Thank you for this video. I am a manual therapist and have been trying to release my own scalenes and this video has done the trick!! Thank you so much. 🙏😘
That's awesome Snavit! So glad I could add context to technique videos, definitely something that is not given enough time and weight in most education programs. Dr. B2
I find your explanation very clear, human and respectable, considerate and professional. I am neither a manual therapist nor a masseuse, but a social worker, nevertheless I find the anatomy lessons interesting; you communicate both with the viewer, the patient and the body of the patient.
I love that you talk about all the relevant precautions for neurovascular structures. You're also really great at explaining palpation skills. Wish I found you a few years ago! :)
You are extremely similar in your knowledge and experience to my mentor, who was also my instructor for two years. I will be forever in debt to him and now yourself for the willingness to share these skills and make me a superior therapist. Thank you.
Thanks for sharing! I love the details on your videos. Your work is very helpfull and insightful. For all the people having trouble palpating the scalenes even after this amazing presentation, or wanna make sure they are on the right spot, I found a little trick that works for me. While palpating the area, you can ask the patient to do a few sharp forced inhalations and the scalenes will fire up trying to elevate the first two ribs, so you can actually feel them under your fingertips and even see them in some people. Hope this helps :)
I don't even know if this video will even help me but i liked it just off the strength of accuracy and thoroughness! You explain this very well and in detail. 👍 great teacher
I am someone who played driver seat accordion yes crushed hip along with other great injuries good way to test self strength & endurance thank you for inspire the best out of self god bless for life
Me again. Just can't thank you enough Brent. Every video is superb. This one is better still (how much better do they Get?!) GREAT review on a difficult and challenging area. Thank you thank you thank you!
Well, let's hope I never stop getting better. I am not sure how much better I can get, and I am sure I will have my highs and lows like anyone, but I am continually compelled to improve. I do hope you will check out our website... I think you will really enjoy it... and in the next 6 months we plan on starting to add joint mobilization videos! Exciting stuff, Dr. B2
We're glad it was helpful! We just recently added our business to Google my Business, if you enjoy our content, would you mind leaving a quick review? g.page/r/CR1LsEAZ5W6AEBM/review
I stumbled on this video while looking for any new ideas in treating the scalenes. This muscle group in particular can be challenging to treat effectively ( and not over treat) . This guy should help out the universities. Very great explanation and thorough clinical reasoning skill. By working with these muscles incorrectly you can create more issues than what the patient comes in with. I really appreciate these tutorials being out there . I don't know this guys background but he is a very effective teacher. Anatomy Anatomy Anatomy ! He covers this key fact very well. Thank you Sir On a side note: Who thumbs downed this video?? That is just odd
insertion/origins of scalenes are. Anterior S Orig c3-c6 (Anterior tubracle of trasv process) ins first rib Mid S Orig c2-c7 (Ant tubracle of TP) ins first rib Post S Orig c5-c7 (Ant tubracle of TP) ins second rib The three scalene groups derive their name from the Greek word skalenos meaning “uneven.” Although anatomists depict the scalenes as individual muscles, most touch therapists are aware of how they work together as a functional unit during neck sidebending and rotation . Considered accessory muscles of inspiration, they can elevate the first and second ribs and aid in neck flexion. It was once believed the scalenes were only active during heavy or forced breathing, but improved electromyography shows the scalenes firing even when the intake of breath is quite small. This has led some researchers to drop the accessory label and regard them as primary muscles of inspiration.
Incorrect! Function of the scalene muscles - ...The scalene muscles function the cervical spine against lateral movement, and they serve a primary role in respiration.
Do u have a website with all the various techniques organised for review with videos I'd be happy to pay to be able to go through various stretches, soft tissue work, etc. I'm a 4th year physio and love your content.
Hi Justin, we do. BrookbushInstitute.com. We have over 500 videos and articles, over 150 CEC approved online courses that also count towards any of the 3 certifications we offer (HMS, CPT, IMT).
Is release what we are looking for if we suspect bilateral tinnitus is due to those muscles spasming or irritating nerves? If so, what is the long term plan to make sure we keep neck corrected and healthy? Release - stretch - strengthen?
This is a terrific video. I suffer from dizziness and other neurological symptoms that haven't been diagnosed by allopathic physicians. Oddly, when I raise my arms above my head, the symptoms nearly vanish. My doctors don't know what to make of this, but I suspect it has something to do with the scalenes/SCM. Is this possible? This is such an annoying condition to deal with, going on five years now. Thanks again!
It sounds like some physical therapy for your cervical spine may be a potential solution. Many of the muscles of the neck can develop trigger points with referral patterns that bring on weird symptoms. Further, over-activity of muscles like your levator scapulae and traps can do some pretty strange stuff to your upper cervical spine that can lead to cervicogenic headache. I would suggest you start looking for a PT who could help. Dr. B2
Scalenes are locked up on me. The guy I'm working with is having me work a lot on breathing and core strength to take the pressure off of the neck, however, he is not doing and isn't planning on doing any manual therapy to the scalenes to help give this recovery a boost. It's been 9 months I've been having the brachial plexus getting choked - my core is much stronger and my breathing is a little better. I'm wondering how long I should expect to wait before the scalenes to relax as they still feel like suspension cables that are wrapped as tight as can be. I'd also thought about needling them to help boost that as well.
I would say that manual therapy like the video above is well worth a try. 1st and 2nd rib mobilization can also be very helpful. I like the stuff you have already done, but I can't think of a legitimate reason why you would not include manual therapy. Sincerely, Dr. B2
Great video doc. What’s your opinion on strengthening the scalenes? I’ve read some manual therapists are adamant that scalenes are tight because they are weak and that you should not release them but strengthen them? Or else you’ll ultimately only get tighter and weaker scalenes
In the video you mention the "searing pain" of stretching a nerve and I'm curious what kind of damage this can cause, if any (besides a little trauma!). I had a chiropractor a few years back who would work on my neck in this supine position and basically put biofreeze on my neck and stretch it and do manual therapy on my neck muscles to the point it felt like an excruciating brain freeze. I could hardly tolerate it and stopped going to him because of this. He had the attitude of yep, it's gonna hurt - but I don't think it should hurt THAT bad regardless of how tight they are. Thanks for any feedback you can offer.
Back to basics set in chair hold seat keep upright posture gently tilt head different angles tell get good strech and or both lay on floor with arms to sides legs at 90 slowly lower legs to oneside while gently gliding head opposite direction creating good strech if unable to do 90 try bent legs see if neck is looser
I really wish you could be my PT.. 😢 Ive gone thru so many bad chiros and pts before.. But i found a great chiro to get the joints lubricated and bones in alignment. The joints were dried up before but now i need muscle fascia and ligament problems fixed now and cant find a good PT. I hope you know that it takes hard chiro manipulations to unlocked the most locked up joints. Mine were so darn locked up that it took hard twisting the first several times for a huge release! Pts think they can release extremely locked up joints but literally it takes twisting force.. My muscles and ligaments pull different ways also i probly have cranial bone misalignment which it makes me mad most chiros and pts wont learn how to do! My sphenoid bone is misaligned causing deep.head pressure my.whole life and thats the bone that cradles the brain and can and has obstructed CSF fluid and upper neck problems contributing to it and blood flow. On xray my bones looked good but had to be palpated to discover just how bad my.neck curve was. Chiros only adjusted my c1 alot yrs because they were too incompetent to check all.the other bones because i only mentioned the base of my skull dysfunction. My occipital joints had to have an OCCIPITAL LIFT TECHNIQUE to get released. Are you familiar with that one? Theres way more things pts and chiros NEED TO LEARN. it sucks there cant be a doctor with 15 yrs of college and certified in every area 😢😢 doctors think they know it all after 4 yrs.. That is NOT enough schooling to help the most difficult even normal looking cases that had normal range of motion and xrays!! 😭😭
Yes too much information for me!! I do massage by short technique , I do massage directly through scalane muscles, tendons, tissue around your neck and shoulder blades!!
Great video, and very thorough! I'm a PTA, but I am "personally " having chronic pain and dysfunction in my L scalene area. Its become very debilitating. Is there a scalene release I can do on myself?
Thank you for the compliment Chris, I never thought of my bedside manner as my strong point... I am pretty direct, and can be a bit demanding... but I suppose there is something to be said for genuinely caring and wanting my patients to feel better. Dr. B2
Hey Michael, Can you clarify. Are you saying that NYC therapists do not have adequate knowledge (including this video), or are you saying that you have had some poor experiences in NYC? I would like to be an advocate for some of my colleagues and say that there are some tremendous PT's in NYC if you are willing to look... and you have an out-of-network benefit or are willing to pay cash. Dr. B2
Brent Brookbush Lol. No I'm sure there are some of the best over here also. I guess I have not found any. Seriously I have explained every detail of my injury and dysfunction to these therapists. Then they go and do the bare minimum one size fit all bootleg therapy. There is a lot of insurance scamming over here.
Just to give you another perspective, It could be called "Insurance Restricted" therapy. I have met many great PT's who have been forced to take 3 patients an hour do to very low payouts from insurance companies, and the side-effect is cookie cutter programs... because, no matter how good you are, 20+ patients a day wears you down. It is hard to be focused, and "smart" in your intervention design that many times a day. I am not trying to say that you do not deserve the best... you do... and their are many complacent, or just horrible PT's out there, but I think we all need to be aware of the factors that are contributing to your experiences ;-) Dr. B2
I understand, but my experiences were not up to standard because of the communication problem with the PTs. Explaining my problem then them doing the exact procedure they to everybody else. For instance I've been to 3 different PTs and not one has done even a basic miofascal release in any form to me. I had to learn by researching pros such as yourself. Not to mention places I've had most didn't have good english and like every session somebody new services me, so I had to explain everything all over. Not one ever even opened my file containing most of the info.
I understand, but my experiences are not about that. Not any type of miofascal release of any form was ever done to me after 3 different PT clinics. English is also limited in all 3. Very rarely has the same PT practitioner actually serviced me twice. My folder was never opened once. IDK the list goes on and on. Being in any populous city quality takes a hit and basically real money always talks. I mean I see all these videos, all I at least want is real in depth spinal /muscular analysis. Usually the owner sees the folder once then all other PTs just go one their one size fits all routine.
This video was one of the most informative and thoughtful massage videos I have ever watched on UA-cam
" The quickest way to get anything done is to do it right the first time" -This guys mom.
Best quote I have heard in a while .
Thank you for this video. I am a manual therapist and have been trying to release my own scalenes and this video has done the trick!! Thank you so much. 🙏😘
Dr.B2,you are amazing! A bow to you!🙏
Happy to help!
wow, talk about being thorough. A gentleman and a scholar!
Thank you Alex
Love this guy....great advice and good to hear his explanation not just about the technique but also about being a therapist :)
That's awesome Snavit!
So glad I could add context to technique videos, definitely something that is not given enough time and weight in most education programs.
Dr. B2
I find your explanation very clear, human and respectable, considerate and professional. I am neither a manual therapist nor a masseuse, but a social worker, nevertheless I find the anatomy lessons interesting; you communicate both with the viewer, the patient and the body of the patient.
Thank you very much Deborah!
I love that you talk about all the relevant precautions for neurovascular structures. You're also really great at explaining palpation skills. Wish I found you a few years ago! :)
Absolute BEST explanation and instruction I have come across yet on exactly how to palpate this this important muscle group! Thank you!!
You are extremely similar in your knowledge and experience to my mentor, who was also my instructor for two years. I will be forever in debt to him and now yourself for the willingness to share these skills and make me a superior therapist. Thank you.
You're very welcome!
Brookbush Institute oo o pop
this guy knows what's up
Thanks for your support!
Thanks for sharing! I love the details on your videos. Your work is very helpfull and insightful.
For all the people having trouble palpating the scalenes even after this amazing presentation, or wanna make sure they are on the right spot, I found a little trick that works for me.
While palpating the area, you can ask the patient to do a few sharp forced inhalations and the scalenes will fire up trying to elevate the first two ribs, so you can actually feel them under your fingertips and even see them in some people. Hope this helps :)
THANKYOU!
I don't even know if this video will even help me but i liked it just off the strength of accuracy and thoroughness! You explain this very well and in detail. 👍 great teacher
I am someone who played driver seat accordion yes crushed hip along with other great injuries good way to test self strength & endurance thank you for inspire the best out of self god bless for life
Me again. Just can't thank you enough Brent. Every video is superb. This one is better still (how much better do they Get?!) GREAT review on a difficult and challenging area. Thank you thank you thank you!
Well, let's hope I never stop getting better. I am not sure how much better I can get, and I am sure I will have my highs and lows like anyone, but I am continually compelled to improve.
I do hope you will check out our website... I think you will really enjoy it... and in the next 6 months we plan on starting to add joint mobilization videos! Exciting stuff,
Dr. B2
Brent this is really a GREAT video, thank you! The Scalenes create a lot of problems for the LMT in locating them AND the patient.
Happy to help James!
Yeah, great job. I also like the close-up shots at the end to recap the class. Please keep up the good work and God bless!!!
No problem, will do!
Thanks so much for this video, you are fantastic instructor.
You're very welcome! Thank you for your support!
Thanks for the video Brent! I appreciate the sharing of your wealth of knowledge. I've used this technique on my patients with good success.
That's exactly what we want to hear Patrick,
That you are enjoying how we deliver education and that it is improving patient outcomes!
Very informative! Thank you!
We're glad it was helpful! We just recently added our business to Google my Business, if you enjoy our content, would you mind leaving a quick review? g.page/r/CR1LsEAZ5W6AEBM/review
Too bad the camera is not directed to show your excellent treatment.
Thank you very much . Your hard work is much appreciated .
You are very welcome, it's what we do ;)
I stumbled on this video while looking for any new ideas in treating the scalenes. This muscle group in particular can be challenging to treat effectively ( and not over treat) . This guy should help out the universities. Very great explanation and thorough clinical reasoning skill. By working with these muscles incorrectly you can create more issues than what the patient comes in with. I really appreciate these tutorials being out there . I don't know this guys background but he is a very effective teacher. Anatomy Anatomy Anatomy ! He covers this key fact very well. Thank you Sir On a side note: Who thumbs downed this video?? That is just odd
Thank you very much Dr. Hanna.
insertion/origins of scalenes are.
Anterior S
Orig c3-c6 (Anterior tubracle of trasv process) ins first rib
Mid S
Orig c2-c7 (Ant tubracle of TP) ins first rib
Post S
Orig c5-c7 (Ant tubracle of TP) ins second rib
The three scalene groups derive their name from the Greek word skalenos meaning “uneven.” Although anatomists depict the scalenes as individual muscles, most touch therapists are aware of how they work together as a functional unit during neck sidebending and rotation . Considered accessory muscles of inspiration, they can elevate the first and second ribs and aid in neck flexion. It was once believed the scalenes were only active during heavy or forced breathing, but improved electromyography shows the scalenes firing even when the intake of breath is quite small. This has led some researchers to drop the accessory label and regard them as primary muscles of inspiration.
Incorrect! Function of the scalene muscles - ...The scalene muscles function the cervical spine against lateral movement, and they serve a primary role in respiration.
Do u have a website with all the various techniques organised for review with videos I'd be happy to pay to be able to go through various stretches, soft tissue work, etc. I'm a 4th year physio and love your content.
Hi Justin, we do. BrookbushInstitute.com. We have over 500 videos and articles, over 150 CEC approved online courses that also count towards any of the 3 certifications we offer (HMS, CPT, IMT).
Every other Scalene video should be deleted.
This was amazingly thorough
Good work. I have subscribed your channel👍
Thank you for your support @abhishek!
Thank you. Very informative and instructive.
You are very welcome! Check out everything we have to offer at BrookbushInstitute.com
Is release what we are looking for if we suspect bilateral tinnitus is due to those muscles spasming or irritating nerves? If so, what is the long term plan to make sure we keep neck corrected and healthy? Release - stretch - strengthen?
This is a terrific video. I suffer from dizziness and other neurological symptoms that haven't been diagnosed by allopathic physicians. Oddly, when I raise my arms above my head, the symptoms nearly vanish. My doctors don't know what to make of this, but I suspect it has something to do with the scalenes/SCM. Is this possible? This is such an annoying condition to deal with, going on five years now. Thanks again!
It sounds like some physical therapy for your cervical spine may be a potential solution. Many of the muscles of the neck can develop trigger points with referral patterns that bring on weird symptoms. Further, over-activity of muscles like your levator scapulae and traps can do some pretty strange stuff to your upper cervical spine that can lead to cervicogenic headache.
I would suggest you start looking for a PT who could help.
Dr. B2
Absolutely agree with positioning! Thank you.
He is like watching Bob Ross paint !!
Lol.
Brent #1 for life.
Thank you for your support @IvanAndreevich!
Scalenes are locked up on me. The guy I'm working with is having me work a lot on breathing and core strength to take the pressure off of the neck, however, he is not doing and isn't planning on doing any manual therapy to the scalenes to help give this recovery a boost. It's been 9 months I've been having the brachial plexus getting choked - my core is much stronger and my breathing is a little better. I'm wondering how long I should expect to wait before the scalenes to relax as they still feel like suspension cables that are wrapped as tight as can be.
I'd also thought about needling them to help boost that as well.
I would say that manual therapy like the video above is well worth a try. 1st and 2nd rib mobilization can also be very helpful. I like the stuff you have already done, but I can't think of a legitimate reason why you would not include manual therapy.
Sincerely,
Dr. B2
Eddy Lindenstein Did you end up getting some manuel therapy done to your scalenes? It is such an important initial step to getting better.
Great video doc. What’s your opinion on strengthening the scalenes? I’ve read some manual therapists are adamant that scalenes are tight because they are weak and that you should not release them but strengthen them? Or else you’ll ultimately only get tighter and weaker scalenes
In the video you mention the "searing pain" of stretching a nerve and I'm curious what kind of damage this can cause, if any (besides a little trauma!). I had a chiropractor a few years back who would work on my neck in this supine position and basically put biofreeze on my neck and stretch it and do manual therapy on my neck muscles to the point it felt like an excruciating brain freeze. I could hardly tolerate it and stopped going to him because of this. He had the attitude of yep, it's gonna hurt - but I don't think it should hurt THAT bad regardless of how tight they are. Thanks for any feedback you can offer.
Back to basics set in chair hold seat keep upright posture gently tilt head different angles tell get good strech and or both lay on floor with arms to sides legs at 90 slowly lower legs to oneside while gently gliding head opposite direction creating good strech if unable to do 90 try bent legs see if neck is looser
Where do i find someone as skilled as you?
I really wish you could be my PT.. 😢 Ive gone thru so many bad chiros and pts before.. But i found a great chiro to get the joints lubricated and bones in alignment. The joints were dried up before but now i need muscle fascia and ligament problems fixed now and cant find a good PT. I hope you know that it takes hard chiro manipulations to unlocked the most locked up joints. Mine were so darn locked up that it took hard twisting the first several times for a huge release! Pts think they can release extremely locked up joints but literally it takes twisting force.. My muscles and ligaments pull different ways also i probly have cranial bone misalignment which it makes me mad most chiros and pts wont learn how to do! My sphenoid bone is misaligned causing deep.head pressure my.whole life and thats the bone that cradles the brain and can and has obstructed CSF fluid and upper neck problems contributing to it and blood flow. On xray my bones looked good but had to be palpated to discover just how bad my.neck curve was. Chiros only adjusted my c1 alot yrs because they were too incompetent to check all.the other bones because i only mentioned the base of my skull dysfunction. My occipital joints had to have an OCCIPITAL LIFT TECHNIQUE to get released. Are you familiar with that one? Theres way more things pts and chiros NEED TO LEARN. it sucks there cant be a doctor with 15 yrs of college and certified in every area 😢😢 doctors think they know it all after 4 yrs.. That is NOT enough schooling to help the most difficult even normal looking cases that had normal range of motion and xrays!! 😭😭
How about: "Self Release of the Scalenes" ?
Thanks for experience sharing
Yes too much information for me!! I do massage by short technique , I do massage directly through scalane muscles, tendons, tissue around your neck and shoulder blades!!
Where are you located at I need your help???
Great video, and very thorough! I'm a PTA, but I am "personally " having chronic pain and dysfunction in my L scalene area. Its become very debilitating. Is there a scalene release I can do on myself?
Summary at 15:00
I wish doctors had your bedside manner
Thank you for the compliment Chris,
I never thought of my bedside manner as my strong point... I am pretty direct, and can be a bit demanding... but I suppose there is something to be said for genuinely caring and wanting my patients to feel better.
Dr. B2
So much easier in a side lying position.
I never had a phys therapist even with 5% of technical knowledge. Only one size fits all butchers over in NYC.
Hey Michael,
Can you clarify. Are you saying that NYC therapists do not have adequate knowledge (including this video), or are you saying that you have had some poor experiences in NYC?
I would like to be an advocate for some of my colleagues and say that there are some tremendous PT's in NYC if you are willing to look... and you have an out-of-network benefit or are willing to pay cash.
Dr. B2
Brent Brookbush Lol. No I'm sure there are some of the best over here also. I guess I have not found any. Seriously I have explained every detail of my injury and dysfunction to these therapists. Then they go and do the bare minimum one size fit all bootleg therapy. There is a lot of insurance scamming over here.
Just to give you another perspective,
It could be called "Insurance Restricted" therapy. I have met many great PT's who have been forced to take 3 patients an hour do to very low payouts from insurance companies, and the side-effect is cookie cutter programs... because, no matter how good you are, 20+ patients a day wears you down. It is hard to be focused, and "smart" in your intervention design that many times a day.
I am not trying to say that you do not deserve the best... you do... and their are many complacent, or just horrible PT's out there, but I think we all need to be aware of the factors that are contributing to your experiences ;-)
Dr. B2
I understand, but my experiences were not up to standard because of the communication problem with the PTs. Explaining my problem then them doing the exact procedure they to everybody else. For instance I've been to 3 different PTs and not one has done even a basic miofascal release in any form to me. I had to learn by researching pros such as yourself. Not to mention places I've had most didn't have good english and like every session somebody new services me, so I had to explain everything all over. Not one ever even opened my file containing most of the info.
I understand, but my experiences are not about that. Not any type of miofascal release of any form was ever done to me after 3 different PT clinics. English is also limited in all 3. Very rarely has the same PT practitioner actually serviced me twice. My folder was never opened once. IDK the list goes on and on. Being in any populous city quality takes a hit and basically real money always talks. I mean I see all these videos, all I at least want is real in depth spinal /muscular analysis. Usually the owner sees the folder once then all other PTs just go one their one size fits all routine.
When do these guys ever have male subjects in skimpy clothing?
Answer:
Never.