scalenesThis muscle is broken down into three parts (anterior, middle and posterior) with one end attached to the bones in the back of the neck and the other one either on the first or second (and sometimes third) rib.  Its main function is to tilt the head to the side (ear to shoulder) and helps in moving the head back and forth.  We also tend to use this muscle to hold up the ribcage and as an inappropriate accessory muscle in shallow breathing.

The axillary artery and brachial plexus (nerve bundle) pass between the anterior and middle scalenes and can become entrapped at some point by tightness in these muscles.   The scalenes are prone to refer pain

  • over the shoulder and down the inside of the shoulder blade,
  • over the upper chest,
  • down the front of the upper arm
  • Down the outside of the forearm and into the thumb and fingers, especially the index finger

Because it has such a broad referral pattern, similar to many heart complaints, your Massage Therapist may request clearance from your doctor before proceeding with the massage.

Tension is rarely restricted to just this muscle group so treatment will usually include muscles in the back of the head, neck, upper back and perhaps the upper chest.  Remedial massage treatment will include stripping and compression to the muscles while you are either lying down or seated and gentle stretching to ease away tension and soreness while increasing your ability to move your head and drop your shoulders.  As always, keep your massuse informed as to the amount of pressure that is comfortable for you or if you are feeling nauseous or dizzy at any time.
Basic Clinical Massage Therapy, 2003.

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