By David Lauterstein

Did you know the scalenes are actually the uppermost of the intercostal muscles?  Yes!

The intercostals lie between your ribs and assist inhalation and exhalation.  Of course, there are no ribs in the neck!  However, a number of books note that the scalenes attach to the vestigial ribs of the cervical vertebrae.  That is, in our embryological development 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 the neck?  Yet scalenes do have a very important respiratory function.  They, interesting enough, live right where the gills would be.

Many books consider the scalenes, next to the diaphragm, the second most important muscles of respiration.  The scalenes move the ribcage from above, while the 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 throat chakra.  The head forward posture therefore may arise from sadness, self-esteem issues, chronic fear, reactions to recent stress, or long-held defeats.  Inhibitions to speak one’s mind or heart may also manifest in the scalenes.

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 of your left hand, assisted by your other fingers, near the origin of the sternocleidomastoid, just above the sternal end of the clavicle.  Take out the looseness.   THROUGHOUT THIS TECHNIQUE IT WILL BE BETTER TO USE LESS, RATHER THAN MORE PRESSURE.  HONOR THE DELICACY OF THE MUSCLES AND VESSELS HERE!

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.

Now 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.

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The poet Rumi said, “Loosen the knot of greed so tight around your neck!”  I say at least loosen the scalenes!  Then you may notice a strikingly more balanced relationship between mind, body and breath.




  • The word “fulcrum” in Deep Massage: Lauterstein Method and Zero Balancing denotes a technique through which, like the balance point of a see-saw, clear touch can help the client come into a higher state of structural and energetic balance.  For more information, see The Deep Massage Book p.15-23.


Join David in a workshop on Deep Massage on September 28, 29, and 30, 2012 at the Downeast School of Massage, in Waldoboro, ME. See for details under continuing education.