Sternocleidomastoid Referred Pain Pattern

Sternocleidomastoid Muscle (SCM): Trigger Point Pain

The sternocleidomastoid muscles (SCM) are the large ropey muscle located toward the front and side of the neck. One of the muscles’ functions is to stabilize the head, not allowing it to fall too far forward or backward. The SCM muscle is not painful unless touched or pressed. However, the muscle is notorious for referring pain in many areas of the head.
The muscles attach to the mastoid bone behind the ear and split into two heads, one connecting to the collarbone (clavicle) and the other attaching to the breastbone (sternum). Each connection contributes to different pain and symptoms.
Contents of Article

    Advertisement




    Sternocleidomastoid Muscle

    Where is the Sternocleidomastoid Muscle?

    The Sternocleidomastoid (SCM) muscles are the two big ropey muscles located at the front of the neck. They attach behind the ear (mastoid) and run down the front of the neck where they split into two heads. One head attaches to the collarbone (clavicle) and the other head attaches to the breastbone (sternum) at the base of your throat.

    What Movements Does It Control?

    • Bends the neck and head forward, bringing chin to chest
    • Bends the neck sideways, bringing ear to shoulder
    • Turns the head side to side
    • Stabilizes head (as a “check-rein) when tilting chin upward or extending head backward
    • Assists in chewing and swallowing

     For detailed anatomy information: Sternocleidomastoid Anatomy Page

    What pain and symptoms are associated with the sternocleidomastoid muscle?

    1. Sternal Division – This is the muscle head that connects to the breastbone (sternum).
    • Pain may be felt in these areas:
      • Cheek and jaw
      • Sinuses
      • Back of head at the bottom of the skull
      • Around one eye
      • Top of head
    • May also be associated with these symptoms:
      • Tearing of eye
      • Visual disturbances when viewing parallel lines
      • Chronic “sore throat” when swallowing,
      • Chronic dry cough.
     2. Clavicular Division – This is the muscle head that connects to the collarbone (clavicle).
    • Symptoms:
      • Pain across the forehead
      • Sinus-like headache
      • Earache
      • Nausea
      • Dizziness
      • Car-sickness
      • Faulty weight perception of held objects
      • Hearing loss in one ear

    TWD Recommends

    SCM tightness and pain responds well to hot and cold treatments. The Huggaroo Neck Wrap treats the neck, top of the shoulder, and upper back. Use hot or cold.

    What causes trigger points in the sternocleidomastoid muscle?

    Whiplash

    Whiplash affects most of the muscles of the neck and the forceful whipping of the head forward and backward or side to side is especially detrimental to the SCM muscle. If you have ever suffered a whiplash injury, even if it was years ago, you should check the muscle for trigger points.

    Incorrect Breathing and Respiratory Problems

    Chest breathing also known as shallow breathing overworks many neck and chest muscles including the SCM. When breathing your abdomen should expand while inhaling and relax when exhaling. If breathing movement is in the chest you need to concentrate on taking deep breaths until the abdomen expands. Keep practicing until this becomes a habit.

    If you have asthma, COPD, or develop bronchitis or pneumonia you may develop TrPs in the sternocleidomastoids. Struggling to breathe deeply along with coughing and sneezing can overwork and stress the SCM.

    Working With Your Head Turned To The Side Or Tilted Back

    One of the primary jobs of the SCM muscle is to maintain the head in a stable and neutral position. If you hold your head up, down, or tilted for extended periods of time, the SCM becomes stressed. Have you ever experienced or heard of a word-processor headache? This is caused by constantly keeping your head turned to one side while entering data on a computer. If you sleep on your stomach you will likely experience problems with the SCM.

    Likewise, if your job or activities necessitate keeping your head tilted back looking up, think painting ceilings, high walls, and hanging wallpaper, these activities all stress the SCM. Sleeping on a pillow with a neckroll or wadding the pillow under your neck can also be problematic

    Neckties

    If you wear a tie, be careful not to wear it so tight that it compresses the tissues in the neck and throat area. This not only leads to muscle tightness and soreness, but it can also affect circulation and possibly breathing.

    TWD Recommends

    Does your pillow support your head and neck?

    Sleeping without proper head and neck support is sure to aggravate the SCM as well as other neck and shoulder muscles. The Sweetnight Pillow has adjustable filling and is highly recommended for its neck support.

    Sternocleidomastoid Muscle Trigger Point Treatment

    The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief is a book that I recommend to those suffering from headaches migraine, sinus, and whiplash pain. The author Claire Davis explains what trigger points are, what muscles are involved in whiplash, headache, migraine, and sinus pain, and best of all gives you step-by-step instructions for self-treatment. This is not a miracle cure or 10 minutes fix-it plan, but if you are willing to dedicate the time the techniques can greatly reduce or eliminate your pain. Once learned, you can apply these techniques to other muscles throughout the body at any time or anywhere nipping the pain in the bud. This book is a highly recommended resource for anyone suffering from headaches, migraines, whiplash, and sinus pain.

    Though the SCM muscles are easily accessible, many people are reluctant to try self-treatment. There are many massage therapists, chiropractors, and physical therapists who are trained in trigger point therapy. Someone knowledgeable in the treatment can show you how to find specific TrPs and how to apply the treatment.

    SCM trigger points need 1-2 minute treatments 2-3 times a day for optimal come.

    Biofreeze Pain Relieving Gel is an excellent pain-relieving gel and I recommend it for those who have sudden onset muscle pain or recent injuries.  It is better than warm therapy gels and creams for recent injury muscle pain as it cools the area much like ice and does not promote swelling.   Biofreeze is recommended for those who have had a recent neck injury or sudden onset pain. Rub Biofreeze into the upper back and shoulders, into the front, side, and back of the neck going up to the base of the skull and over behind the ears.  Highly recommended for early treatment of whiplash.

    Sombra Warm Therapy Pain Relieving Gel is a pain-relieving gel that I use both personally and professionally in my massage therapy practice. Unlike other over the counter heating creams, it provides warmth without burning heat. It can help reduce tightness and pain in the back of the neck and the base of the skull often caused by the sternocleidomastoid muscles. Applying Sombra to the back and sides of the neck, up behind the ears and along the base of the skull will help headache and whiplash pain caused by the sternocleidomastoid muscles.

    How Long Before I Feel A Reduction In Pain?

    Trigger points in the SCM muscle can be stubborn and take several days of treatments before you notice a positive change. It is imparative that you stay with the treatment program to rid the muscle(s) of trigger points.  Consistent treatments several times a day for 1-2 minutes per treatment until the trigger point(s) can no longer be felt is necessary for successful treatment.

    Interesting facts about the sternocleidomastoid:

    • The sternocleidomastoid muscle is the muscle most injured in whiplash.
    • The SCM muscle should be examined anytime you have pain in the head or neck area. Often when trigger points are released and the muscle is softened and relaxed, you will find that the pain is considerably reduced or eliminated.
    • If dizziness, nausea, loss of balance and falling are present and have eluded diagnoses, the clavicular branch of the SCM should be examined for trigger points. Trigger points in the clavicular branch of the SCM can also contribute to problems with vision, and hearing.

    Sternocleidomastoid muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • Spasmodic torticollis (Wryneck syndrome)
    • Headaches
    • Whiplash
    • C1 C2 radiculopathy
    • Ménière’s disease
    • Dizziness
    • Vertigo
    • Motion sickness

    Advertisement




    Other muscles that should be considered and examined:

     Satellite trigger points associated with the muscle:

    If you find trigger points in the sternocleidomastoid muscle it is likely you will find trigger points in some or all of these muscles:

    • Sternocleidomastoid Muscle on the opposite side
    • Scalenes
    • Levator Scapulae
    • Trapezius
    • Splenius Cervicis
    • Sternalis
    • Pectoralis Major