Logan Steele
The sternocleidomastoid (SCM) is a powerful neck muscle that allows you to bend your neck and turn or tilt your head. It is the largest muscle in the front of your neck and is located just below your skin. SCM syndrome can cause head and face pain, nausea, dizziness, and blurred vision. Treatment for SCM syndrome includes physical therapy, stretching, osteopathic manipulation, and in some cases, surgery. To prevent SCM issues, it is important to manage stress and maintain good posture.
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Physical therapy
- Ischemic compression technique (ICT) and pincer-grip
- Dry needling and muscle energy for SCM
- Positional release
- Stretching of both heads separately after trigger point (TP) treatment
- Strengthening of the neck with isometric neck exercises
- Self-massage and daily stretching
In addition to physical therapy, it is important to manage stress and maintain good posture to care for your SCM.
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Massage and stretching
Massage
Self-massaging the SCM muscle can help to relieve pain and tension in the muscle. During self-massage, it is normal to feel tenderness or sensitivity in the muscle, as well as behind and around the eye. To perform a self-massage, locate the SCM muscle by placing your fingers on the area between your ear and your shoulder. Then, using gentle pressure, massage the area for a few minutes. You can also use a massage tool or device to apply pressure to the SCM muscle.
Stretching
Stretching the SCM muscle can help to release tension, increase movement, and decrease neck pain. To stretch the SCM muscle, rotate your head away from the side you want to stretch, then gently tilt your head back to engage and stretch the SCM muscle fibres. Hold this stretch for 20 to 30 seconds per side, and repeat two to three times per side, aiming to do this at least once per day, and twice a day if possible. If you feel pain while stretching, stop the exercise and consider using less force or changing the angle of the stretch.
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Surgery
SCM surgery can be traced back to NASA experiments in the 1950s and 1960s, where the SCM muscles of primates were surgically cut to understand the muscle's role in providing balance. While such experiments are unlikely to be conducted today, they revealed the SCM's critical role in maintaining balance and normal gait.
In cases of SCM syndrome, characterised by vertigo, dizziness, and balance issues, surgery may be considered. SCM syndrome can also cause acute or chronic neck stiffness and pain, and trigger points, which are tight, sensitive areas within the muscle that refer pain to other areas, such as the eye, forehead, and back of the head.
Ultrasound-guided platelet lysate hydrodissection is one surgical procedure used to treat SCM-related nerve issues. This procedure involves a doctor injecting platelet growth factors around the irritated transverse cervical nerve (TCN) to facilitate nerve repair and restore function.
It is important to consult with a qualified healthcare provider to determine if surgery is the most appropriate treatment option for SCM-related conditions. Non-surgical treatments, such as stretching, physical therapy, osteopathic manipulation, and massage, are often explored before resorting to surgical intervention.
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Stress management
Stress and anxiety can cause tension in the sternocleidomastoid (SCM) muscle, leading to pain and stiffness. This is a powerful muscle in the neck that allows you to bend your neck and turn or tilt your head. It is also involved in breathing, chewing, and swallowing. SCM pain can be treated and prevented through various means, including stress management techniques. Here are some ways to manage stress and treat SCM pain:
Exercise and Sleep
Regular exercise and adequate sleep are essential for stress management. Yoga, in particular, can be beneficial as it provides overall stretching and relaxation. Simple stretches or yoga poses can be practiced daily to target the SCM muscle and release tension. For example, standing or sitting upright, exhale and slowly turn your head to the right, keeping your shoulders relaxed. Inhale and return to the center, then repeat on the left side.
Massage Therapy
Massage therapy is an effective way to promote relaxation and release tightness in the SCM muscle. Techniques such as trigger point therapy, myofascial release, and Swedish massage can be used to target the SCM muscle's tension. Massage also helps improve blood flow and oxygenation in the affected areas, promoting healing and reducing inflammation.
Posture
Maintaining good posture is crucial for SCM health. This includes being mindful of how you position digital devices like cell phones and computers to avoid craning your neck. When reading, ensure your neck is in a comfortable position. Additionally, supporting your neck during sleep is important. Sleeping on your back with a pillow supporting your neck is recommended.
Physical Therapy and Osteopathic Manipulation
Physical therapy and osteopathic manipulation can be effective treatments for SCM pain. These approaches can help with stretching and rehabilitation, improving overall musculoskeletal health.
Chinese Medicine
According to Chinese medicine, treating the SCM muscle through the Gallbladder meridian can help balance the Liver meridian, which is associated with emotions like anger and stress. By promoting the smooth flow of Qi and blood along these meridians, relief from stress and anxiety can be provided.
Medication and Surgery
If conservative treatments are ineffective, medication may be prescribed by a doctor to help manage pain and symptoms. In severe cases of structural damage, such as major tears or tumors affecting the tissue, surgery may be necessary.
It is important to explore different treatment options and consult with a healthcare professional to determine the best approach for managing SCM pain and stress.
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Corrective exercises
Lateral Flexion:
Lie on your side and lift your head upwards towards the ceiling. This exercise targets the lateral flexion movement, which is controlled by the SCM muscle.
Rotation:
Sit up straight and place your hand on the side of your head. Gently turn your head into your hand, working the rotational movement of the SCM.
Flexion:
While sitting upright, place your hand on your forehead and slowly nod your head downwards. This exercise isolates the flexion movement, which is also controlled by the SCM.
Seated Neck Stretch:
Sitting up straight, take your right hand over the top of your head and reach down across to the left side of your face with your fingertips. This simple stretch can be done daily to improve flexibility and prevent injury.
Shoulder Shrug:
Stand or sit up straight and bring both shoulders up towards your ears. Hold for five seconds, then release. Keep your chest lifted and avoid hunching forward during this exercise.
Neck Tilt:
Stand or sit with your spine straight. Slowly tilt your head to one side until you feel mild tension along the opposite side of your neck. Hold for 10-15 seconds, then repeat on the other side.
Chin Tuck:
Sit or stand tall with your shoulders relaxed and your chin parallel to the floor. Slowly drop your head forward until you feel a stretch along the back of your neck. Hold for 20-30 seconds, then slowly return to the starting position.
Breathing Techniques:
Focus on deep, slow breathing to help manage stress and reduce muscle tension. This can include practices like meditation and yoga.
It is important to consult with a healthcare professional or physiotherapist before starting any new exercise routine, especially if you are experiencing pain or other symptoms. They can advise on the best treatments for your specific needs and guide you through proper form and technique to ensure safe and effective corrective exercises.
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Frequently asked questions
The SCM is a powerful neck muscle that allows you to bend your neck and turn or tilt your head.
Symptoms of SCM syndrome include facial pain, nausea, dizziness, blurred vision, eyelid jerking, headaches, and sinusitis.
Treatment for SCM syndrome includes medication, physical therapy, and surgery. Medication includes nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, muscle relaxants, and anticholinergics. Physical therapy includes stretching, massage, and exercise. Surgery includes selective denervation, dorsal cord stimulation, and sternocleidomastoid release.
To prevent SCM syndrome, maintain good posture, manage stress, and practice daily neck stretches, especially if you sit most of the day or work in an uncomfortable position.
