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Anatomy Highlight: The Sternocleidomastoid, or the “SCM”, Trigger Points and Referred Pain

You are probably more familiar with this muscle than you think. Look in a mirror. Place your palm upon your forehead. Watch the front of your neck as you press your forehead against your hand and resist. See those cords that stick out on each side? Those are your SCMs.

Photo, with permission by Pffft on Flickr. My highlights/text.

Why the big name?

Each part indicates where this muscle is attached: “Sterno” refers to the sternum (“breastbone”);
“cleido”is clavicle (a.k.a. “collar bone”) and “mastoid” mean the mastoid process, which is the part of your skull right behind your ear. The SCM connects behind your ear then branches at the other end; one
branch attaches to the top of the sternum and one attaches to the middle of your clavicle.

What do they do?

The SCMs are powerful muscles.
1. Along with other neck, shoulder and back muscles they help to stabilize and balance your head on top of your spine.
2. They move your head. They:
  a. Rotate your head like when you want to look at the person in the seat next to you.
  b. Flex your head forward, as in a nod, and flex each ear to its shoulder.
3. The SCMs also come in to play when you take a deep breath. Look in that mirror. Take a huge
Can you see them stand out, again?

Look around you. Do you see people with a “forward head” jutting, stuck chicken-like in mid-peck?
Their SCMs can probably use some relief. They can get sticky or rigid or knotty if they are underused or overused.

How do they feel?

Unlike many muscles, the SCMs rarely feel painful themselves. When a tissue has an injury or is overused, it can send pain to other regions of the body. This is called referred pain (or sensation). For example, this happens to the heart muscle; sometimes it refers pain to the chest, neck or back when it is in trouble. 

In myofascial tissue, referred pain is caused by a “trigger point” — fibers of a muscle that have become and stay contracted. If the problem is big or long in duration, the referral sensation may be more intense.

In the SCM, pain or other sensations are referred toward the head, face, jaws and sometimes the sternum. This can include the frontal lobe above the eyes, and pain that is felt in the teeth and ears. In serious cases, sometimes trigger points in the SCM are the source of balance or other sensory disturbances.

What can you do?

Besides receiving massage, you can work on yourself very easily to free some of the trigger points and sticky fascia. Maybe you don’t have pain, but you might have some tension. Try this:

a- Sit or stand in a relaxed, supported position with your feet flat and even, spine and head balanced over your tailbone. Breathe easily. Sometimes closing your eyes can be helpful to keep you focused on the task.
b- Flex your head forward, letting your chin fall toward your sternum. This allows the SCM to slacken.
c- With the opposite hand, find the SCM. Gently but firmly grasp any part of it between thumb and fingers.
d- Squeeze while gently pulling outward.
e- Work your way up and down the muscle, trying to feel the “fork” as it braches near your clavicle and sternum.
f- Try rolling the muscle between your fingers.
g- Note the tender spots. These are the areas that need the most attention! Do you feel any referral sensations?
h- One or two passes on each side should be enough for each treatment. 

Are they hard to grasp? With your head bowed, turn it slowly to the side opposite the SCM (turn right if you are trying to grasp the left). If all you can get is the skin and tissue above the muscle, work on that. It’s a good place to begin to unstick things!

A note of caution: The body’s main blood pressure sensors are located near the carotid artery in this part of the neck, so be sure never to push in toward the neck, but always pull outward. 

(With gratitude to The Trigger Point Therapy Workbook, Second Edition. Davies and Davies. 2004.)