dr. flanagan, i had put this on tims thinking this cold benefit some. but, i'd really like your input.
i know the scalene muscles play a big part in tos. but looking at this animation and then reading the massage protocol maybe some will get better flow and relief.www.youtube.com/watch?v=MygDJtu8EtA
After years of massage and also my own experience of stress in my body, two important muscles to massage in the neck are the SCM (which is the sternocleidomastoid) and the scalenes.
First, the SCM (sternocleidomastoid) gets its name from: sterno which refers to sternum, or breastbone, cleido refers to clavicle, or collarbone, and mastoid comes from attaching to the mastoid process which is the bony knob behind the ear. This muscle gets used when leaning one’s neck forward looking at the computer or with any activity where one leans the head forward, i.e. looking at your blackberry. Also, anyone who slouches are habitually leans forward will experience pain here. These are the muscles that can pull so tight they can cause a hump behind the neck (when they are not released). (This happens over an extended amount of time.) The stress put on this muscle can cause trigger points which can cause various problems ranging from sinus tension, sinus congestion, headaches, ear aches or flutter in the ear, jaw tension (which is sometimes misdiagnosed as TMJ) and even dizziness. They can refer pain to the back of the neck and top of the shoulders, too. The list goes on, yet you get the idea of how powerful of an effect this muscle can have when it is taxed.
When I massage this muscle it is not pleasant, by no means. In fact, at times some clients will literally reach up and put their hand on my hand (the one doing the massage), as a sort of reflex. I usually start the session off by saying, “This is an intense muscle to work and during the time I am working it you may feel sensations in your head that will stop when I stop working on it, yet the results will be great relief.” I joke by saying that the nickname I have for this muscle is the- B**** muscle or the cussing muscle, because it hurts while I am working it. Although, I have to say I do have some clients who enjoy the feeling. It is a sort of, “Hurts good,” as they say. Some people have such tight SCM muscles that I can barely put my fingers around it. There are those whom I can not even massage their SCM, it is too tight and thick. When this is the case, I do point work by releasing the scalenes and tilting the head to the side along with breath work.
A way to grab your own SCM muscle is to look straight ahead. Tilt your head to the right as if in the 3 o’clock position. Then while keeping it at that position, bring your chin towards your left shoulder (the opposite shoulder) only a few inches. Now, take your pointer finger and thumb on your right hand and pinch the thick muscle. You can move your fingers up or down from where you started to see where you feel the most sore area. That will be your key that you have found the area that needs tension released. If you do this a few minutes a couple times a day, you can relieve a lot of tension from your neck. You can do the same on the left side, yet reverse the directions as explained with the right.
One thing to be aware of when you work the SCM is to steer clear of the carotid arteries. If you feel a pulse, stay away from that area. Do not massage where you feel the pulsing of the artery. These are located high up under the chin near your windpipe. STAY AWAY from that area when massaging the SCM. (The SCM connects at the back of the jaw bone below the ear.)
The second group of muscles that are key to releasing much tension in the neck are the scalenes. Scalenes are the size of spaghetti noodles and they attach behind the SCM. There are some that even attach to the first and second ribs. There are three to four scalenes depending on the person. Some people do not have the scalenus minimus. (It is a normal human variation.) They contract when lifting your shoulder to keep your purse, bag or backpack in place. Or if you are nervous and hike your shoulders up from shallow chest breathing (versus breathing from the diaphragm), this can also cause tension in these intricate muscles. Asthma, allergies, and a bad cough can cause bad trigger points, as well. Even though these muscles are small, the pain can be extremely painful when they have trigger points. The pain from these can trigger pain in the upper arm, forearm, hand, pectoral area, back of arm and between the shoulder blade and spine (the rhomboid area). Many times pain from the scalenes can be misdiagnosed as bursitis or tendonitis in the shoulder. Another interesting fact is that tight scalenes can cause swelling in the hands and fingers. The reason being is that tight scalenes can compress the axillary vein, since it runs behind the scalenes.
Both the SCM and scalenes are affected when one experiences whiplash or any other violent movement of the head during a fall or an auto accident.
A way to work your scalenes is to look straight ahead and tilt your head to your right shoulder. Take your thumb and press in behind the SCM(on the right side). Turn your nose towards your shoulder. I find it easiest to place your thumb and walk it up and down behind the SCM. While that action is taking place you can move your head back and forth by moving nose towards shoulder, then ear towards shoulder. Alternating back and forth. Another move that helps is while your head is turned and tilted, press your thumb against the scalenes and wiggle your thumb back and forth while it keeps contact behind the ridge of the SCM. You can also place your thumb on the scalenes and tilt the head into the thumb between your muscle and shoulder while the head is pressing down towards the shoulder you are pressing up against the scalenes.
This may be tricky to understand by reading this article, therefore I want to recommend the book that taught me my tricks. The name of the book is, “The Trigger Point Therapy Workbook, “ By Clair Davies. It is an amazing book that is easy to follow and very friendly to people who do not know much about bodywork. For instance, if you have neck pain, you can look up neck pain and then it will describe every muscle that can cause neck pain and show where the areas of pain referral are for each muscle. I feel it is an important book that everyone should own, because it empowers one to figure out which muscle is causing pain in the various regions of the body. The book addresses all muscles in the body that can cause trigger points.
When I massage these muscles on my clients, I have tailored the techniques and made up my way of releasing them. These muscles can be so painful to work, that sometimes it is nice to have someone work them for you. Another key is to focus on your exhale while applying pressure. While I do this work, I coach the person by telling them when to inhale and exhale which helps tremendously. This seems to calm the person, as well. In the meantime, get to know your SCM and scalenes until I see you. Or find a therapist near you who knows how to work these important muscles. Happy trails and many wishes for happy neck muscles…