Every new patient’s first appointment at Performance Health Center includes a comprehensive functional examination. During our assessment, we always check for nerve entrapments. The most commonly entrapped nerves are those coming from the neck (the brachial plexus) and those coming from the low back (the sciatic).
When I check the nerves coming from the neck, they are commonly entrapped by the scalene muscle group. The scalenes are muscles in the front of the neck. They are responsible for flexing, rotating and side-bending the neck. They are also responsible for elevating of the first and second ribs when we inhale
Why is this important?
When the scalenes are tight, they can compress and irritate the brachial plexus. The brachial plexus is a bundle of nerves that travels into the arm. If the nerves are pinched, they can cause numbness in the arms and fingers; and can contribute to conditions like golfer’s elbow, tennis elbow, and carpal tunnel.
The scalenes are divided into three parts: the anterior (the front most portion), the middle, and the posterior (the portion furthest back). The brachial plexus travels through the anterior and the middle scalenes. Since the scalenes are an accessory muscle involved in breathing, tension here can affect your ability to fully inhale and get the oxygen you need.
Now that you are familiar with the scalenes, why are these muscles important?
We are headed into winter. So many of our family, friends, and our patients are developing respiratory illnesses like Covid-19, pneumonia, bronchitis, and RSV. All of these have an associated cough. Most of my patients who have been coming in after they have recovered are reporting pain in their chest, upper back, and ribs. Fortunately and unfortunately the rib cage has little movement. It is protecting our vital organs. However, if it is not moving at all, that’s a problem. All joints should move. They like to move. But when we’re coughing or sneezing, the muscles get very tight and restrict the joints that need to move so that we breathe properly. This is where the scalenes come in. They become overused when the appropriate muscles are stressed (these are the intercostal and serratus muscle groups). When they are tight they limit the expansion of the lungs.
Consider using the stretches below for the following reasons: improved joint mobility, activating the muscles used for breathing muscles, reduce spasm / tightness in the muscles of the neck and upper back, and decreased pain (and potentially numbness and tingling). Below are some stretches that you can use to stretch your scalenes.
Starting on the right side:
ANTERIOR SCALENE
* place your right hand behind your back aiming towards your left back pocket of your pants
* tilt your head back and to the left as you aim your nose up and to the right the ceiling
MIDDLE SCALENE
* with your right hand hold onto the seat of your chair or sit on your hand
* sit up straight
* use your left hand over top of your head and place it on the right side of your head
* using your left hand, gently pull head over to your left, bringing your left ear towards your left shoulder
POSTERIOR SCALENE
* place your right hand behind your back aiming towards your left back pocket of your pants
* use your left hand over top of your head and place it on the right side of your head
* using left hand, gently pull head down as if you were bring your nose to your right armpit
Now repeat on the left side!
I hope you try these out! You will not regret it!
If you are having issues with tingling in your fingers, or having chest/back/neck pain, or difficulty taking deep breaths after recovering from a respiratory illness, please schedule an appointment, or email me with questions, or for more information at: [email protected]