Tag Archives: neck tension

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Muscle in Review: Sternocleidomstoid

Sternocleidomastoid muscle highlighted in red

Sternocleidomastoid, regularly abbreviated to SCM is located superficially, either side of the neck.

It originates at the sternum (sterno) and inserts at the clavicle (cleido) and mastoid process of the skull. It’s main function is head rotation and flexion of the neck.

How does SCM become injured?
SCM can be easily injured with sudden movement or jerks of the head, mostly commonly with whiplash.

 

Muscles in Upper Cross Syndrome

 

It is also often innervated in ‘upper cross syndrome’ where the upper neck and lower shoulder muscles are weak, while the upper shoulder and chest muscles are tight. This is largely due to poor posture as we hunch to use the mouse/keyboards or crane our necks over to look at our laptops or mobiles, or while driving.

What are the symptoms of an injured SCM?
A strained SCM can produce swelling and redness along the muscle, at the site of the injury. In severe cases, you also may see bruising along the path of the injury. If the strain results in a muscle spasm, you may notice a twitching or fluttering beneath the surface of the skin along the side of your neck. Stiffness, muscle fatigue and difficulty holding your head upright may occur, along with dull pain along the path of the injury, accompanied by sharp pain when turning or tilting your head.

Trigger points in SCM can cause headache pain in the back of the head, behind the ear, in the forehead but it can also cause a list of other symptoms that some may not normally attribute to muscles.

SCM trigger points

Primary Symptoms include;
Back of Head Pain
Cheek Pain (like Sinusitis)
Dizziness When Turning Head or Changing Field of View
Double/Blurry/Jumpy Print Vision
Dry Cough
Ear Pain
Earaches/Tinnitus (Ringing)/Itch
Feeling Continued Movement in Car After Stopping
Feeling Tilted When Cornering in Car
Front of Chest Pain
Frontal Headache
Headaches or Migraines
Post Nasal Drip
Runny Nose
Sore throat
Tearing/Reddening of Eye, Drooping of Eyelid
Temple and Eyebrow Pain
Temporal Headache (Temples)
Temporomandibular Joint (jaw) Pain
Throat & Front of Neck Pain
Travelling Nocturnal Sinus Stuffiness
Vertex Pain
Visual Perception Problems

How is SCM treated?
Applying ice for 10 minutes several times daily may relieve swelling and redness. Wearing a neck brace supports the weight of your head, temporarily relieving the stress on SCM although may only recommended temporarily and only in severe cases. Over-the-counter nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Advil, Neurofen) and naproxen (Naprosyn, Aleve) and analgesic rubs can relieve some of the pain associated with the strain.

SCM is very responsive to massage and other soft tissue techniques such as gentle cupping, dry needling, and stretching.

  • Rotate your head to look over your shoulder, as far as is comfortable, not to strain.
  • Then gently tilt the head to the same side, as if trying to reach the ear to the shoulder.
  • Hold for 20-30 seconds, rest and stretch the other side.

 

 

If you are a yogi, some basic yoga poses that can help lateral and anterior neck tension include;

Bitilasana (Cow Pose) and Marjariasana (Cat Pose)

Cow-Cat pose is a gentle up-and-down flowing posture that brings flexibility to the entire spine. It stretches and lengthens the back torso and neck. It’s a wonderful and easy movement to open and create space through the entire neck.
To begin with cow pose, kneel on your hands and knees in a neutral, tabletop position. Be sure to align the hands below the shoulders and knees directly beneath the hips. Looking straight ahead, inhale, and slowly extend through your spine as you look up and forward, softly arching through the back and neck. Take care to expand through your chest and lower your shoulders down and back.

Move into cat pose by reversing the movement as you exhale and bring your chin towards your chest while gently hunching and rounding your back. Repeat this sequence for 7 to 10 cycles, softly flowing with your breath.

Ardha Matsyendrasana (Seated Twist Pose)

The seated twist is a wonderful pose to bring flexibility to the entire spinal column. It provides an inner massage to the abdominal organs and encourages side-to-side flexibility of the neck.

Begin seated on the floor with both legs extended in front of you and hands at your sides. Bend the right knee and draw the right foot to the outside of the outstretched left leg. Sit up tall, inhale, and extend your left arm out to your left. As you exhale, draw your left arm across your body so the elbow joint gently wraps around your right knee. Take your right hand and place it palm down on the floor near your tailbone, fingers pointing away from you. Draw your chin toward your right shoulder, making sure to keep your spine tall, and the crown of your head reaching toward the sky. Bend the right elbow slightly to allow the right shoulder to sink down.

Breathe deeply in this pose for 5 to 7 breaths, making sure to twist (not crank) your spine comfortably. Repeat on the left side to maintain the balance in your body and spinal column.

Ear to Shoulder Pose

This is an easy pose that can be done just about anywhere. The pose facilitates the lateral movement of the neck as well as stretches down into the shoulder and trapezius muscles. This pose can be performed standing or sitting, provided the spine is straight.

Begin by looking straight ahead with your arms down at your sides. Take a deep breath and as you exhale, bring your right ear down toward your right shoulder. Try to avoid leaning your head forward or back so that your head remains in the same plane as your shoulders. Inhale as you draw your head back to center and exhale as you repeat the movement to the left.

To deepen the stretch, place your right hand on the left side of your head as it drops over towards the right shoulder. Don’t pull your head over; just allow the weight of your hand to softly guide it down. Perform this cycle 7 to 10 times per side before returning to centre. (1)

Vertebrobasilar insufficiency: Causes, Symptoms & Diagnosis

VERTEBROBASILAR INSUFFICIENCY (VBI)

What is vertebrobasilar insufficiency?
Vertebrobasilar insufficiency (VBI) refers to a condition in which blood flow to the vertebral and basilar arteries is restricted, thereby providing transient insufficient blood flow to the posterior portions of the brain. It is sometimes known as beauty salon or Golden Gate Bridge syndrome, due to the effect of tilting the head back, causing vertigo or drop attacks.

What are the signs and symptoms?
Vertigo, the loss of full control of bodily movements, dizziness, temporary loss of consciousness, ‘drop’ attacks, visual disturbances and motor and sensory changes.

Who gets vertebrobasilar insufficiency?
Risk factors for the development of VBI include:

  • smoking,
  • high blood pressure (hypertension),
  • diabetes,
  • obesity,
  • being over the age of 50,
  • family history of the disease,
  • elevated lipids, or fats, in the blood (known as hyperlipidemia).

People who have atherosclerosis or peripheral artery disease also have an increased risk for developing VBI.

How vertebrobasilar insufficiency diagnosed?
Your doctor will perform a physical exam and run a series of tests if you have symptoms of VBI.
Your doctor will ask you about your current health conditions and may order the tests such as CT or MRI scans, magnetic resonance angiography (MRA), blood tests to evaluate clotting ability, an echocardiogram, an X-ray of your arteries, which is called an angiogram.
In rare cases, your doctor may also order a spinal tap, or lumbar puncture.

How vertebrobasilar insufficiency treated?
• Medication and lifestyle changes
Patients should quit smoking immediately, attempt to lower cholesterol levels through diet, and exercise regularly. Physicians may also prescribe medication to control high blood pressure, lower blood cholesterol levels and reduce blood coagulation.
• Open Surgical Repair
Three basic surgical procedures can be used to restore flow to the brain through the vertebral and basilar arteries. Bypass grafting, direct arterial or endarterectomy.
• Endovascular repair
A newer technique called endovascular repair is used to treat vertebrobasilar insufficiency by expanding the artery wall.

Can massage help?
Manual therapies such as chiropractic or physiotherapy treatments can create a change in blood flow, but little research has been done to show its effectiveness.
Manual therapists such as massage, physio or chiropractors need to be made aware of the condition in order to take precautions in positioning and treating the client to avoid any ‘drop attack’. If there has been a diagnosis of blood clots massage is contraindicated.

Are there any complications?
The outlook for VBI depends on your current symptoms, health conditions, and age. Younger patients who experience mild symptoms and control them through lifestyle changes and medication tend to have good outcomes. Advanced age, frailty, and strokes can negatively affect your outlook.

How can I avoid getting vertebrobasilar insufficiency?
Sometimes VBI can’t necessarily be prevented. This can be the case for those who are aging or those who’ve had a stroke. However, there are steps that reduce the development of atherosclerosis and VBI. These include:

  • quitting smoking,
  • controlling blood pressure,
  • controlling blood sugar,
  • eating a healthy diet that’s rich in fruits, vegetables and whole foods,
  • and being physically active.

Further reading
http://www.nebraskamed.com/neuro/surgery/vertebral-basilar-insufficiency
http://www.healthline.com/health/vertebrobasilar-insuficiency#Symptoms4
https://www.ucdmc.ucdavis.edu/vascular/diseases/vertebrobasilar.html

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