Fair question and your points are completely accurate. For the majority of people this exercise is completely safe. TH-cam is a general population and so I need to cast a wide safety net. Those at risk will be people with peripheral vascular disease, vertebrobasilar artery issues etc.
@@Sylorinnis apologies, I never responded! Yes, Kjetil and I have had some similar education. Hence the potential crossover. The dizziness may well be because of mild hyper perfusion. The exercise will also challenge the vestibular system and for some, this may be a novel stimulus. Additionally, dizziness can come from the upper cervical spine, another region challenged by this exercise. In essence, it can be multi-factorial. If the dizziness persists or worsens I'd encourage seeking local help for an in-person assessment. I personally don't experience dizziness while doing this exercise.
I like how properly you explain things, there's certain things people need to know wen exercising the neck and its good that your so clear about that. You have really good vibes, I'm glad I found your channel.
I found this very helpful. I really appreciated the caveats at the beginning. These muscles are fragile and need to be built slowly and perhaps checked with your doctor. But I followed your instructions and felt it really helped me ... a lot. Thank you for making this video!
Thanks for this video. 12 reps and it finally didn't feel like bone and actually a muscle. 2 more sets of 30 n I felt sick n dizzy 5 minutes later I can move without feeling like I'm been choked out n collapsing 😅.hope you have a posterior vid too
@@theMSKphysio lol yea neck tight again now haha.i like to push it to extreme but will spread out the reps through out days to make easier from now on. Thanks again.
This is a good exercise if you have atrophy from Spinal Accessory Nerve Palsy. I am 1 year and 2 months into my recovery and I still have some atrophy above my clavicle. The muscles in that area are not as strong as on my left side.
I did not find any study about this specific exercise, nor anyone talking about it. Could you please tell us where you found it (who taught you, what it's called) to get more information about it?
What information are you hoping to find? What exactly were you searching for? It's unlikely to find many research articles focusing on a singular exercise. The exercise is based off of manual muscle testing positions that align an origin and insertion of a muscle by their fiber orientations. The premise of improving interfacing with nerves comes from theoretical work around neurodynamics. While not the only resource to consider for this exercise, this physiopedia page covers some of the above - www.physio-pedia.com/Scalene Let me know if I can help further.
@@theMSKphysio I couldn't find any mention of this specific exercise on your link. Am I wrong? It's true that "it's unlikely to find many research articles focusing on a singular exercise," but I'm not asking for many, just a single one. Most (not all) exercises have been tested at least once (some many times). It's fine if you personally invented it without testing it in a study; I'm just curious to know who invented it (that's actually the information I'm looking for). If not, please tell us where you found it, who taught you, and what it's called. Thanks!
@@yop109 I understand what you are asking for and I appreciate your curiosity. There isn't a singular study that I have been able to find focusing exclusively on anterior scalene strengthening. I have looked through many databases. I am trying to tell you that the exercise derives from an eclectic mix. My personal studies and teaching roles (which you can find on my website), play a part here. So do the below influences. I have explained in my previous reply that the exercise is based off manual muscle testing positions that align an origin and insertion of a muscle by their fibre orientations. On the link supplied there is a picture from the section on manual muscle testing where the patient is in supine and the force vector is the same as in this exercise. Exercises don't really get invented. They are based off of principles and theories and you get different flavors depending on what an individual is hoping to achieve. To satisfy your curiosity I encourage you to look through the various texts on manual muscle testing: Amazon search here - www.amazon.com/s?k=manual+muscle+testing&crid=3F7P3MP8BUTG8&sprefix=manual+muscle+test%2Caps%2C352&ref=nb_sb_noss_1 There are also articles investigating various forms of testing. Here are a couple from a quick search: doi.org/10.1016/j.jbmt.2010.11.001 www.jospt.org/doi/pdf/10.2519/jospt.2002.32.10.488 If you have other specific questions I can help with, please do ask.
I notice you don't lower your head down to the ground when moving your eye socket away from the shoulder. What are your thoughts on lowering the head back until it slightly touches the ground, with a slight pause while holding the head off the ground? Any dangers or cons to this? I feel like I get a heavier workout as its a heavier lift and more range to cover.
@ReelEC nice pick up. As you've noted, just increased effort/work. No dangers in most cases. If one has a history of neck related structural injury, neurological or vascular compromise I'd encourage checking in with a local professional 😊.
@theMSKphysio Thanks for your swift response, and thanks for posting this exercise as well. It is a rare find. People typically recommend supine chin tucks for scalenes or isometric side head presses and lateral neck flexion, but this exercise you recommended works them better as well as traps and levator scap potentially.
@@theMSKphysio so the thing is I have this chronic sort of spasm behind the ear and upper neck on the left side and weakness in the shoulder blade and feel like a constant pulling sensation in the front part and side of neck down towards the rib.can tight scalenes be a reason ? I have done mris and nothing came out .
A tight scalene could be contributing. Functional issues don't always show on on imaging. For example a muscle would have to look smaller to be relevant on imaging. Even then a smaller muscle may not mean it is an issue functionally. This is just an example. Ultimately, test both sides, and if your symptomatic side is harder then try the exercise for 3-6 weeks. Most exercises (if they are going to), have benefit after 8-12 exposures. Less is more though! Especially if there is irritable tissue. Try checking out some shoulder blade exercises like this - th-cam.com/video/zmZpAA0QHIc/w-d-xo.html
Hello Dr. so I have costochondritis they say. My pain originated at my lovely dowagers hump back in October. By December anytime I laid down on my bed for longer than a half of an hour that dowagers hump area and my traps would start burning and tingling until I sat back up! The tingling has since stopped I’m not sure what made it stop but it’s no longer there. Occasionally my upper traps will feel tingly though. The pain/stiffness then went on to my ribs the following weeks and my chest. My scalene‘s are also jacked up and super tight especially on the right side not to mention my upper traps feel like they are constantly engaged! Do you happen to know whether or not the pain from that hump can also cause pain in the ribs a.k.a. costochondritis? One thing I also noticed was in the beginning when my scaling‘s were very tight and irritated the right side of my throat was also slightly swollen… My chest ribs feel like they are locked. How can I tell if I have a rib out of place or if I truly have costochondritis?
Hi there. Sounds very uncomfortable! It is impossible to give you specifics over TH-cam without an assessment. That being said, joint's are not usually out of place. If they are this is more an emergency and is treated medically. Think broken bones, dislocated joints etc. Usually what has happened is someone has lost flexibility at a joint. Dowagers humps usually have loss of upper thoracic extension. Look for our step 1 to thoracic extension video. Scalenes are also a breathing muscle and generally perform side flexion. Have a look at our breathing videos and side plank videos.
This exercise only works if the arm and shoulder on the floor are positioned very precisely. Even a slight misalignment prevents it from being effective. Unfortunately, this crucial detail isn't mentioned in the video. The level of precision required can't be inferred just by watching. Could you please provide a more detailed video of this exercise, showing exactly how it should be done? This information is essential for performing the exercise correctly, as without it, success is likely to be rare and accidental.
Respectfully, you may be over thinking this. The exercise is about lifting your head and neck up and lowering it down. One's back and shoulder flexibility may dictate comfort of the position, but does not determine success. Maybe I'll understand what you're alluding to differently if you could please elaborate more on the precision of arm and shoulder position. Happy to clarify things!
@@theMSKphysio I appreciate your effort in providing this exercise. However, I believe there might be some challenges that aren't immediately apparent. Since you don't personally need this exercise, it's understandable that you might not be aware of some of the difficulties patients face. If I may suggest, before introducing a new exercise, it could be beneficial to: - Have patients try to replicate the exercise exactly. (For instance, I've struggled to match your demonstration despite numerous attempts, and even four of my friends in good health couldn't replicate it after trying for several minutes, with a camera as feedback). - Identify common mistakes and consider anatomical variations: What aspects do people find challenging when attempting the exercise? How might individual physical differences affect the exercise performance? (E.g., variations in shoulder width or mobility, in chest shape (e.g., V-shaped vs. barrel-chested), spine curvature or flexibility...). Are there ways to modify the exercise to accommodate these variations while maintaining its effectiveness? - Assess the exercise's effectiveness: Even when I manage to perform it correctly (I know because I'm either helped by a friend or recording a video), I haven't experienced pain relief. It would be helpful to understand why this might be the case. - Fine-tune the technique: If the exercise is only effective sometimes, it would be invaluable to explore the various factors at play (such as shoulder placement on the floor). Understanding these nuances could help develop a method that yields consistent results. [I hope you don't mind this feedback. While this particular exercise hasn't worked for me (in a few weeks or months of intense daily practice, I know I'll eventually find the solution), my intention is to offer insights that might help enhance your practice and enable you to assist others more effectively in the future. I thank you for the invaluable help you've provided in my journey towards healing.]
Thanks. I appreciate your enthusiasm. The nuances you are highlighting are definitely important and are the type of pieces that are addressed in face to face appointments with patients. This is one of the limitations of TH-cam.
Hi i do this exercise now for 5 months and its increase the pain that i have. They say that the scalenes are too weak thats the reason of the pain. And that stretching would the problem more worse…
Hi Dimitrios. If something is leading to you experiencing more pain then it is always a good idea to stop and reassess. Many things can influence the pain you experience. If you have tried the exercise and it has not helped, you likely need to look at other factors. We are unable to give you that guidance over TH-cam and encourage you to get a second opinion with a local health professional!
Is it possible that my scalenes need to be strengthen instead of stretching to get rid of TOS symptoms? Stretching doesnt work for me for over 1 year. Everyone told me that my muscles are too big because of training in the gym so I have to stretch them
Hi there! TOS is multifactorial, meaning that there is typically 2+ things going on. Some people have some structural contributions. Others are more functional in nature (muscles, joint position, habits etc). It requires a thorough assessment to identify what that individual needs. Yes, your scalenes may require some strengthening. We don't know until you test your strength and find out if they are truly weak. Other common functional contributors to TOS are upper thoracic flexibility and breathing skill/habits. I'd check out the entry level thoracic extension videos and breathing flexibility videos too :)
![เจ็บที่ยังฮัก - ม่อน วรวิทย์ [ Official Mv ] จอนนี่มิวสิค](http://i.ytimg.com/vi/KALIGSRSjFs/mqdefault.jpg)
5:14 exercise commences
Some safety considerations beforehand 😊
I have added chapters 👍
Fair question and your points are completely accurate. For the majority of people this exercise is completely safe. TH-cam is a general population and so I need to cast a wide safety net. Those at risk will be people with peripheral vascular disease, vertebrobasilar artery issues etc.
@Sylorinnis any update as the usefulness with this exercise for TOS?
@@Sylorinnis apologies, I never responded! Yes, Kjetil and I have had some similar education. Hence the potential crossover. The dizziness may well be because of mild hyper perfusion. The exercise will also challenge the vestibular system and for some, this may be a novel stimulus. Additionally, dizziness can come from the upper cervical spine, another region challenged by this exercise. In essence, it can be multi-factorial. If the dizziness persists or worsens I'd encourage seeking local help for an in-person assessment.
I personally don't experience dizziness while doing this exercise.
I like how properly you explain things, there's certain things people need to know wen exercising the neck and its good that your so clear about that. You have really good vibes, I'm glad I found your channel.
Thanks so much for the feedback mate! Glad you're enjoying the content 🤗
Yes!! I agree. You have the best explanations 🙌🏼 and transmit so much calmness too 😅 I love your page! Thank you for all that you do for us to learn
I found this very helpful. I really appreciated the caveats at the beginning. These muscles are fragile and need to be built slowly and perhaps checked with your doctor. But I followed your instructions and felt it really helped me ... a lot. Thank you for making this video!
Glad you found it helpful!
Yes, while very rare, it's important to put some safety netting in place.
Excellent video with thorough instructions. Thank you for sharing.
Thank you!
Thanks for this video. 12 reps and it finally didn't feel like bone and actually a muscle. 2 more sets of 30 n I felt sick n dizzy 5 minutes later I can move without feeling like I'm been choked out n collapsing 😅.hope you have a posterior vid too
Take it easy!! :). Try 3x5-15 to start. See comment on the other video re posterior scalene.
@@theMSKphysio lol yea neck tight again now haha.i like to push it to extreme but will spread out the reps through out days to make easier from now on. Thanks again.
This is a good exercise if you have atrophy from Spinal Accessory Nerve Palsy. I am 1 year and 2 months into my recovery and I still have some atrophy above my clavicle. The muscles in that area are not as strong as on my left side.
I did not find any study about this specific exercise, nor anyone talking about it. Could you please tell us where you found it (who taught you, what it's called) to get more information about it?
What information are you hoping to find? What exactly were you searching for? It's unlikely to find many research articles focusing on a singular exercise.
The exercise is based off of manual muscle testing positions that align an origin and insertion of a muscle by their fiber orientations.
The premise of improving interfacing with nerves comes from theoretical work around neurodynamics.
While not the only resource to consider for this exercise, this physiopedia page covers some of the above - www.physio-pedia.com/Scalene
Let me know if I can help further.
@@theMSKphysio I couldn't find any mention of this specific exercise on your link. Am I wrong? It's true that "it's unlikely to find many research articles focusing on a singular exercise," but I'm not asking for many, just a single one. Most (not all) exercises have been tested at least once (some many times). It's fine if you personally invented it without testing it in a study; I'm just curious to know who invented it (that's actually the information I'm looking for). If not, please tell us where you found it, who taught you, and what it's called. Thanks!
@@yop109 I understand what you are asking for and I appreciate your curiosity.
There isn't a singular study that I have been able to find focusing exclusively on anterior scalene strengthening. I have looked through many databases.
I am trying to tell you that the exercise derives from an eclectic mix. My personal studies and teaching roles (which you can find on my website), play a part here. So do the below influences.
I have explained in my previous reply that the exercise is based off manual muscle testing positions that align an origin and insertion of a muscle by their fibre orientations. On the link supplied there is a picture from the section on manual muscle testing where the patient is in supine and the force vector is the same as in this exercise.
Exercises don't really get invented. They are based off of principles and theories and you get different flavors depending on what an individual is hoping to achieve.
To satisfy your curiosity I encourage you to look through the various texts on manual muscle testing:
Amazon search here - www.amazon.com/s?k=manual+muscle+testing&crid=3F7P3MP8BUTG8&sprefix=manual+muscle+test%2Caps%2C352&ref=nb_sb_noss_1
There are also articles investigating various forms of testing. Here are a couple from a quick search:
doi.org/10.1016/j.jbmt.2010.11.001
www.jospt.org/doi/pdf/10.2519/jospt.2002.32.10.488
If you have other specific questions I can help with, please do ask.
I notice you don't lower your head down to the ground when moving your eye socket away from the shoulder. What are your thoughts on lowering the head back until it slightly touches the ground, with a slight pause while holding the head off the ground? Any dangers or cons to this? I feel like I get a heavier workout as its a heavier lift and more range to cover.
@ReelEC nice pick up. As you've noted, just increased effort/work. No dangers in most cases. If one has a history of neck related structural injury, neurological or vascular compromise I'd encourage checking in with a local professional 😊.
@theMSKphysio Thanks for your swift response, and thanks for posting this exercise as well. It is a rare find. People typically recommend supine chin tucks for scalenes or isometric side head presses and lateral neck flexion, but this exercise you recommended works them better as well as traps and levator scap potentially.
Can it be done twice a day ie 14 times a week?
It really depends on your tissue tolerance. For anyone with a lack of tissue tolerance I would suggest 1-2x/week!
@@theMSKphysio so the thing is I have this chronic sort of spasm behind the ear and upper neck on the left side and weakness in the shoulder blade and feel like a constant pulling sensation in the front part and side of neck down towards the rib.can tight scalenes be a reason ? I have done mris and nothing came out .
A tight scalene could be contributing. Functional issues don't always show on on imaging. For example a muscle would have to look smaller to be relevant on imaging. Even then a smaller muscle may not mean it is an issue functionally. This is just an example.
Ultimately, test both sides, and if your symptomatic side is harder then try the exercise for 3-6 weeks. Most exercises (if they are going to), have benefit after 8-12 exposures. Less is more though! Especially if there is irritable tissue.
Try checking out some shoulder blade exercises like this - th-cam.com/video/zmZpAA0QHIc/w-d-xo.html
@@theMSKphysio thanks
Hello Dr.
so I have costochondritis they say. My pain originated at my lovely dowagers hump back in October. By December anytime I laid down on my bed for longer than a half of an hour that dowagers hump area and my traps would start burning and tingling until I sat back up! The tingling has since stopped I’m not sure what made it stop but it’s no longer there. Occasionally my upper traps will feel tingly though.
The pain/stiffness then went on to my ribs the following weeks and my chest.
My scalene‘s are also jacked up and super tight especially on the right side not to mention my upper traps feel like they are constantly engaged!
Do you happen to know whether or not the pain from that hump can also cause pain in the ribs a.k.a. costochondritis?
One thing I also noticed was in the beginning when my scaling‘s were very tight and irritated the right side of my throat was also slightly swollen…
My chest ribs feel like they are locked. How can I tell if I have a rib out of place or if I truly have costochondritis?
Hi there. Sounds very uncomfortable! It is impossible to give you specifics over TH-cam without an assessment. That being said, joint's are not usually out of place. If they are this is more an emergency and is treated medically. Think broken bones, dislocated joints etc. Usually what has happened is someone has lost flexibility at a joint.
Dowagers humps usually have loss of upper thoracic extension. Look for our step 1 to thoracic extension video. Scalenes are also a breathing muscle and generally perform side flexion. Have a look at our breathing videos and side plank videos.
This exercise only works if the arm and shoulder on the floor are positioned very precisely. Even a slight misalignment prevents it from being effective. Unfortunately, this crucial detail isn't mentioned in the video. The level of precision required can't be inferred just by watching. Could you please provide a more detailed video of this exercise, showing exactly how it should be done? This information is essential for performing the exercise correctly, as without it, success is likely to be rare and accidental.
Respectfully, you may be over thinking this. The exercise is about lifting your head and neck up and lowering it down. One's back and shoulder flexibility may dictate comfort of the position, but does not determine success.
Maybe I'll understand what you're alluding to differently if you could please elaborate more on the precision of arm and shoulder position. Happy to clarify things!
@@theMSKphysio I appreciate your effort in providing this exercise. However, I believe there might be some challenges that aren't immediately apparent. Since you don't personally need this exercise, it's understandable that you might not be aware of some of the difficulties patients face. If I may suggest, before introducing a new exercise, it could be beneficial to:
- Have patients try to replicate the exercise exactly. (For instance, I've struggled to match your demonstration despite numerous attempts, and even four of my friends in good health couldn't replicate it after trying for several minutes, with a camera as feedback).
- Identify common mistakes and consider anatomical variations:
What aspects do people find challenging when attempting the exercise?
How might individual physical differences affect the exercise performance? (E.g., variations in shoulder width or mobility, in chest shape (e.g., V-shaped vs. barrel-chested), spine curvature or flexibility...). Are there ways to modify the exercise to accommodate these variations while maintaining its effectiveness?
- Assess the exercise's effectiveness: Even when I manage to perform it correctly (I know because I'm either helped by a friend or recording a video), I haven't experienced pain relief. It would be helpful to understand why this might be the case.
- Fine-tune the technique: If the exercise is only effective sometimes, it would be invaluable to explore the various factors at play (such as shoulder placement on the floor). Understanding these nuances could help develop a method that yields consistent results.
[I hope you don't mind this feedback. While this particular exercise hasn't worked for me (in a few weeks or months of intense daily practice, I know I'll eventually find the solution), my intention is to offer insights that might help enhance your practice and enable you to assist others more effectively in the future. I thank you for the invaluable help you've provided in my journey towards healing.]
Thanks. I appreciate your enthusiasm. The nuances you are highlighting are definitely important and are the type of pieces that are addressed in face to face appointments with patients. This is one of the limitations of TH-cam.
Hi i do this exercise now for 5 months and its increase the pain that i have.
They say that the scalenes are too weak thats the reason of the pain. And that stretching would the problem more worse…
Hi Dimitrios. If something is leading to you experiencing more pain then it is always a good idea to stop and reassess. Many things can influence the pain you experience. If you have tried the exercise and it has not helped, you likely need to look at other factors. We are unable to give you that guidance over TH-cam and encourage you to get a second opinion with a local health professional!
You have to do it in very few reps like 5 or less and twice a week , if you do much more you will hurt yourself
do less reps. 2x week , 3 - 5 reps
@@davidcayjohnston4165 yes i tried it and it works ❤️
@@davidcayjohnston4165 Are you strengthening them because of TOS?
Is it possible that my scalenes need to be strengthen instead of stretching to get rid of TOS symptoms? Stretching doesnt work for me for over 1 year. Everyone told me that my muscles are too big because of training in the gym so I have to stretch them
Hi there! TOS is multifactorial, meaning that there is typically 2+ things going on. Some people have some structural contributions. Others are more functional in nature (muscles, joint position, habits etc). It requires a thorough assessment to identify what that individual needs.
Yes, your scalenes may require some strengthening. We don't know until you test your strength and find out if they are truly weak. Other common functional contributors to TOS are upper thoracic flexibility and breathing skill/habits.
I'd check out the entry level thoracic extension videos and breathing flexibility videos too :)