Anatomy Review: Massage for the Scalenes

The scalenes are actually the uppermost of the intercostals muscles, those muscles lying between your ribs that assist inhalation and exhalation. However, big surprise, there are no ribs in the neck! Actually a number of books say the scalenes attach to the vestigial ribs of the cervical vertebrae. That is, little buds appear on the cervical vertebrae that in fish, for instance, would develop into ribs, but in humans they end up being just little bumps to which the scalene muscles attach.

Who ordinarily thinks about breathing with their neck? Yet scalenes do have a very important respiratory function. They may indeed be, next to the diaphragm, the second most important muscles of respiration. The scalenes move the ribcage from above, while the thoracic diaphragm moves it from below.

The anterior scalene runs from the side of the second cervical vertebrae down to the first rib beneath the clavicle. Because it attaches to the front of that rib, the chronic contraction of the anterior scalene is one of the muscles that pulls our head forward; in chronic head-forward posture it is useful to address this muscle among others. The medial and posterior scalenes are more along the side of the neck and therefore have more to do with tilting the head to one side or the other.

It is common in whiplash that the scalenes are injured as the head is whipped forward then forcefully back, slightly tearing some of these muscle fibers through a sudden excessive stretch.

Energetically, the scalenes can be connected with all the virtues and challenges of the neck. The head forward posture can signify sadness, self-esteem issues, reactions to recent or long-held defeats. General neck tension will also manifest in the scalenes. That tension points to all the various reasons for inhibitions or tensions people may have about expressing themselves.

Try this Massage Technique

Here is a very helpful Deep Massage fulcrum which affects the scalenes as well as the superficial posterior neck muscles.

  • Therapist: seated at the head of the table
  • Client: supine
  • Center yourself

Working on the left side of the scalenes, place your middle finger, assisted by your other fingers, near the origin of the sternocleidomastoid, just above the sternal end of the clavicle. Take out the looseness.


This fulcrum utilizes the active movement of the client. Ask the client to lift the chin as if looking up. This will take up the slack, stretching the anterior scalenes particularly. Now let us add additional vectors, again in a movement partnership. Ask the client to slowly turn the head to their right, as if to look over the right shoulder. As they move draw your fingers horizontally through the tissues on the left side of the neck. For this whole pass you are at the level of C6 and 7.

You may continue with your tractioning of the fascia all the way back as far as the spinous processes at the center of the neck. In this case, you will have gone considerably past the scalenes, but you will more completely address the soft tissues of the neck pulling them back and with them the head comes back more of top of the body instead of being projected out in front of it.

Now ask your client to bring their head back to center. Begin a second fulcrum, now at the level of the middle of the neck, around C3-5. Repeat each of the steps above. Finally, asking your client to return to center again, begin a third fulcrum at the level of C1-2.

You should repeat these steps on the other side – with the client turning their head to the left, drawing your fingers through the right side of the neck in three passes with movement as described above.