Tony Fox, PT, DPT, CMTPT – Instructor
Brazilian Jiu Jitsu player (BJJP): “I’ve got a lot of pain in my back by my shoulder blade and my arm hurts down to my hand. It started a couple hours after training, but I didn’t get hurt.”
Me: “Did someone get your shoulder in a submission?”
BJJP: “No.”
Me: “Did you twist your neck weird during a scramble?”
BJJP: “No.”
Me: “Did you get choked?”
BJJP: ……
Me: ……
BJJP: “… I got choked… a lot… we worked chokes during drills.”
Me: “Got it. Let’s check you out.”
One way muscles can develop trigger points is through direct trauma. Getting caught in a choke during active grappling or the repeated choking that occurs during drilling can cause direct trauma to one of my favorite muscles to treat, the scalenes. I love treating the scalenes because of their clinically significant referral pattern, which can be of myogenic, neurogenic, or vascular origin.
Trigger points in the scalenes muscles can cause a patient’s specific pain complaint or have a biomechanical impact on the muscles that may lead to a brachial plexus neural tension dysfunction. Oftentimes, it is a combination of both.
I’ve had great results treating patients with this presentation through dry needling or manual release of the scalenes muscles, followed by a home program of scalene stretching and brachial plexus nerve gliding exercises.
Bonus Pearl: Choking causes similar trauma to the SCM. How would SCM trigger points present differently?
Photo by freetime Jam on Unsplash