Scalene trigger points are very important to know about and treat. This is because they can cause pain radiating down your arm, and compress the nerve bundle that supplies your arm and hand.
The scalene is a muscle with three main branches. You can find the primary trigger point on the side of the neck towards the front. It’s a very sensitive place, as the brachial plexus passes between the anterior and middle branches of the scalene, and the first rib. (The brachial plexus is the bundle of nerves that supplies your arm and hand.)
When you treat a trigger point here, you need to very gentle so as to not irritate the nerve.
The scalene attaches to the neck vertebrae and the first two ribs. The scalene is used to lift your ribs, and to bend your neck. Because of this, the scalene acts as an accessory muscle of respiration. This means that when you stress breathe a lot (up in your chest) you can turn on scalene trigger points.
An active scalene trigger point refers pain locally in the neck. It also can cause pain into the chest, and right down the arm into the hand and fingers.
This makes it an incredibly important point to treat. When the scalene is very tight due to trigger points it compresses the nerve bundle (brachial plexus) supplying the arm against the top two ribs.
This can cause tingling, numbness, pins and needles and loss of function in the arm. Compression of the brachial plexus is also known as thoracic outlet syndrome.
The issue here is identifying the root cause. A neck injury (the commonest would be whiplash) can cause similar symptoms when a disc in the neck compresses the nerve supplying the arm.
However, trigger points in the scalene and pectoralis minor muscles can cause very similar symptoms and are much easier to treat.
Scalene trigger points need to be treated very gently. We recommend using ischemic pressure, or myofascial release techniques.
The important part about both these treatments is they allow you to turn the trigger point off while staying below the pain threshold. This means you are not triggering the protective reflex that turned them on in the first place.
The stretch for the scalene muscle is to drop your head to the side, and lean it ever so slightly backwards. This is to fully stretch the muscle against where it attaches to the front ribs.
Many people with tight scalenes feel the stretch come on immediately. It’s important to not hurry or force this stretch. Just breathe evenly and allow the stretch to gradually happen.
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