Treating Scalenes Trigger Points - Dr. Jonathan Kuttner
Treating scalenes trigger points can bring fast relief for some painful disorders
Trigger points in the scalenes are associated with a number of upper body complaints and can also refer pain along the whole length of the arm down to the thumb and index fingers.
Some therapists are slightly afraid to work on trigger points in the scalenes as they sit close to several nerve trunks and blood vessels in the neck.
In reality, there are a number of safe ways to approach the treatment of these trigger points.
Scalenes - Common Trigger Point Sites
Scalenes - Trigger Points can be treated safely and effectively
Stretching and Muscle Energy Techniques can be very useful
SCALENUS ANTERIOR, MEDIUS, POSTERIOR
Greek skalenos, uneven; Latin anterior, before; medius, middle; posterior, behind
Transverse processes of cervical vertebrae.
Anterior and medius: 1st rib. Posterior: 2nd rib.
Acting together: flex neck. Raise 1st rib during a strong inhalation. Individually: laterally flex and rotate neck.
Ventral rami of cervical nerves, C3–C8.
Referred Pain Patterns
Anterior: persistent aching, pectoralis region to the nipple. Posterior: upper medial border of scapula.
Lateral: front and back of the arm to the thumb and index finger.
Back/shoulder/arm pain, thoracic outlet syndrome, scalene syndrome, edema in the hand, phantom limb pain, asthma, chronic lung disease, whiplash, “restless neck,” irritability, hyperventilation syndrome, panic attacks.
Posture (head forward or upper crossover patterns), anxiety, stress, pillow height, chronic lung problems, heavy lifting/bracing, allergies, playing musical (wind) instruments.
Brachial plexus. Subclavian vessels. Cervical discs (C5–C6). Thoracic outlet syndrome. Angina. Carpal tunnel syndrome. Upper trapezius. SCM. Splenius capitis.
Self help compression techniques can help bring relief, but proceed with caution and seek professional advice before you start!
General Advice to Clients
Lifestyle - Use of pillows, avoid heavy backpacks, consider breast reduction in some cases, warm scarves in winter, avoid pulling and lifting.
Posture - head forward or upper crossover patterns can be treated with a combination of manual therapy and prescribed exercises.
Breathing - Hyperventilation syndrome is strongly associated with scalene syndrome. Breathing techniques from yoga and Butyeko method are worth exploring.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
We are honored to have received the "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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