Common Compensations of the Neck: Scalenes for the Deep Anterior Neck Flexors

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Just like our common compensator upper trap makes life easier for a weak and easily fatigued rotator cuff muscle, supraspinatus, our common compensator we are highlighting this month is the scalene group. This group of muscles makes up the thickness of muscle on each side of your neck, extending upward from your posterior first rib up to the bottom of the temporal bone just below your ears. The scalene muscle group normally acts to side bend or tilt your neck as needed throughout your day. In an emergency, it can also act as part of the group of muscles that help you breathe called accessory breathing muscles, but like I said, this is only in an emergency. Most of the day, these muscles should generally be mostly off and relaxed.

Neck Muscles

In someone with very common weakness in the small, stabilizing muscles of the neck (rectus capitus lateralis, longus colli, longus capitus, and rectus capitus anterior, if you must know), the scalenes can help stabilize the neck to keep your head from rolling off your shoulders. The down side to this compensatory pattern, however, is that the scalenes are not designed to be on all day like a typical postural or slow twitch muscle would be able to. The scalenes muscles are considered non-postural or fast twitch muscles, meaning they fatigue quickly. When they fatigue and are overworked, the muscle fibers tighten and waste products accumulate, making the neck stiff and sore on each side, and making tilting the neck painful and nearly impossible. When dysfunctional, the scalene muscles can also send trigger points into the temporal region of the head, the jaw, cheek, behind the eye, and just above the eye in the forehead, causing tension headaches. Because the anterior and middle scalene muscles are attached to the posterior first rib, compensation of this muscle can result in an elevated posterior first rib, which can lead to compression of the brachial plexus which runs between these two muscles. The brachial plexus is the bundle of nerves that exits your cervical spine and travel down to your arms. Symptoms of nerve compression can include numbness, tingling, and weakness, and even pain in certain areas of the arm, hand, and fingers.

How can you tell if your scalenes are compensating for your deep anterior neck flexors? Try this exercise. Lie down on your back with your head on a pillow with your knees bent. Gently tuck your head down towards the floor, but only a small range of the distance of the lead of a sharpened pencil (or ¼ inch). Feel which muscles are “on” as you do the motion, the muscles deep at the front of your neck, or the thick, prominent scalene muscles on each side of your neck. Double check several times, using your fingers to feel which muscle is contributing more to the motion. If your scalenes are firing to perform the chin tuck each time, you have a problem.

Chin Tuck

How do you fix this compensation? Work on activating your deep anterior neck flexors. Check out our article on exactly this topic, Build a Better Body: Stabilizing the Neck.