
- Thoracic Outlet Syndrom (TOS).
- Carpal Tunnel Syndrome.
- C5-C6 radiculopathy.
- C4, C5, and C6 articular dysfunctions.
- Articular dysfunction that involves elevation of the first rib.

- Pulling or lifting, as when hauling roes in sailing.
- Handling and riding hoarses.
- Tug-of-war.
- Competitive swimming.
- Carrying awkwardly large objects.
- Certain musical instruments.
- Paradoxical breathing (chest breathing)
- Sleeping in a bed where the head of the bed is lower than the foot – may happen with a thick rug under the foot of the bed.
- Short upper arms*
- Whiplash accident.
- Severe limping will perpetuate scalene TrPs since the muscles in the neck will contract severely to help movement while walking.
*Short upper arms occur when the elbows of a person are not long enough to reach their iliac crests (the upper aspect of the hip bone) when standing. Short upper arms are characteristic of Native American body structure, but not limited to that race. This condition perpetuates TrPs in the shoulder girdle by placing undue stress on shoulder elevator muscles.

- Paradoxical (chest) breathers should learn diaphragmatic breathing.
- Avoid carrying heavy and awkward packages.
- Avoid strenuous tugging.
- Be aware of stress and stressful situations that will cause a person to unconsciously raise their shoulders. This is the “stressed out” position.
- Use the unaffected arm to talk on the telephone or use a headset for hands free conversing.
- The head of the bed may be elevated 3-3.5 inches by placing telephone books under the legs of the head of the bed. Blocks should be avoided as they allow the bed to slip off.
- Keeping the neck and body warm is very effective to reduce muscle irritability. Use of a scarf helps to avoid cold drafts while outside in cold climates. A scarf may also be used in drafty bedrooms and is extremely useful during airplane flights.
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References :
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.
Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.
This information is not intended to diagnose, treat, or cure any disease.
A proper diagnosis should be sought from a licensed health care provider. |