Last week, I was lifting a 45 plate (that normally is not heavy for me) and trying to get it on the bar. All of a sudden I had a sudden pain in my shoulder. Being a very curious person, I tried it again– there it was again! So of course I started massaging my rotator cuff muscles. I started with the Supraspinatus, which does abduction of the arm. While it was sore, it just was not triggered the shoulder pain I had experienced. I tried other movements too, in an attempt to trigger the pain, but nothing. As I awkwardly hit my Subscapularis (hidden muscle under the armpit area), I was sure it had to be this pesky muscle.
But again, nothing.
Finally, after a few cupping sessions to my Deltoids and Rotator Cuff muscles, I finally, broke open my trigger point workbook– and there it was in plain sight.
Just like that, I knew it was this neck muscle that was causing that phantom pain down the side of my shoulder. I was so excited, I started pushing and prodding and just like that I felt the sensation I had felt earlier, without even moving my shoulder. Of course I had to retest, so I grabbed the heaviest thing I could find and lifting it.
Nothing. No pain at all this time.
According to Janet Travell, MD ” Trigger Points high in the Anterior Scalene and high in the middle scalenes are often the cause of pain in the shoulder, upper arm, forearm, thumb and first finger.” In my reading, I discovered that the scalenes, are so often missed and instead diagnosed as tendonitis, bursitis, upper back pain.
Causes of Scalene Pain
Because the Scalenes attach to your first 2 ribs, they are exacerbated during any kind of breathing or intense exercise, deep inhalation or when you are coughing and sneezing. In fact, when you habitually breath from your chest instead of your diaphragm this will cause a lot of stress on your scalenes. Emotionally stressed people will often times find trigger points in their scalenes.
Recent car accident? Do you play a wind instrument? Working for long hours with arms out in front of your body (90% of us)? All of these causes and then some can be contributing to scalene trouble.
So what can you do about it?
- Self-Massage- I always try to encourage people to perform self-massage as much as they can. Here is a picture of what you are looking for and how the muscle refers down the arm. I find that moving your head to the opposite side to get the SCM out of the way, is the best way to reach your Scalenes.
- Get a Massage- The neck can be a tricky area to self-massage, mainly because there are so many nerves and other muscles on top of each other. If you don’t feel you have a good grasp of anatomy or just prefer to relax as you get trigger point treatments on your neck (I don’t blame you), then getting a medical massage is a great option. Ideally you want to find a therapist who is trained in orthopedic, medical or trigger point therapy.
- Change Your Habits- It’s not enough to just de-active painful Scalene trigger points, maintaining a good posture and also being aware of your breathing during exercise can reduce the triggering effects of this muscles. Of course there will always be those who have occupational hazards or because of their work or sports will have repetitive strain in the scalenes. IN this scenario you should consider getting monthly or biweekly massages and/or purchase massage tools to consistently keep up with this tightness.
I hope this article has helped you identify your shoulder pain. Now it’s your turn! Tell me how you keep your shoulder pain under control.