When the scalenes are healthy and working in a balanced way, they help support the upright posture of your cervical spine, which is the upper part of your spine. Sometimes the scalenes can give you problems because they’re prone to a lot of tension.
The Three Scalene Muscles
Before we dive into these conditions and what you can do to loosen your scalenes, let’s take a closer look at the three muscle groups that make up your scalenes.
Anterior Scalenes
Of the three muscles that make up the scalenes, the anterior is located closest to the front. Like all scalene muscles, it is considered a side neck muscle. It has more than one function.
It’s helpful to remember that you have these muscles on both sides of your neck. When acting only on one side of your neck, the anterior scalene can bend and rotate your neck. When both of your anterior scalenes work together, they flex (bend) your neck.
The anterior scalene also lifts the first rib, but that’s a pretty subtle action that you might not be aware of while it’s happening. It is considered an accessory breathing muscle because it lifts the first rib during an inhale.
Medial Scalenes
The medial scalene (scalenus medius) resides between the anterior and posterior branches of the scalene muscle. As with the other muscle branches of this group, your left or right medial scalene can contract (move) alone, or your medial scalenes can contract together.
When only one side contracts, it elevates (lifts) the first rib to flex and laterally bend (move to the side) the neck. Like the anterior scalene, the medial scalene muscle is considered an accessory breathing muscle because it lifts the first rib during inhalation.
When both medial scalenes contract, they flex the neck. These actions are similar to those of the anterior scalene because the attachment sites (origins and insertions) are located near one another.
Posterior Scalenes
The posterior (back) scalene occupies the farthest back position of all the scalene muscle branches. It does not contribute to the scalene triangle; only the anterior and medial branches do that.
When only one posterior scalene is contracting, it flexes and rotates the neck joints. When both posterior scalenes contract, they cause the neck to flex and raise the second rib, an action that may be difficult to detect when it’s happening.
The posterior scalene muscle is considered an accessory breathing muscle because it lifts the second rib during inhalation.
The Scalene Triangle
The anterior and medial scalene, together with part of the first rib, form an anatomical area known as the scalene triangle. Another name for this formation is the scalene fissure or scalene haitus.
The scalene triangle is important because the brachial plexus nerve complex branches pass through it. Scalene tension may compress these branches, and that may be a sign of thoracic outlet syndrome (TOS).
What Makes the Scalene Muscles Tight
The scalenes are implicated in a number of neck problems. Below are a few of the more common ones.
Torticollis
Torticollis, also known as wry neck, is a condition in which your neck muscles stay contracted in chronically shortened positions. All of the scalene muscles are involved in torticollis.
Sometimes torticollis occurs due to genetic factors that affect the nervous system. It can also develop due to trauma or drugs.
Forward Head Posture and Dowager’s Hump
Forward head posture or dowager’s hump occurs when the anterior scalenes are hard, tight, and short, pulling the lower cervical vertebra forward into a rigidly flexed position. If you have this condition, you may need to bring your head up so you can see what’s in front of you.
When they are rigidly tight in the forward head position, the scalenes can’t counterbalance tension in the back of the neck. Maintaining this position chronically can perpetuate this posture problem.
Although usually considered cervical flexors (they bend the neck forward), once the neck is extended in this way the scalenes can become cervical extensors (they are used to bend the neck backward).
Whiplash
Scalenes can be affected by a whiplash injury, especially when the trauma is on the side of the neck. Deep tissue work on scalenes can aggravate symptoms if done too soon after the inciting incident.
Respiratory Problems
The scalene muscles are accessory breathing muscles that help you inhale. They all contract when you breathe in, opening space for the lungs to expand in the thorax by lifting the top ribs. When you have respiratory issues (for example, asthma) your scalenes may have to work extra hard.
Tips for Happy Scalene Muscles
Stretching your scalenes is important:
When you tilt your head to one side you will stretch your middle scalene on the other side. As you stretch your middle scalene, looking up over the shoulder towards the opposite direction can stretch your anterior scalene. As you stretch your middle scalene, looking down with your head turned towards the same side can help you stretch your posterior scalene.
Depending on the cause of your scalene muscle tension, getting regular massages might also help keep these muscles flexible.
