Weightlifting and Trigger Points: Scalenes

Photo credit: www.pendlayforum.com

Article written by Chris Branam

I know in my last article I said I was wrapping up the trigger points of the neck, so you might be wondering why there’s a picture of a neck smack dab in the middle of this article.

Photo credit: Myofascial Pain and Dysfunction, Travell and Simons

Photo credit: Myofascial Pain and Dysfunction, Travell and Simons

Well, that’s because the scalenes (a.k.a. scaleni) are a tricky, tricky set of muscles. They typically will not make your head or neck hurt like the other trigger points previously discussed. Trigger points in the three scalene muscles will refer pain to the chest, upper back, shoulder, arm, and even as far as the hand. Additionally, they will cause trigger points in these areas, meaning you might be treating the satellite trigger point in your shoulder, but not the root trigger point in the neck causing the problem. Most weightlifters have probably had pain in one or all of these areas at some point. The pain diagram below will help to show more specifically the areas affected by trigger points in the scalene muscles.

Photo credit: Myofascial Pain and Dysfunction, Travell and Simons

Photo credit: Myofascial Pain and Dysfunction, Travell and Simons

This diagram also shows the location of the three muscles that make up the three scalene muscles—the anterior, the middle, and the posterior. These three bands of muscle form a scalene triangle or as some have called it the “anatomical Bermuda Triangle.” Part of the reason behind the foreboding moniker is the extreme range of pain these relatively small muscles can cause.

When you understand the role of these muscles, it makes sense. Essentially, the scalenes are the cables of a suspension bridge holding up the first and second rib. They are responsible for stabilizing the neck and elevating the first and second rib during respiration. When you constantly breathe with tension (i.e. chest breathing), hold heavy weights (isn’t that the whole point of all of this?), or sit with poor posture, you are putting additional stress on those cables holding up the bridge. If you tend to sleep with your shoulders up to your ears, trigger points can become active in these three areas. Also, placing stress on these muscles is the strain of pressing weight overhead and holding weight on the chest in preparation for the jerk. Clair Davies calls these muscles “among the muscles most abused in sports activities.”

When trigger points become active in the scalenes, they keep the first rib pulled against the collarbone. Give this drill a try and you will probably be amazed at how tight your scalenes are and how they’re keeping your shoulders from moving as well as they could.

Outside of the hindrance a compressed first rib causes in overhead movements, this tightness can lead to neurovascular entrapment. You have nerve compression, which occurs when nerves are squeezed between bones, such as the clavicle and the first rib, and then you have entrapment, which happens when muscles are so tight they compress blood vessels (such as the subclavian artery) and nerves. This can lead to thoracic outlet syndrome. One of the symptoms of which is pain similar to carpal tunnel syndrome, which can make you unexpectedly drop things. Most weightlifters and strongmen I know don’t like unexpectedly dropping things.

Weightlifter Samantha Lower understands the dangers of tight scalenes all too well.

I broke my First Rib during competition, in Shenzhen, China at the World University Games, on my second attempt Clean and Jerk (94kg). No trauma happened, a bar didn't fall on me, in fact I made the lift! And with all the adrenaline I even went out for a third attempt (97kg), cleaned it, then felt and heard a second pop on the dip of the jerk, and was unfortunately done after that. It broke (Doctors think) because of a very tight scalene that connects to the First Rib, pulled and broke it. And on X Rays and CT scans, it showed healed marks that I had previously fractured it before...

I broke my First Rib during competition, in Shenzhen, China at the World University Games, on my second attempt Clean and Jerk (94kg). No trauma happened, a bar didn’t fall on me, in fact I made the lift! And with all the adrenaline I even went out for a third attempt (97kg), cleaned it, then felt and heard a second pop on the dip of the jerk, and was unfortunately done after that. It broke (Doctors think) because of a very tight scalene that connects to the First Rib, pulled and broke it. And on X Rays and CT scans, it showed healed marks that I had previously fractured it before…

So enough doom and gloom about these pesky scalenes. How do we treat them? We’ll start with the anterior scalene, which as the name suggests, is located at the front of the neck. It is largely overlapped by the sternocleidomastoid, so we have to move this muscle out of the way to get to the scalene. Grab your sternocleidomastoid between your thumb and first two fingers as if you were going to massage it. Instead, pull it toward your windpipe. It should be apparent that your neck needs to be relaxed to accomplish this. Once you’ve moved it out of the way, let go of the thumb’s grip and using your first two fingers push toward the back of your neck. You will be sandwiching the scalene between your fingers and the bones of your cervical spine. If you find a trigger point, it will likely feel like a shock as if you were pressing on a nerve. The trigger points in this area are particularly sensitive. Remember shoot for a pain level of a 6 or 7 out of 10. No need to kill yourself. When you locate a trigger point, slide your fingers toward the side of your neck for 6 strokes per trigger point. Work your way down the whole length of the sternocleidomastoid, from the attachment under the ear to the collarbone.

Anterior scalene massage

Anterior scalene massage

The middle scalene is much easier to work on. Just reach across to the side of your neck. Press into your neck. From the jaw line to the base of the neck, search for trigger points, stopping when you find one to perform 6 massaging strokes. Move in one direction, across the trigger point.

Middle scalene massage

Middle scalene massage

The posterior scalene is located in the divot between the collarbone and trapezius. Using two fingers, push down and back at the lateral end of your collarbone just before where it attaches to the acromion. This should be a soft area you can press down into. If you feel like you’re pressing into the end of the trapezius, you are too far laterally. Once you’ve pushed down and back into this area, stroke across the muscle toward the neck. Again, 6 strokes is plenty for this muscle.

Posterior scalene massage

Posterior scalene massage

Massage on these three areas could be the answer to soothing your inexplicable pain ranging from your upper back all the way to your hands.

 

Sources:

http://abbottcenter.com/bostonpaintherapy/?p=2638

https://www.painscience.com/articles/spot-04-scalenes.php

Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 2nd ed. Oakland: New Harbinger Publications, 2004. Print.

Travell, Janet  G., and David G. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore: Williams & Wilkins, 1999. Print.