Sternocleidomastoid trigger point pain referral patterns

Onelove healing arts

This educational article is a brief introduction to trigger points, and trigger point referral patterns. In this article particularly we are focusing on the sternocleidomastoid muscle. You'll learn what trigger points are, and where some common pain patterns are in the body. I hope you enjoy this article.

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What is a trigger point? Janet Travell, A pioneer in documenting trigger point’s and their referral patterns describes them as

” a highly irritable localized spot of exquisite tenderness in a nodule in a palpable tight band of muscle tissue”


Our muscles are similar to strands of spaghetti that contract and lengthen as the spaghetti strings slide past each other. In our body these spaghetti strings are called myofibrils. And the sliding of the myofibrils past each other we callcontraction and relaxation. So far so good right? Great.

How do they form, what is their cause?

Every time the muscles contract, they consume calcium and every time they relax, they require magnesium. When a bundle of muscle fibers, myofibrils, contract and do not return to their normal length we referred to this as a knot.

This can happen due to a lack of minerals in the bloodstream such as magnesium, and or water. This can happen from activities which repetitively stress the same muscle in the same way over a sustained period of time. This can also happen from postures that are sustained for a long time which aggravate certain muscle groups.

So, we categorize knots and the massage therapy profession into two classifications a tender point and a trigger point.

A tender point isa knot that is more tender than the immediately surrounding muscle fibers of that tissue, and pain is localized. Directly where we are pressing or very close to it.A trigger point is a knot that refers pain away from where we are pressing. This referral sensation is known as a referral pattern.

There Does exist in the human body common referral patterns proceeding from common trigger points, however there is no definite place where knots are. Contrasted with acupuncture points for example, there are definitely places where acupuncture points are on everybody and are not, however trigger points can occur anywhere in the body where muscles, ligaments, and tendons are present.

According to a person’s pattern of movement on a daily basis, a well trained and experienced massage therapist, personal trainer, chiropractor, physical therapist, or similar healthcare professional, will have a good idea of where tension is likely to be in the body. When we know what you do most of the day, we can visualize what muscles are contracted and what muscles are lengthened. This is then combined with A thorough assessment of the client, which often includes the persons subjective experience of where they feel pain, measurements of the motion, and other assessment Procedures. and then that information is combined with what I actually feel when I put my hands on the tissue.

Furthermore as I put my hands on a tissue and feel whatever I feel, my brain also associates with every person that I have previously palpated in the same muscle group, And I have a sort of intuitive compass led by intuition, palpation, and understanding of anatomy, and understanding of common trigger pointreferral patterns, and informed by previous experiences with other clients with the same pain issues in the same areas of the body.

When I actually do feel a tight bundle of muscle fibers and I suspect that there may be a Trigger Point, I will ask the client if this area feels tender painful and refers sensation to some other place in the body. There are a few indicators that suggest to me it is a trigger. One indicator and perhaps the most important is that after a length of time trigger points will change and diminish in their pain sensation. A structure in the body that is unrelated to trigger points such as nerves and broken bones, will not change sensation no matter how long you press on Them.A second indicator is the documented body of work that shows common trigger point referral patterns for the general population. From authors such as Janet Travell, and others.

So, there is a brief definition of TriggerPoints and how we find them.

Now let’s move on to the actual muscle of the week…and begin to answer the question: What are common symptoms presenting from common trigger points in common muscle groups?

The sternocleidomastoid


The sternocleidomastoid is a muscle in the anterior portion of the neck as pictured above which when activated on the left side turns the head to the right and when activated on the right side it turns theheadto the left. When both muscles contract at the same time theytilts the head forward.

Knots commonly develop in this area in a large body of the population of people who spend a majority of their day sitting at a desk looking down at a computer screen or down at an angle reading a book. The downward tilt of the head puts these muscles in his shortened position, which overtime can lead to developing knots, which in turn can lead to developing Trigger Points with common referral patterns into the eye jaw temples, top and back of the head as pictured below.

This may be commonly referred to as a tension headache.

How do we treat them in the context of massage therapy and in the context of self-care at home?

To avoid these pain patterns, it is advisable to take breaks from studying every 30 minutes and walk around. During that time practice looking up and to the left and right exercising your range of motion to lengthen this muscle group. Also be sure to stay hydrated.

In the context of massage therapy, I like to grab the band of muscle gripping it and slowly work up of the length of the muscle belly pausing every inch feeling for the tight nodules. As I do this, I will communicate with my client about what sensations they are feeling, specifically referral patterns. Meanwhile holding the knots once found, for 30 – 90 seconds and moving on. Followed by a stretch.


I hope you found this article to be of value to your understanding of how the body works, and that it empowers you to recognize trigger point referral pain and respond to it appropriately.


Thank you for being the best part of one love healing arts, May peace prevail on earth. Benjamin Joseph Onelove, LMT, BCTM

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