I’ve already told you about my left upper trap; now meet my left scalene. When I lift too much, these muscles, which live on the side of the neck, get tight. Why?
The scalene muscles make up a large-muscle group that lives on either side of the neck, connecting the neck to the ribs. You can experience tightness in these muscles while lifting weights (e.g., benching or deadlifting) or doing work above your head or even just with driving or using your arms in a way that works the scalene muscles. If you have a consistent forward-head type of posture, these muscles can be chronically tight, and on the video, I provide a stretch that can help you open up your chest and hips if this is an issue for you. Scoliosis, meaning a side-bent spine, can also make one side of the neck tight because it’s literally being pulled away from the ribs.
If stretching the scalene muscle out doesn’t seem to hold and the tightness in the side of the neck continues, this big muscle may be doing work it wasn’t meant to do, and you may have a bigger problem that needs to be addressed before more damage is done.
The spinal column consists of bones that sit one on top of the other called vertebrae, and the neck segment of the spine is called the cervical spine. Between each cervical vertebra are small multifidus neck muscles (e.g., semispinalis capitis, splenius cervicis, etc.), and these deep muscles actually function to stabilize one neck bone on the other every time you turn or bend you head or neck. Watch the video above for a moving image showing cervical vertebrae functioning properly with a stabilizing multifidus muscle.
If these small muscles atrophy (shrink) and become weak, this can cause excessive motion between the vertebrae, and the big scalene muscle (or other large muscles, such as the trapezius and levator scapula) may be recruited to step in and do their job, a function is was never intended to do. Tightness in the side of the neck can then be the result of an overworked scalene muscle.
What could cause a multifidus muscle to atrophy? Typically this would be a nerve injury, such as a pinched nerve, or neck injury. Even an older long-forgotten, or even unknown, injury can cause a gradual decline of the small neck muscles. You may just experience tightness in the side of the neck but otherwise feel strong, or you may have accompanying neck pain and headaches or even a feeling that your head is just too heavy for your body.
Watch the video to see an image of normal neck muscles providing stability and protecting the structures of the neck compared to an image of atrophied neck muscles resulting in unstable movement and painful joints, discs, and nerves.
Weak neck muscles can be treated nonsurgically to help relieve the scalene muscle from its extra duties and relax the tightness in the side of the neck. Some ways to treat these muscles that cause tightness in the side of the neck include the following:
People often turn to nonsteroidal anti-inflammatories (NSAIDs) for pain relief, but due to the dangerous side effects we don’t recommend these drugs. Likewise, it’s best to avoid steroid injections as these destroy cartilage and carry other risks or Botox injections, which may cause more muscle damage.
The upshot? Your upper trap and scalenes are both muscles that compensate for weak neck stabilizing muscles. So just continuing to blindly stretch these tight muscles day after day without asking why the tension keeps coming back may be one of the definitions of insanity, You know the one, where you keep doing the same thing to get the same poor result!
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…