Why the Scalene Muscles Get Tight

The scalene muscles are a muscle group in your neck. You have more than 100 muscles in your neck, head, and face area. The scalenes are made up of three pairs of muscles, with one set located on either side of your body. 

Woman rubbing her neck
Sam Edwards / Getty Images

Sometimes the scalenes can give you problems because they're prone to a lot of tension.

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.

The 3 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.

To imagine what they look like, you might think of the angled rigging of a ship’s mast; the scalenes resemble and are positioned on the neck and collarbone similarly.

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.

So what does the anterior scalene muscle actually do for you? A number of things, but first, it’s helpful to remember that you have these muscles on both sides of your neck.

The anterior scalene, when acting only on one side of your neck, can bend and rotate your neck.

It also lifts the first rib, but that’s a pretty subtle action that you might not be aware of while it’s happening. The anterior scalene muscle is considered an accessory breathing muscle because it lifts the first rib during an inhale.

When both of your anterior scalenes work together, they flex (bend) your neck.

Medial Scalenes

As the name suggests, 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 furthest 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 branches pass through it. Scalene tension may compress these branches, and that may be a sign of thoracic outlet syndrome (TOS). 

A 1990 study published in the American Journal of Surgery suggests that fibrotic scalene muscles contribute to symptoms of traumatic thoracic outlet syndrome.

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, and it can also develop due to trauma or drugs.

Torticollis is characterized by a twisted neck position that is very difficult to release. The head also tilts to the opposite side. 

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.

Alternative treatments and movement systems such as Feldenkrais, the Alexander Technique, and somatics may help loosen tight scalene muscles.

Depending on the cause of your scalene muscle tension, getting regular massages might also help keep these muscles flexible.

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