Sternocleidomastoid Muscle - Healing Therapies

Headaches? Stiff neck? It may be your SCM muscles, explains Vatché Papazian

The Sternocleidomastoid, also known as SCM for short, is a two-branched muscle, which has two heads on the point of origin.

Let us look at the basics before we go any further.

Origins of the SCM: One branch of the SCM originates on the Sternum (the breastbone) hence the name sterno and the other branch originates on the Clavicle (the collarbone) hence the name cleido, forming the initial part of the word – Sternocleido.

Insertion: Mastoid Process – this is the bony prominence behind the ear – hence the word mastoid forming into the final part of the muscle name: Sterno-cleido-mastoid.

I hasten to add that these muscles are not limited only to one side of the neck. They are on both sides of the neck, i.e. two-branched SCM muscles on either sides of the neck which brings me to their functions.

Functions of the SCM muscles: Each muscle acting alone rotates the head to the opposite side. Both muscles acting together flex the cervical column (head and neck) forward. However, they also have another function and that is the role they play as an ‘accessory muscle’ in respiration.

The sternocleidomastoid muscles are fairly easy to see and touch with a simple rotation of the head all the way to the right thus exposing the muscle on the left, right under the skin in front of the neck. The same can be done with the rotation of the head to the opposite side. The easy access to the sternocleidomastoid makes it possible for us to rub and massage these two muscles when faced with trigger point discomfort and pain which we will cover next.

Painful SCM and its causes: The sternocleidomastoid is almost the ‘invisible’ muscle, as it is hardly painful itself. It does, however, generate pain to other areas, known as referred pain. Due to the anatomy of the SCM: one branch originating from the sternum and the other branch originating from the clavicle, the resultant pains or trigger points are related to these points of origins i.e. Sternal and Clavicular which in turn insert on to the Mastoid Process.

Before we go into these individual pain-generating locations, let us first look at the actions and our postural behaviours that can cause trigger points with the SCM muscle:

Overhead activities, such as looking up whilst painting the ceiling for long periods.
Pressure on one side i.e. sleeping on one side of the neck.
Looking at the computer monitor which is placed sideways rather than facing you straight.
Having phone calls whilst supporting the phone with your shoulder and neck.
Sleeping on your stomach which pulls the SCM muscles.
Car accident – whiplash.
Shirts with tight collars.
Violent coughs or chronic asthma.
Stress which causes muscle tension in the neck area.
Head leaning forward for long periods of time.
Infections such as sinusitis.
Poor posture.
Lifting heavy weights.

When talking about the SCM muscles’ pain generating patterns, we need to take into consideration its anatomy, i.e. the clavicular and the sternal sides. Each of these sides generates different symptoms or pain patterns.

The Sternal side
(The side that originates from the Sternum)

Aches and trigger points of the Sternal (chest bone) side of the SCM generate:

Pain deep in and around the eyes, causing ‘red eye’ and drooping of the eyelid of the same side of the SCM. Possible blurred vision on the affected side.
Pain can imitate symptoms of sinusitis.
Pain to the breastbone (Sternum)
Pain in the back of the throat and tongue with difficulty when swallowing. Can also imitate symptoms of sore throat.
Pain in the chin.
Pain behind and on top of the head similar to that of sinusitis.

The Clavicular side
(The side that originates from the Clavicle)

Aches and trigger points of the Clavicular (collarbone) side of the SCM generate:

Pain in the forehead.
Pain in the inner ear.
It can mimic a toothache (molars) and pain in the face and cheek on the corresponding side of the SCM.
Dizziness and loss of balance.
Earache with a possible loss of hearing.

How to treat the SCM trigger points?

Massage: Fortunately, if the pains you are experiencing are due to the SCM muscles, then this is something you can do it yourself. If you are scared that you might be using the wrong technique, see a massage therapist, preferably one who does deep tissue/sports massage. However, let us go through the routine of self-massage for the two pairs of the SCM muscles.

Real life image of the SCM muscle

Rotate (do not bend) your head to the right and the left SCM muscles will pop out. With people who are leaner in the neck area, the muscles will be quite visible and easy to handle. Please note the sternal SCM is in front of the clavicular one and, therefore, it will be more prominent. The clavicular one is the deeper of the two and it may not be so visible but as you progress with the kneading (pinching) process you may feel both of them at same time as you approach the mid-neck and up to the skull area and start feeling the girth of both muscles between your fingers.

Start pinching the bottom of the sternal muscle (it helps if you do this in front of a mirror) and pinch enough to notice some pain or discomfort. The so-called pain or discomfort should not be caused by your hard pinching of the muscle, which means you are the cause of the pain. If the muscle itself feels painful, then it means that you are dealing with the trigger points. You can either pinch with your thumb and index fingers together or apply a firm enough kneading action from the bottom and moving up to the top. But ‘pinching’ will produce better results than trying to ‘knead’ the muscles with the heel of your palm. The latter will not isolate the SCM muscles but will massage other areas of the neck muscles. Once you start approaching the mid-neck and the jaw line area, the muscles get thicker which is an indication that you are now handling both the sternal and the clavicular SCM’s. Sometimes pinching the SCM will reproduce the symptoms you have been having as described in the above paragraphs.

Try to squeeze hard enough that you may feel the trigger points or start feeling the symptoms that you had been having. I hasten to add: if you are squeamish about squeezing or pinching these muscles, then just gently massage them with your two fingers – from the sternal up to the clavicular points.

Real life image of the left SCM

When you find a trigger point which is painful to your pinching-squeezing action, don’t let go; just hold on to it until the pain eases off and then continue further along the length of the muscles.

Real life image of the right SCM

As you reach the borders of the skull (Mastoid process) go back down to the starting point at the sternal section and repeat the process 3 to 5 times a day. Repeat this for about two weeks and in time it will be difficult for you to find those painful points on these muscles and you will be symptom free. However, should the symptoms re-appear, take note of your daily actions, movements, posture etc. (mentioned above under Causes) and see which one of them is causing these symptoms.

Warning: there are two large arteries near these muscles called the Carotid Arteries. These arteries provide oxygen to the brain. These arteries are under the chin and alongside the windpipe. If you can feel your pulse whilst massaging your SCM muscles, then you are too close to these arteries and you should only handle the SCM muscles and none of the surrounding areas. If in doubt about these self-massage techniques, please see a professional or consult your physician.

Image by Patrick J. Lynch

Stretching the SCM muscles to avoid/relieve pain

There are several ways to stretch the SCM muscles and I will mention the most basic and the simplest way to do them. I would go as far as saying that these probably are the best and safest ways of stretching the SCM muscles to relieve pain.

Rotation of the neck: Note that ‘rotation’ is not the same as ‘bend’.Rotate the neck to the left and you will be stretching the right sternocleidomastoid muscles. Hold for 20 seconds or so. Rotate the neck to the right and you will be stretching the left sternocleidomastoid muscles. Hold for 20 seconds or so.
Neck drop forward: Drop your neck comfortably towards your chest. There is no need for the chin to touch the chest; just easy and gentle drop towards the chest. In that position – chin down towards the chest – rotate the neck to the left as though trying to reach your left ear to the left shoulder. Hold for 10-15 seconds. Come back to the centre and do the same with the opposite side.
Rotate neck and chin up: Rotate the neck to the left and raise your chin up to look at the ceiling. This will stretch the right SCM. Hold this position for 15 seconds and then come back to the centre and do the other side.

At any point if any of these stretches cause you pain or discomfort, please stop and refer to a physician or bodyworks professional.

Vatché Papazian
Massage & Complementary Therapist

Disclaimer: The information provided in this blog is not a substitute for medical or professional care. If you have any doubts about your symptoms and the self-care methods described here, see a professional or consult a physician.

Images courtesy of gustrength.com; Carotid Artery Picture by Patrick J. Lynch; Real life images modelled by a friend who prefers to remain anonymous.