Monday, 29 September 2008

The Scalene Muscles

We've had one weekend back at Oxford Brookes and have dived straight into the anatomy of the neck, which on first look is quite a tricky area as there is literally so much happening in this region. The support and movement of the head is obviously extremely complex so the structure of the muscles of the neck along with the related viscera can be quite involved...

The scalene muscles are key movement and positioning muscles and have significant clinical importance. I have already seen this first hand in clinic and worked to reduce hypertonicity in these muscles to relieve symptoms radiating into the upper extremity.

Anatomy of the Scalene Muscles.
There are 3 scalene muscles in either side of the anterior neck: the anterior scalene, the middle scalene and posterior scalene.

The anterior scalene arises from the anterior tubercles of the transverse processes of the C3 to C6 vertebrae and extends down the anterior neck to attach to scalene tubercle on the inner border of the first rib. It is innervated by the ventral rami of cervical nerves C5 to C7.

The middle scalene sits posterior to the anterior scalene and arises from the posterior tubercles of the TPs of C2 to C7, attaching to the upper surface of the first rib, behind the groove for the subclavian artery. It is innervated by the ventral rami of cervical nerves C3-C8.

The third of the scalene muscles, the posterior scalene arises from the posterior tubercles of the TPs of C5 to C7 and attaches to the outer surface of the second rib. The innervation of this muscle comes from the ventral rami of cervical nerves C7 and C8.

Primarily the scalenes are a muscle of breathing, elevating the upper ribs in deep inspiration but they also flex the neck when they act together. Individually they laterally flex and rotate the neck.

Of clinical interest, the brachial plexus and subclavian artery pass between the anterior and middle scalenes whilst the subclavian vein sits anterior to the anterior scalene. Tightness or spasm of the scalenes can cause compression on these structures contributing to Thoracic Outlet Syndrome, resulting in symptoms such as:

- numbness of whole arm and hand which can be constant or intermittent
- deep ache or pain into arms and/or shoulders
- pain can be worse in bed causing a disruption to sleep patterns
- feeling of the circulation to the arm being cut off
- if the circulation becomes restricted, the hands and fingers can become white and even blue and feel cold
- tight muscles in the neck can also lead to compression of the vertebrae making the neck stiff and difficult to tilt or rotate
- extreme tightness of the scalenes may also cause the upper ribs to be elevated affecting breathing

Luckily, treating tight scalenes is possible using manual techniques... but that's another post for another day!

Monday, 22 September 2008

Cryogel back in stock!

Just a quick note to say that I'm fully stocked up with Cryogel again so if you're looking for 120g tubes of blue, green or lavendar formula just visit the Buy Cryogel page on my main site. Tubes are £7.95 each.

Or if you want to try Cryogel out for free, I alse have Free Cryogel Samples available. You just pay postage and get a couple of freebies to be getting on with. I'm sure you'll be as impressed as I was when I first used it.


Thursday, 18 September 2008

Reflections at the start of the second year

I start the second year of my osteopathy degree at Oxford Brookes University on Saturday and thought I'd spend 5 minutes reflecting on the first year and preparing for Year 2.

Overall, I think the experience has been a very positive one, stressful at times, exciting at others but always interesting and thought provoking. The subject itself is immense and working alongside some of the tutors, particularly in clinic has really opened my eyes to what can be achieved and what level of knowledge can be gained. Very inspirational indeed.

My overriding memory of the first year though is the amount of time and effort it has taken to get through the year and pass all the exams. I've been lucky in that probably 60-70% of the content has been revision from my studies at the Midlands School of Massage here in Nottingham but even that has been hard work sustaining and growing upon what was already 'in there'.

I'm expecting the second year to be an extension of Year 1 but also anticipating the level to elevate as we get deeper into certain subjects. The nervous system, anatomy of the head and in particular the dreaded cranial nerves all appear this year so I anticipate that this will be a generally harder year with more expectation in clinic and tougher coursework (not to mention exams...). That said, I've been exposed to some very complex ideas already and can't be afraid to go even deeper.

Fingers crossed that this time next year I'll be writing a very similar blog post, looking forward to Year 3. But let's not jump too far ahead...!

Tuesday, 16 September 2008

Building an online reputation

An interesting thing that I've recently noticed is that the more popular your blog or website, the more people are interested in either advertising with you or asking for links back. I've been getting a lot of interest from sites in the USA and Europe and even as far afield as Australia!

One such site is Cliffside Malibu, a drug rehab center in Malibu, USA. Its a good looking site in a very slick, American way but does actually offer a lot of interesting information both about Drug Rehabilitation and Drug Treatment. We've not covered much about addiction and its effect on the body and psyche but I'm hoping we're go into it in a bit more depth in years 2 and beyond as I personally think it's a very interestinf subject.

Talking of which, back to Oxford this weekend for Year 2! I'm looking forward to it in a way but will miss all my free time at evenings and weekends... never mind!!