Content area
Full Text
This article presents a case study of a patient diagnosed with dysfunction of the sternocleidomastoid (SCM) muscle, a condition which can result in head and face pain, nausea, dizziness, coryza, and lacrimation. In this particular case, the SCM muscle had developed tightness and weakness with presence of multiple trigger points within both heads. A combination of passive and active treatments were utilized to successfully treat this condition.
(JCCA 2004; 48(3):201-205)
KEY WORDS: (MeSH) chiropractic, manipulation, exercise/rehab (NonMeSH) rehabilitation, sternocleidomastoid, trigger point.
Introduction
The sternocleidomastoid (SCM) muscle has a complex multidirectional pattern of movement. It is composed of clavicular (short head) and sternal (long head) divisions. Both divisions of the muscle attach to the head of the mastoid process and along the superior nucheal line.1 The sternal division attaches below the sternum and the deeper clavicular branch attaches posteriorly and laterally onto the clavicle. Acting unilaterally, the SCM causes ipsilateral-lateral flexion, contralateral rotation, and lifts the chin superiorly. Acting bilaterally, it causes both flexion of the lower cervical spine and extension of the upper cervical spine.2
The SCM may develop myofascial trigger points in both heads.3 Trigger points are typically taut bands of muscle fibers and are "ropy" and sensitive to pressure when compressed. They can create a local twitch response or "jump sign", which is due to involuntary contraction of muscle fibers.3 Trigger points usually occur longitudinally along the length of the muscle and are more common in postural axial muscles. The referred pain is often described as deep and dull. Compressing the trigger point will commonly elicit a consistent referral pain pattern.4 Trigger points can be classified as active or latent, with the former causing constant pain and the latter "silent" until aggravated.
The clavicular division of SCM trigger points can produce pain over the forehead and around the ipsilateral eye, over the cheek, the tip of the chin, sternoclavicular joint and deep in the throat upon swallowing. The clavicular division3 of SCM has also been documented to play an important role in the sense of equilibrium.3 The sternal trigger points can cause pain over the ipsilateral and bilateral forehead, inside and behind the ear.3 The sternal head trigger points may further produce autonomie disturbances, such as excessive lacrimation, conjunctivitis, rhinitis, blurred...