three muscles that run laterally on the neck. They originate from C-2 to C-7 on the transverse processes and attach on the first and second ribs.
So far, the majority of my clients come in with complaints that stem from these particular muscles. Sharon Sauer, CMPT, and LMT of the MYO Pain Clinic, even went so far, in a c.e. class I had with her, to aptly call them the "entrappers". Nerve entrapment is not uncommon due to the immediate proximity of the brachial plexus. Also, trigger points in the scalenes can mimic Thoracic Outlet Syndrome (Carpal Tunnel being an associated syndrome), and may be confused with cervical radiculopathy. TrP's here also cause headaches, some of them migraine caliber.The list goes on and on. In short, this is often a troublesome area.
Clients that suffer with shortened scalenes are definitely affected in their posture because it pulls the side of the head lower, at a tilt, and it also pulls on the ribs. In a client with a head-forward position, it is usually the anterior scalene that has such a taut pull on the cervical vertebra that contributes to this posture. Keep in mind that the scalenes are involved in inspiration, right alongside the sternocleidomastoid so when these muscles are suffering, it affects the body in a number of unpleasant ways.
When I work these muscles I personally get very cautious because the brachial nerve is right there among the scalenes and they are admittedly delicate. I also find that I have the most success by working origins and attachments so that does take some of the strain off the caution area. I do apply a broad effleurage to the area and use the broad pads of my fingers when isolating individual scalenes and this helps minimize touching directly on that nerve. Slow and steady has gotten me the best results thus far. Trigger points are far more willing to undo themselves when they aren't under a direct attack and working the area slowly allows for a minimum of discomfort.
This video is really wonderful for the intense focus on the scalenes and clearly demonstrates how to work the area.
And this is a handy, dandy trigger point illustration from AskTheTrainer.com...
Further Reading and Resources:
Great article and breakdown of the scalenes
Point-by-point
Love this article and how thorough it is!
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