Parasthesias (altered nerve sensation – pain, tingling, numbness) going down the arm to the fourth & fifth fingers.
Radial pulse diminishes or is absent when arm is raised overhead.
History of whiplash.
This is often confused with Carpal Tunnel Syndrome.
Go cautiously and get feedback when working scalenes as this area may be very tender.
Work scalenes by rotating and flexing head toward affected side to minimize skin tension, then move thumb laterally under superior border of clavicle, moving from the sternum toward the acromion process.
Work pectoralis major by placing your fingertips under the anterior wall of the axilla and doing petrissage with your thumbs across the fibers of the pecs. It’s best to keep your fingers stationary and only move your thumbs because the axilla may be very ticklish.
Work pectoralis minor by sliding your fingers on the rib cage under pectoralis major, pressing toward the coracoid process. Press into pectoralis minor and move your fingers superiorly while bringing your clients arm overhead. The movement of your hand on the reb cage can be tolerated better if it is done while moving your clients arm overhead.
Scalenes may be stretched by having your client laterally flex their head with the head rotated toward the shoulder, pointed straight ahead, then rotated away from the shoulder. Show your client how the pectoralis major muscle may be stretched in a doorway.
Soft Tissue Release - Scalenes
Soft Tissue Release - Pectoralis Minor
Scalenes - Sidelying
Scalene Side Lying Variation
Anatomy - Scalenes
First Rib Release
First Rib Release Side Lying
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