TRIGGER POINT OF THE WEEK – SUBCLAVIUS
The Subclavius is a small and often forgotten muscle but, as you can see from its extensive pain map, it is an important area for trigger point pain. The Subclavius depresses the shoulder, carrying it downward and forward. It draws the clavicle inferiorly as well as anteriorly. The Subclavius protects the underlying brachial plexus and subclavian vessels from a broken clavicle - the most frequently broken long bone. The pain map for trigger points in the Subclavius muscle is referred to the ipsilateral Biceps Brachii and lateral forearm. Locally pain will be experienced just below the clavicle. Pain may be felt as pins and needles in the arm, shoulder, and hand. The pain typically bypasses the elbow and wrist, and runs to the radial half of the hand, thumb, and middle finger.
In our experience trigger points in the Subclavius muscle are often implicated in complex regional pain syndrome CRPS of the upper extremity (used to be called reflex sympathetic dystrophy). This rare but extremely debilitating condition can get so bad that sometimes the limb needs to be amputated! Often, low grade CRPS is associated with some cases of adhesive capsulitis (about 3%). Treating trigger points in the Subclavius muscle (and the Scalenes and sternocleidomastoid) may really have a significant impact on improving CRPS – especially if it’s not too advanced.
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.