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Instep Dance Magazine Articles

Reprints of monthly column as first appearing in Instep Dance Magazine.

August 2000

Back Pain - Part 9: Scalenus Anticus Syndrome

By Rick Allen, DC

"Better health leads to better dancing."

Scalene diagram

Another condition that can tie in with the rib subluxations that I described last month is Scalenus Anticus Syndrome. Being a bit rusty on your Latin, you may ask, "What is that?" It is best described by first looking at the anatomy of the neck (See figure). Note the three scalene muscles that go from the side of the top cervical vertebrae down to the first two ribs. Their function is to flex the head and neck and to assist in breathing.

The problem

The scalene muscles are used and overused daily during many movements. An example given by Michael Gazdar, D.C. is that any pulling done by the arm from front to back, such as a supermarket checker might do, could cause the muscles to overwork, get larger (hypertrophy) and cause some compression on the nerves going to the hand.

Another common situation is that when you are anxious, you will tend to breathe from your upper chest, instead of using your abdomen and diaphragm. You will probably lean your head forward in an abnormal posture. You may also hunch your shoulders up, looking like a turtle. This all leads to chronic tension in the scalene muscles. The muscles will develop "trigger points" that, when pressed, may give a painful "doorbell sign" down the neck and arm. The trigger points may also refer pain into the chest, shoulder, back and sides of the arms, and even to the medial or inside edge of the shoulder blade, according to Donald Murphy, D.C. It may be so bad that the anterior and middle scalene muscles clamp down on the subclavian artery and brachial plexus, restricting nerve impulses and blood flow to the arm and hand. In plain language, your hands may develop numbness, tingling, pain, and coldness, probably in that order according to Dr. Gazdar. You may be incorrectly diagnosed as having carpal tunnel syndrome.

The solution

A combination of myofascial release and chiropractic adjustment of the neck works quite effectively to relieve the tension in tissues, reduce the abnormal motion of the neck, and, hence, reduce the problems due to pressure on the nerves and blood vessels. Your doctor may use a "spray and stretch" technique, developed by Janet Travell, MD, which uses a cold spray on the neck to temporarily numb the tissues while they are stretched beyond their normal pain tolerance. It is not as unpleasant as it sounds -- it is quick and almost painless.

But for the treatment to be effective long-term, you must also address the poor posture and tendency to hold anxiety and tension in the neck. As I have pointed out in prior articles, there are a number of simple things you can do each day to help yourself:

  • Be aware of your posture.
  • Adjust your computer workstation.
  • Take stretch breaks every half hour. Here are two neck stretches.
  • Learn to relax and breathe deeply from the abdomen and diaphragm.
  • And, of course, stand tall when dancing - your coach can help.

Other articles directly about posture are:


  • Taking Your Back to the Future by Michael Gazdar, D.C., C.C.S.P.
  • Textbook of Anatomy by W. Henry Hollinshead, Ph.D.

Future articles: Michelle Uttke gave me some tips that I want to pass on to you for avoiding painful torque of the shoulders and possible rib subluxation. And shortly, we'll check on improving conditions of Mary Lou's compression fracture and my own posture. For now, know that we are both doing well.

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