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SCM Headache Trigger Points

It’s safe to say that everyone will experience a headache at least some point in their life. Headaches can vary in intensity and occur for a number of different reasons. If you have regular, mild-to-moderate headaches you could have tight muscles in your neck and shoulders contributing to these tension headaches.


Headache “Trigger Point” Patterns

Since there are varied opinions and misconceptions about what trigger points are and how to treat them, we prefer to think about these as “pain referral patterns” instead of specific trigger points.

While there is a broad collection of muscles that can contribute to tension headaches, there are a few “usual suspects” that are generally to blame for the majority of tension headaches. Below are the common headache pain patterns that these muscles create and some self-massage techniques on how to treat them at home.


Sternocleidomastoid (SCM) Headaches

SCM headache patterns

SCM Headache Patterns

The sternocleidomastoid muscle, or SCM for short, is the large vertical muscle that pops out of your neck when you turn your head to the side. It’s primary functions are to rotate the neck (look left and right) and flex it (look down).

The SCM most often creates headaches behind the eye and near the temple. In extreme cases, it can even cause dizziness and mimic vertigo.


Self-Massage for SCM Headaches

Fortunately, the SCM is a great muscle for self-massage. Simply look to the opposite side of the SCM you want to massage, and then slowly pinch your SCM between your thumb, pointer, and middle fingers. Now bring your head back to a neutral position and this will relax the muscle. You can now carefully “walk” up and down the muscle using opposite hands, pausing along the way to gently squeeze and massage the muscle between your fingers.


Trapezius Headaches

trapezius headache patterns

Trapezius Headache Patterns

The trapezius muscles, or “traps”, span much of the upper back in a diamond shape and include attachments at the shoulder and top of the neck.

Trigger points at the muscle attachments by the left and right corners of this muscle are usually the most problematic. Tension headaches from these trapezius trigger points most often present in a classic “coat hanger” pattern that travels up the side of the neck, behind the ear, and wraps around the side of the head to finally concentrate at the temple.


Self-Massage for Trapezius Headaches

The trapezius muscles aren’t quite as easy to self-massage as the SCM, but it can still be done. There are a couple methods self-massage for trapezius headaches that we’ve found to be effective:

  1. The first is to use a self-massage tool like a TheraCane or a BackBuddy. Both of these tools have hooked ends that will allow you to apply very focused pressure to these trapezius trigger points that tend to develop near the shoulder. The downside of these tools, is that you’ll probably have to engage muscles your upper body to apply the pressure. Ideally, we want the entire upper body to be relaxed.
  2. A second way to treat trapezius headaches on your own requires access to a squat rack for weightlifting. Using this approach, you’ll want to set the bar at a height slightly lower than your shoulders. Then add weight to the bar as you normally would. Finally, turn your body perpendicular to the bar and squat just enough to slip your shoulder underneath the bar. From here, you can use your legs to press your trapezius into the bar, leaving your upper body free to relax. Add a towel between your shoulder and the bar for padding if desired.


Suboccipital Headaches

suboccipital headache pattern

Suboccipital Headache Patterns

These small muscles at the base of the skull control some of the finer movements of the head, like looking up or a subtle nod to a friend in passing. Chronic tension in the suboccipitals is often the result of a compensation pattern from a forward head posture or other structural issues.

Ever catch yourself leaning toward your computer when really engaged in your work? This is a very common movement that often results in compression of the suboccipital muscles.

Road cycling is another activity that chronically engages these muscles. To maximize aerodynamics, the cyclist’s arms come in to the body as the torso comes down and the suboccipitals engage to bring the head and eyes up to see ahead. Spending hours in this position on a regular basis can lead to chronic tension and headaches.


Self-Massage For Suboccipital Headaches

The suboccipitals are probably the most difficult to effectively self-massage, but don’t worry…here are a few techniques that can help take the edge off:

  1. As with the techniques above for the trapezius muscles, you’ll be using a couple props for this one. All you’ll need is a couple of tennis balls (or something similar) and a long sock (or panty hose). Simply slip the tennis balls into the sock and tie them off so they don’t move around. Now lie on the floor and place the sock underneath your neck, just below the back of your head so the tennis balls straddle your spine. That’s it. Just relax and let gravity do the work. You can periodically readjust to focus the pressure on different areas.
  2. Another approach is to simply stretch the suboccipital muscles. For this stretch, all you need is a wall. Stand with your back flat against the wall and if your head is not already touching the wall, slowly move your head back until it touches the wall. This may be enough of a stretch already. If so, just hold the pose for 20-30 seconds and relax for 10 seconds. If you need a deeper stretch, simply bring your head to the wall and then tuck your chin toward your throat. Hold for 20-30 seconds and relax for 10. (This chin-tucking technique can even be combined with the tennis ball approach listed above.)


Cervical Spine Compression

In addition to the specific muscle groups and their corresponding pain referral patterns above, another source of headache pain is a general compression of the cervical spine (neck). The muscles above can team up with other neck muscles to create intervertebral pressure in the spine. This pressure can then contribute to cervical arthritis, sticky facet joints, neurovascular compression, and subluxations.


Don’t let those fancy words scare you though. Regular movement (yoga, exercise, etc) and heat packs are usually enough to help decrease muscle tension and decompress the spine to provide some lasting relief. If you’ve tried that and are still experiencing regular tension headaches, contact a local massage therapist trained in deep tissue (or medical) massage to provide an assessment and treatment.