Middle Scalenes
Region
Origin & Insertion
['Origin: Transverse processes of C2–C7', 'Insertion: Upper surface of 1st rib behind subclavian artery groove']
Synergistic Muscles
['Anterior and Posterior Scalenes']
Joints
['Cervical vertebrae C2–C7']
Primary Actions
['Elevates 1st rib', 'Lateral neck flexion']
Nerve & Spinal Segment
Cervical spinal nerves C3–C8
Cervical and brachial plexus
Interesting
Largest and longest scalene. Assists in deep breathing. [Moore's]
Reversal of Action
Elevates 1st rib with neck stabilized
Common Dysfunctions
Neck stiffness, upper extremity tingling
How to Stretch
Side bend neck away, pull shoulder down.
Trigger Points
How to Strengthen
Lateral neck resistance drills.
Concentric Action
Laterally flex neck
Applications:
Stretches useful in reducing brachial plexus compression
Eccentric Action
Control return from side bend
Isotonic Action
Band resisted side bending
Related Conditions
['Thoracic Outlet Syndrome', 'Brachial neuralgia']
Isometric Action
Hold neutral position against lateral resistance
Exercise Ideas
['Side neck holds', '1st rib depressions', 'Neck stabilization drills']