If the scalenes are tight and over engaged, what is weak?
 

I think we all know by now that forward head posture contributes to TOS symptoms. Your scalenes start to do more work and get tight. So if we somehow inhibit the scalenes to disengage something needs to pick up the slack.

Right?

So the question is, what neck muscles, posterior muscles I'd gather, need to be strengthened?

I've been watching videos today on exercises that are best for a pinched nerve. All of these videos show one movement over and over:

* The double chin exercise

Now last time I had an episode I did start doing this pretty frequently. The symptoms disappeared and I stopped doing that exercise.

I'm wondering if maybe this kind of strengthening and others could help give the scalenes a break.

KY

My pt is having me strethem my muscles in the back of my neck in preparation for my scalenectomy.

How so?

I would think if you were to lie on the floor face down and lift your head up repeatedly and then with resistance, that would do the trick.

No takers?

I'm guessing the muscles you have to strengthen here are your cervical extensor muscles. Usually if there is a muscle imbalance you have to loosen one muscle, but strengthen the other. In this case, loosen scalenes and tighten the extensors.

I think I'm not the only one who has noticed that loosening the scalenes is no small feat. But maybe if you strengthen the extensors it becomes easier.

One exercise I've read for this is to lie prone on your stomach, keep the head neutral, lift your forehead off the floor by an inch and hold for a few seconds. Repeat.

Going to try it today.

The one you mention above really works for scalenes! For the head to be in neutral, place a towel folded flat under your forehead, pillow under your stomach and lift the forehead about an inch off the towel and hold for 30 seconds and do 3 repetitions at any given time. You can start with fewer second holds and work it upto 30 secs. The hold is important!!!

Interesting -- I am wondering if you guys have a link with more description that you can share ??

Did this work for you?

I've got to think that you have to strengthen those muscles so you can give the scalenes a break. Once they feel like they're not needed as much maybe they'll give a little.

I just did 4 sets at the gym on a bench. Raised my head to neutral position, held for 5 seconds, repeated for 15 repetitions.

I must say I'm a bit flared up right now.

I don't know if strengthening is the best way to go if you are still having pain levels higher than 3 or so..

If you can get the scalenes released & relaxed it will be easier to bring the shoulders back where they should be.

*make sure any possible trigger points are resolved too*

The way I understand it. Can't recall where it saw or read this... but it made sense to me.

tight frontal muscles (scalenes etc) = over stretched upper back muscles

So trying to strengthen an overstretched muscle will only make the front muscles clamp down more..


This is a loose plan similar to what my chiro & the best PTs did for me.. I also spent a lot of time doing self care at home..

These steps all take time, may even take months or longer for best outcome..

1. check & treat any trigger points ( can't stretch or relax a muscle fully if there are trigger points in it.)

2. the tight muscles must be relaxed /resolved before the next step
*may require ultra sound, low level laser, IF stim, massage, deep tissue work... probably need a pro for this part so you can be relaxed and passive for best results.

3. If low pain /symptoms you can slowly add some light activities & light strengthening ( back off if any increase in pain or symptoms)

4. If all goes well slowly add more activities and as always be aware of posture and possible overdoing of activities..

5. Keep hydrated- to keep those tissues moist and to flush out the toxins..

6. If after time you feel normal, wait another month or 2 before fully getting back into normal mode.. often we feel better but will have a set back due to overdoing..


If you have high pain it will take longer to see improvements.

If you have a direct nerve compression vs slight impingements and sticky tissues/muscle, this may not help much.
Or if there is internal scar tissue, I don't enough about it's properties.


Years ago a DC posted this, it only takes a slight bit of pressure or resistance on a nerve to make it complain.

I lie flat on my back with a pillow under my head. Then with my chin slightly tilted down (move you chin up and down doing this at first to find the appropriate tilt) then push your head back slightly into the pillow, maybe half an inch or so, then relax, and repeat. Once or twice per day, fifteen or twenty reps.

It is the neck extendor muscles that you would want to strengthen. Live strong has another exercise for these muscles, I just tried it, it is more difficult, but seems to engage more of these muscles.

I just received the same advice from an "Applied Kineasiologist" in the Boston area and he more or less said the same thing to me among other things.

He noticed that my left shoulder, on the same side I'm seeing TOS symptoms, was much higher and more forward than the right shoulder. He then went on to poke and prod my muscles and told me that my left pec minor was super tight vs. the right. He even put my finger on each so I could see the difference. Same goes with the muscle just beneath the clavicle. These are two key areas of compression. These two muscles are pulling the shoulder bone forward creating less space in the thoracic area.

He then went on to test my back muscles. Compared to the healthy right side, my lats, rhomboids, and infraspinatus were all weak. If healthy, these muscles would pull that shoulder bone down and back into the socket...also creating more space in the thoracic area.

His instructions were to massage the tight areas for 2-3 weeks. NO STRENGTHENING YET. Then, focus on strengthening the lats and rhomboids.

Not sure if anyone else is in my boat, but it's worth a shot if you think you are tight in front, and loose in the back.