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The sternocleidomastoid (SCM) muscle 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 divided into two heads: the sternal head and the clavicular head. The SCM muscle is responsible for several neck movements and plays a crucial role in maintaining posture and neck flexibility. Injuries or tension in the SCM can lead to pain and stiffness, requiring treatments such as stretching, physical therapy, and osteopathic manipulation.
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What You'll Learn
SCM muscle structure
The sternocleidomastoid (SCM) muscle is a two-part, long, bilateral muscle in the anterior portion of the neck. It is one of the largest and most superficial cervical muscles. The SCM muscle is a powerful neck muscle that allows you to bend your neck and turn or tilt your head. It is a superficially palpable muscle that acts as an anatomical landmark within the neck region.
The SCM muscle originates from two locations: the manubrium of the sternum and the clavicle. It travels obliquely across the side of the neck and inserts at the mastoid process of the temporal bone of the skull. The SCM muscle is thick and narrow at its centre, and broader and thinner at either end. The two heads are separated by a triangular surface depression, the lesser supraclavicular fossa. As they ascend, the clavicular head spirals behind the sternal head and blends with its deep surface below the middle of the neck, forming a thick rounded belly. The SCM muscle consists of parallel rows of muscular fibres. The majority (about 60%) are white anaerobic fibres, while the rest (about 40%) are red aerobic fibres.
The SCM muscle borders two neck regions known as triangles. The inner part of the SCM muscle bounds part of the anterior triangle, while the outer part bounds part of the posterior triangle. The triangles contain important nerves, blood vessels, lymph nodes and glands. The SCM muscle is closely related to certain neurovascular structures that pass through the neck towards the head or the periphery of the body. The SCM serves as a primary landmark of the neck, helping to define the location of structures such as the lymph nodes for the head and neck.
The SCM muscle has dual innervation and multiple functions. It is innervated by the accessory nerve (cranial nerve XI) and direct branches of the cervical plexus (C2-C3). The SCM muscle can be divided into four portions, owing to its two sites of origin (clavicle and sternum) and two sites of attachment (occiput and mastoid process): sternomastoid, sterno-occipital, cleidomastoid, and cleido-occipital.
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SCM muscle functions
The sternocleidomastoid (SCM) muscle is a powerful and large neck muscle that allows you to bend, turn and tilt your head. It is a two-headed muscle, with one head originating from the collarbone/clavicle and the other from the breastbone/manubrium. The SCM muscle is involved in how your neck feels and moves. It is the largest muscle in the front of your neck and is easily recognisable.
The SCM muscle borders two regions of the neck known as triangles. The inner part of the SCM muscle bounds part of the anterior triangle, while the outer part bounds part of the posterior triangle. These triangles contain important nerves, blood vessels, lymph nodes and glands. The SCM acts as an accessory muscle of inspiration and protects these structures from damage.
The SCM muscle can produce several different neck movements. One SCM muscle can tilt your head to the ipsilateral (same) side that the muscle is located. For example, the SCM on the right side of your neck tilts your head to the right. One SCM can also turn or rotate your head to the opposite side. When both SCM muscles contract, the movements can include a neck extension movement that takes place at the topmost spinal joint.
The SCM muscle is closely related to certain neurovascular structures that pass through the neck on their way to the head or to the periphery of the body. It is innervated by the spinal accessory nerve (cranial nerve XI) and direct branches of the cervical plexus (C2-C3). Blood supply to the SCM is through the superior thyroid artery, a branch of the external carotid artery.
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SCM muscle injuries
The sternocleidomastoid (SCM) muscle is a powerful neck muscle that allows you to bend your neck and turn or tilt your head. SCM muscle injuries can cause pain and stiffness. They can also lead to more serious complications, such as swelling, redness, and bruising.
SCM pain can be caused by muscle tension, chronic health conditions such as asthma, or acute respiratory infections like sinusitis, bronchitis, pneumonia, and the flu. Tightness in another part of the body can also cause referred pain in the SCM. In addition, repeated activities or sudden movements can cause SCM injuries. For example, violinists, painters, and carpenters work in positions that can strain the SCM muscle over time.
To prevent SCM injuries, it is important to manage stress and maintain good posture. Regular exercise, sleep, yoga, and meditation are all effective ways to manage stress and prevent SCM injuries. Additionally, proactive stretching can reduce the risk of SCM injuries. Daily neck stretches are recommended, especially for those who sit most of the day or maintain an uncomfortable posture for long periods.
If you experience SCM pain, there are several treatments available. These include stretching, physical therapy, and osteopathic manipulation. Identifying and treating trigger points within the SCM muscle can also help manage pain. In more serious cases, physiotherapy procedures such as ischemic compression technique (ICT) and pincer-grip may be required.
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SCM muscle treatment
The sternocleidomastoid (SCM) muscle is a powerful neck muscle that allows you to bend your neck and turn or tilt your head. SCM muscle pain typically results from muscle tension or performing repeated motions. SCM pain can also be caused by certain health conditions, such as asthma and pneumonia.
- Stretching: Simple stretches or yoga poses can help to reduce SCM muscle pain and tension. For example, sitting or standing facing forward, exhaling and slowly turning your head to the right, and then repeating on the left side.
- Physical therapy: A professional therapist can guide you through specific exercises to help stretch and strengthen the SCM muscle.
- Osteopathic manipulation: This involves using hands-on techniques to stretch, mobilise, and manipulate the SCM muscle to reduce pain and improve range of motion.
- Trigger point therapy: This form of treatment targets specific trigger points in the SCM muscle to reduce neck pain and headaches and improve motor performance.
- Massage: Massage can be used in conjunction with stretching to reduce pain and improve range of motion and muscle endurance.
- Moist heat: Applying moist heat to the SCM muscle before treatment can help to relax the muscle and improve the effectiveness of the treatment. This can be done using a hot shower or a moist heating pad designed for the neck.
- Correct breathing techniques: Learning how to breathe correctly can help to reduce SCM muscle tension and improve overall posture.
- Ergonomic pillows: Using ergonomic pillows while sleeping can help to maintain correct spinal posture and prevent excessive head rotation.
- Avoiding certain activities: Activities such as swimming using the crawl stroke, working overhead without support, and wearing tight clothing around the neck can strain the SCM muscle and should be avoided.
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SCM muscle and ageing
The sternocleidomastoid (SCM) muscle 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 easily recognisable. The SCM is a two-headed muscle, with one head originating from the collarbone/clavicle and the other from the breastbone/manubrium. It gets its name from its location and its parts: "sterno" means sternum, or breastbone, and "cleido" means clavicle.
Ageing leads to a loss of muscle tone and strength in the SCM, which can result in forward-head posture and rounded shoulders. This can cause postural and gait changes, decompensations, and kinetic chain pain. The SCM can also develop trigger points (TPs) with age, which can cause issues such as ptosis, blurred vision, sinus headaches, and referred pain patterns. Treatment for TPs includes ischemic compression technique (ICT), pincer-grip, dry needling, muscle energy techniques, positional release, and stretching of both heads separately.
In addition, ageing is associated with a relative increase in the number of red fibres in the SCM muscle compared to white fibres. White fibres are more powerful and can make stronger contractions, but they fatigue more quickly than red fibres. This shift in muscle fibre composition may impact the overall function of the SCM in older individuals.
Furthermore, certain pathological changes in the SCM, such as torticollis, may become more prevalent with age. Torticollis is a tonic spasm of the SCM that can cause difficulties in swallowing, extreme immobility of the throat, facial asymmetries, and scoliosis. It is important to consult with a healthcare professional for an accurate diagnosis and treatment plan if any issues related to the SCM or neck pain are suspected.
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Frequently asked questions
The sternocleidomastoid (SCM) muscle is a two-headed 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.
The SCM muscle divides the neck into anterior and posterior triangles. It is involved in how your neck feels and moves. It also acts as an accessory muscle of inspiration.
An impairment or injury to the spinal accessory nerve can cause weakness or paralysis to the SCM. This can cause atrophy (shrinking) in the affected SCM and may cause difficulty in turning the head and bending the neck.
You can care for your SCM by managing stress and maintaining good posture. Treatments for SCM-related issues include stretching, physical therapy, and osteopathic manipulation.
