Sternocleidomastoid: Pain & Trigger Points

The sternocleidomastoid is the prevailing muscle on both sides of the neck. If it is tense or carries trigger points, it can trigger pain in the head, ear, eye and face.

Fortunately, it is possible to relieve the pain with a self-massage.

If you also work the other muscles that are potentially responsible for your symptom, it is possible to completely relieve it.

All you need is, beside your fingers, the willingness to practice the massage with some patience and to “re-discover” your body.

1. Pain Patterns & Symptoms

If the muscle is tense, it is usually sensitive to pressure. If it has active trigger points, the pain may also extend into the region of the head.

As the muscle consists of two separate muscle heads, it can cause pain in different areas.

1.1 Pain patterns of the sternal part

The sternal part of the muscle can cause pain in the temple, cheek and eye. In addition, it often sends pain to the back of the head and to the top of the head.

Because of the latter characteristics it can be involved in ….

Click on the respective link to find out what you can do yourself against these headaches and learn about other muscles potentially causing the same pain.

1.2 Pain patterns of the clavicular part

The clavicular part of the muscle, i.e. the part that originates from the collarbone, causes pain mainly in the ear and forehead.

If you have a headache on your forehead, just click on the link below.

These may be of muscular origin and can be relieved by yourself.

Note: The muscle often sends the pain to the opposite side of your forehead. Thus, it makes sense to examine it on both sides of the neck.

1.3 Symptoms and complaints

In addition to the pain described above, trigger points in the sternocleidomastoid can also contribute to the following symptoms and ailments….

  • Feeling of soreness on the side of the neck.
  • Watering eye on the affected side.
  • Visual disorders – e.g.: blurred vision, double vision
  • Vertigo (balance issues) and dizziness
  • Nausea

2. Attachment Points

The sternocleidomastoid consists of two muscles, both of which have the same insertion, but different origins.

Both insert at the back of your head, but originate on the collarbone – clavicular part – and breastbone – sternal part – of the respective side.

Latin names of the attachment points

Origin

  • Caput laterale/clavicular part: Middle third of the clavicle.
  • Caput mediale/sternal part: Manubrium sterni of the sternum

Insertion

  • Processus mastoideus of the os temporale & lateral side of the linae nuchae superior of the os occipitale.

Innervation

  • The muscle is innervated by the nervus accessorius and branches of the cervical plexus (C1 – C3/4)

3. Function

Concerning the function of the sternocleidomastoid, we distinguish whether the muscles work on both sides of the neck – bilaterally – or only on one side – unilaterally –

Bilateral contraction provides the following movements:

  • Flexion of the cervical spine: chin tilted forwards
  • Stabilization of the cervical spine during extension
  • Accessory muscle of respiration (inhalation)
  • Spatial orientation
hals-flexion
1

Neck Flexion

hals-extension
2

Neck Extension

Unilateral contraction provides the following movements

  • Head rotation to the contralateral/opposite side and extension of the cervical spine
  • Flexion of the cervical spine to the side, i.e. the ear approaches to the shoulder
  • Compensation of head tilting that would occur due to scoliosis, difference in leg length etc.
hals-extension-rotation
1

Neck Rotation & Extension

hals-lateralflexion-2
2

Neck lateral Flexion

4. Sternocleidomastoid: Trigger Point Activation

The sternocleidomastoid gets tense and develops trigger points especially when it is constantly (or for longer periods of time) kept in a shortened or stretched position. That can happen frequently in your everyday life.

You may recognize yourself in one of the following examples

  • Telephone tucked between ear and shoulder.
  • Head turned to the side to talk to someone
  • Head tilted backwards -painting, climbing –

5. Palpation

It is difficult to read and pronounce the name of this muscle, but it is easy to feel and massage it!

Note: If you feel a pulse while palpating or massaging the sternocleidomastoid, then you have “caught” your cervical artery.

It’s all right, if you don’t massage it and squeeze it constantly. Just let go and try to grab the muscle again, this time without the artery.

Feeling the sternal part

sternocleidomastoideus-sehne-palpation
1

Place one of your fingers on the upper end of your sternum and try to feel the tendon of the muscle.

If you move your finger to the right and left, you can feel it jumping back and forth under your finger.

Now grasp the tendon with a pincer grip and feel the course of the muscle upwards to the back of your head.

sternocleidomastoideus-pars-sternalis-palpation
2

On the first few centimeters, you will only feel its tendon, which will then merge into the muscle.

Note: It’s very easy to feel the "middle part" of the muscle, because you can pull it away from your neck. This is also very convenient for you during the massage.

Feeling the clavicular part

sternocleidomastoideus-pars-clavicularis-fuehlen
1

You will find the clavicular part of the muscle a little further on the side of your neck.

This part is not so easy to pull away from the neck and it is covered by the sternal part from about half on, which will make the palpation and massage a bit more difficult.

Nevertheless, this division can still be felt quite well.

Place your fingers on your collarbone, about 2 centimeters from the tendon you have just palpated on your sternum.

sternocleidomastoideus-pars-clavicularis
2

Now try again to grab the muscle at the side of your neck with a pincer grip.

As soon as you have found it, follow its course. After a few centimeters, it gets covered by the sternal part, which is why it’s "impossible" to feel it further up.

6. Self-massage of the Sternocleidomastoid

For the massage, I recommend the thumb-indexfinger-technique, with which you can massage the sternocleidomastoid between your fingers.

  • Examine both parts of the muscle throughout their length for painful points by rolling them between your fingers.
  • Massage each sensitive point approx. 5 – 10 times, depending on your pain tolerance.

I recommend starting the massage slowly and with care, observing the reactions of your body.

My personal experience is, as well as many persons’ experience with whom I worked so far, that the massage of the sternocleidomastoid is very unpleasant.

My tip: Repeat the massage until you find no more painful points.

This may take a few weeks, but you will not regret it. Anyway, it does not take longer than a few minutes to massage the muscle.

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print