The Neck - Lateral sides

The Neck 

I wanted to write about the muscles of the neck this month and the common complaints that I see in the clinic. I will break down the neck into four parts 

1.   The upper rear neck, base of skull to C2 

2.   The lower rear neck C3-C7 

3.   The front 

4.   The sides 

The Side (lateral) Neck 

The main problems that you will notice are; 

Thoracic outlet syndrome (pain, numbness, tingling in the arm, hand and fingers) pain radiating to chest, pain to the shoulder blade upper back and neck (deep and aching), tension headaches, shallow breathing, chronic coughing, rounded shoulders and forward head posture.

The muscles are;

• Anterior scalene

• Middle scalene

• Posterior scalene

Anterior scalene muscle is the most anterior of the scalene muscles. It arises from the anterior tubercles of the transverse processes of vertebrae C3-C6, and inserts onto the scalene tubercle and the superior border of the first rib. Its purpose is to elevate the first rib during forced inspiration, acts as an accessory muscle of respiration, and contributes to cervical spine movement, including side bending, contralateral rotation, and forward flexion

Middle scalene is the largest of the scalene muscles, that arises from the transverse processes of axis (C2) and atlas (C1), and the posterior tubercles of transverse processes of the vertebrae C3-C7. The muscle then passes posterolaterally to insert onto the superior border of the first rib. It elevates the first rib during forced inspiration. It also stabilizes and provides side-bending to the neck.

Posterior scalene is the smallest and most posterior of the scalene muscles that arises from the posterior tubercles of transverse processes of cervical vertebrae C4-C6. It then extends posterolaterally and inserts into the external surface of the second rib. Similar to the middle scalene, the main function is to help bend the neck sideways and help stabilise and elevate the second rib.

What causes scalene dysfunction?

Poor posture, modern day issue with computer work and phone/screen watching. This creates forward head posture. Sleeping on stomach with head turned.

Overuse of these muscles from coughing due to lung conditions and prolonged anxiety (shallow breathing)

Improper fittings of backpacks, shoulder bags or lifting heavy objects.

Whiplash or sports trauma

Scalenes

How can we help?

Massage to help release the scalene muscles and lower the top ribs. Acupuncture to help reduce your stress. Chiropractic adjustments. Myofascial release to help ease breathing and tension.

What Can you do?

Practice deep, slow abdominal breathing this will help the overworked scalene muscles.

Set up your work station to correct forward head posture. Limit screen time on phone. 

Scalene stretch, sit upright in a chair, hold the bottom of the seat to anchor the shoulder. Gently tilt your head to the opposite side and slightly turn your chin up or away to feel a stretch in the side of your neck, holding for 30–60 seconds.