People complain about pain just inside the shoulder blade, thumb, and index finger. Notably, it doesn’t always create pain in the hand; sometimes, it tingles like it is “falling asleep” or “going numb.” Sometimes, they have pain or tingling when reaching out with the hands near shoulder level, like when you’re driving or cutting hair.
The pattern rarely occurs completely, as illustrated. But this pain along the shoulder blade and in the hand is most common. As the illustration indicates, the pain, tingling, and “numbing” is most likely to occur in the areas of darkest red.
Commonly, when there are stiff, swollen hands, the sensations around the index finger and thumb are a greater focus. However, the tension behind the shoulder is often there. However, if I press into this muscle at the base of the neck, the client describes the sensation between the shoulder blades and down the arm.
The most common cases that I see for this involve people that sit with their shoulders forward so that it is difficult to breathe with their diaphragm. The scalenes go from being assistive breathing muscles to being the primary respiratory muscles as they lift the upper ribs and collarbone to inhale. They get overworked, displace the upper ribs, and create chronic trigger point activity.
When they identify an activity, it usually involves sitting with their hands up in front of them. This might be when they are driving with their arms at 10 & 2, working while slumped forward, rowing, or doing an activity that creates heavy breathing.
Another common report is that their arms go to sleep when they sleep on their back. Tight scalene muscles choke the neurovascular bundle that runs to your arms.
These muscles also assist with heavy breathing when sprinting or climbing stairs. People with this problem complain of tingling in their hands while huffing and puffing. This can also be a sign of thoracic outlet syndrome.
This post on anatomy contains standard information about the origin, insertion, function, and innervation of muscles. Additionally, it includes information on functional considerations and anomalies.
Anatomy posts have a grid of all related posts. This includes posts on pain patterns, self-care, therapy notes, NMT protocols, cranial techniques, and cases.
Self-Care Posts have common sections to make them easy to follow and understand:
Therapy Notes provide details for cranial, spinal, and local joint work. These notes also link to a traditional neuromuscular protocol.
By treating integrative components first, direct work on the muscle becomes less intense while providing longer-lasting relief.
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