*Evidence-Based Reviewed Article
There’s a lot of discussion on the cervical spine related to neck pain and tech neck. Something that we need to think about regarding pain and dysfunction of the neck are the way the muscles of the neck are attached and how they function. One of the main culprit muscles of the neck is the sternocleidomastoid (2).
This muscle is quite prominent in the front and sides of the neck, especially when someone turns their head. The SCM can often be related to general head and neck pain, including migraine headaches. (4)
What does Sternocleidomastoid muscle mean?The name Sternocleidomastoid breaks down into root words that describe the location of the muscle. The first part of the word, sterno, comes from the Latin word “sternon” which relates to the sternum (the breastbone). The second part of the word, cleido, means clavicle, which is the collarbone. The last part of the word, mastoid, comes from the Greek word “mastos” which means breast shaped. In this case it refers to a large bony protuberance just behind the ear, called the mastoid process. You could put all that together to get a muscle that attaches onto the sternum, clavicle and mastoid process.
Where do the Sternocleidomastoid muscles attach?
ORIGIN: The Sternocleidomastoid muscles originate on the manubrium of the sternum, which is a small handle-like bony area of the breastbone and on the medial clavicle (collarbone). (1)
INSERTION: They insert on the mastoid process, which is a large bony protuberance behind the ear. (1)
What actions do the Sternocleidomastoid muscles do?
The sternocleidomastoid muscles work bilaterally (meaning both sides together) to flex the neck. The sternocleidomastoid muscles work unilaterally (one side at a time) to do rotation of the neck to the opposite side and lateral flexion of the neck to the same side. (Bordoni)
However, in the case of SCM, because the muscles work independently, using one side to rotate the head in the opposite direction means that the muscle on the side that you are rotating to is getting lengthened. The same is true of lateral flexion. If I tilt my head to the right, the left side of my SCM is getting stretched. Since the sternocleidomastoid muscles on both sides work to flex the neck, extending the neck will lengthen both sides of the SCM simultaneously.
In addition to the movements initiated by the sternocleidomastoid muscles, they also serve an important function in stabilizing the neck as it attaches at the sternum, the clavicular and the mastoid process. The way this muscle is attached and the movements it creates, both simultaneously and independently, make it extremely difficult when it comes to lengthening because this muscle in particular creates pressure and compression from the skull through the cervical spine and into the shoulder girdle. (3)
In order to manipulate this muscle to relax movement of the head is required. You will need to both lengthen and shorten it in order to squeeeze and reach the belly and its attachments. In order to do this rotate your head toward one side and tip it forward you’ll be able to grab onto this long muscle most easily here. When massaging it be sure to do so at both the belly and at it's attachments sites. You will quickly notice where you are extremely tight.
Excessive contraction and spasm of the SCM creates more pressure on the spinal accessory nerve. (2) I have found that both milking the muscle and stretching while focusing on breath work has been the best way to increase blood flow while decrease tensions and compression on the nerves that result in pain.
When you work on your SCM my advice is to do a little bit of work for at least 5 to 8 breaths, or 30 seconds, switch sides, and then repeat. This allows the muscle to relax and will also give you the ability to create lasting relief.
For a video on how to stretch the lateral neck utilizing breath, click the button below.
Sources
Bordoni, Bruno, Felix Jozsa, and Matthew Varacallo. "Anatomy, head and neck, sternocleidomastoid muscle." StatPearls [Internet]. StatPearls Publishing, 2023.
Büyükturan, Buket, et al. "The effects of combined sternocleidomastoid muscle stretching and massage on pain, disability, endurance, kinesiophobia, and range of motion in individuals with chronic neck pain: A randomized, single-blind study." Musculoskeletal Science and Practice 55 (2021): 102417.
Cheng, C. H., et al. "The effects of disc degeneration and muscle dysfunction on cervical spine stability from a biomechanical study." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 225.2 (2011): 149-157.
Rezaeian, Tahere, et al. "The impact of soft tissue techniques in the management of migraine headache: A randomized controlled trial." Journal of Chiropractic Medicine 18.4 (2019): 243-252.
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