Saturday, October 22, 2011


So, I woke up early this morning and my right hand felt stiff and swollen.  It was very painful when I tried to close my fingers into a fist.  In fact, I couldn't bend my fingers very much at all.  I was still mostly asleep and my mind was trying to remember which muscles I should be checking for swollen fingers.

In the meantime, I remembered something helpful.  When swollen hands or feet are caused by trigger points (as they often are), it is because some place further upstream, the vessel is being partially blocked or squeezed, preventing the returning fluids from passing through.  So, although I could not remember exactly which muscles to work, I knew that raising my hand higher than the rest of my body would help.  So, I stuck my arm straight up in the air for several minutes until the swelling went down a little.

Later, when I was conscious, I went to my handy-dandy Trigger Point Therapy Workbook.  There was not a category for swollen hands and fingers, so I checked under "hand and finger numbness."  Scalenes, subclavius, and pectoralis minor looked like possible candidates, but on p. 140, in the write-up about the pectoralis minor, it said that swelling in the hand and fingers is not a symptom of this muscle, but is caused by "tight scalenes compressing the axillary vein, which runs under the scalenes but not under the pectoralis minor."  I decided that the scalenes would be a good place to work.  (You can find all the info you want about scalenes on p. 78 of the book if you have it.)

Scalenes (pronounced "SKAY-leens)

To give you an idea of how influential your scalenes are, on p. 82, it says, "The scalenes are likely to be involved in any myofascial pain problem in the upper body."  Here are some examples of possible scalene-related symptoms:  Chest pain; upper back pain; restlessness in neck and shoulder; bursitis and tendonitis symptoms; pain, swelling, numbness, tingling, and burning in arm and hand; and, because of the satellite trigger points it creates, headaches.

If you grab a hunk of flesh on the side of your neck, you will grab some fairly pliable muscles. If you press into the side of your neck with your fingertips (still holding onto those fleshy muscles), you will press right into the scalenes.

The scalenes are much tighter than the outer muscles.  Scalene trigger points can be very painful, sometimes feeling like you have hit a nerve.  Trigger points can be found anywhere on the scalenes.  Work each about six times per session.

There are three, sometimes four, bands of scalene muscles.  They basically attach your neck bones to your collar bone.  Some of the muscles are under the softer, outer muscles, so you need to move them out of the way while you work them.  The scalenes extend from under your ear to your collar bone, and from about 1-2 inches behind your ear down to the collar bone. There is also a horizontal band that is in the triangular depression between your collarbone and the big thick muscle of your upper back (the trapezius).  I am thinking that this is probably the one that was causing my swelling.

I have found that using supported fingers works well for scalenes.  It works better if you have fairly short finger nails.

I show just one side of the neck here, but it is a good idea to always work both sides of the body when you are working trigger points.

Start just below the ear.  The hand underneath (from the opposite side of the body) grabs the outer muscles and pulls them forward.  The hand on top pushes on the "tool hand."  The tool hand does not push down.  The top hand is exerting the force.  About six small strokes about one or two seconds each (not too fast) on each trigger point.

Note:  Any time you do massage, if you feel a pulse, just move over a bit.  You should never massage a place where you feel a pulse.  (You would have to go really high up under your chin to get a pulse, and if you are there, you are in the wrong place.)

The opposite hand pulls the outer muscles forward.

Continue down, moving the outer muscles out of the way.

The outer hand exerts the pressure.  
As you proceed lower, there will be fewer muscles to pull out of the way.   Proceed all the way down to the collarbone.  There can be some pretty hot trigger points right by the collar bone so don't quit early.

Continue with the back scalene, which is located in back of the first.

The last scalene actually runs more horizontally, and is located between the bulgy part of your trapezius and your collar bone.  
The stroke goes from under the trapezius (the big, bulgy muscle in back), parallel to the collar bone, and toward the neck.

Written October 5, 2011.


  1. be careful with the behind the ear stuff... I have been doing trigger point therapy for 10 years on myself and I pushed too hard there and got bells palsy. A lot of serious cranial nerves there that can completely mess you up - and they hurt like mad when you find them so you want to trigger them. Most of this trigger point stuff can be cured through yoga and stretching, 10 minutes a day... Prevent instead of trying to "cure".. that's the next logical step... instead of waiting until your messed up before you do anything. Muscles need to be used and stretched regularly or they put out pain for a good reason.
    We are all going fetal - muscles too stretched in the back and too tight in the front. If you never stretch the front, the pain will keep returning no matter how much you trigger point the muscles because the cause is not being taken care of; sitting too much with arms out in front on the computer.

  2. Your scalenes do not attach onto your clavicle. Anterior and medius have attachment to your first rib and posterior onto your second rib. May I echo the above comment too and advise any readers to be very careful about self trigger-pointing anything in the neck. Best of using conservative treatments yourself (heat/stretching) and let a trained professional assess and/or treat if these don't work

  3. Thank you, this was very helpful