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108 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 6 technique MYOFASCIAL TECHNIQUES Working with the Sternocleidomastoid By Til Luchau Listen to the word as you say it: sternocleidomastoid. Even its name is special; six syllables rhyming with themselves in a three-beat cadence that rolls off the tongue like no other anatomical name. And whether you hear this unique muscle's name as a rapper's multisyllabic rhyme, a poet's lyrical trochee, or simply as a mouthful of Latin jargon, your hands- on work with the sternocleidomastoids (less poetically known as the SCMs) can be a crucial part of addressing many client complaints, including cervical pain and stiffness, the effects of whiplash (Image 1), jaw issues, and several other primary indications as listed on page 110. In addition to that list, hands-on work with the SCMs has also been said to help with a host of other less-obviously related conditions, such as facial, sinus, and nasal pain; vertigo, dizziness, and car sickness; tinnitus and hearing loss; upper-chest soreness; persistent coughs; swallowing difficulties and throat pain; and more. 1 Not only is the SCM implicated in an extraordinarily large number of client complaints, it is also involved in many (if not all) head and neck movements. Connecting the cranium to the shoulder girdle and axial skeleton by wrapping diagonally around the neck, the SCMs lift the sternum and clavicles; turn, bend, and flex the cervical spine; and extend, rotate, and tilt the head. No other neck muscles seem quite as sensitive as the SCMs, probably due to the many nerves associated with them and their enveloping connective tissues— the outer (or investing) layers of the deep cervical fascia (Image 2). This multilayered fibrous membrane also encloses the trapezius, as well as the muscles of mastication (masseter, pterygoids, temporalis), and is perforated by, enfolds, and interfaces with numerous sensory and motor nerves (Image 3). For example, the deep cervical fascia of the SCM's inner interface forms part of the carotid sheath, which surrounds the vagus nerve (Image 2), the main parasympathetic trunk. The SCM's inner fascia also gives rise to the prevertebral fascia, which extends across the anterior surfaces of the cervical vertebrae. 2 Injury to the prevertebral fascia and its associated sympathetic ganglia is thought to be a physical cause of the dizziness, anxiety, and other sympathetic autonomic disturbances sometimes seen after hyperextension whiplash injuries. 3 And although pain (especially chronic pain) can have many aspects in addition to any tissue-based contributors, the SCM's The sternocleidomastoids (SCMs) are frequently injured by being eccentrically overstretched (red) in hyperextension whiplash injuries. Image courtesy Primal Pictures, used by permission. 1