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Trigger Point Therapy - Muscle Energy Techniques for the SCM and the Scalenes

Posted by Team NAT on


John Gibbons demonstrates muscle energy techniques for the Sternocleidomastoid (SCM) and the Scalenes


Sternocleidomastoid (SCM)

This Sternocleidomastoid is a long strap muscle with two heads. It is sometimes injured at birth, and may be partly replaced by fibrous tissue that contracts to produce a torticollis (wry neck). A hugely important muscle for trigger point therapists.

Generally speaking, the sternocleidomastoid is the muscle that most people feel hurting or tense when performing sit-ups. When short, it changes the position of the head on the neck, resulting in a forward-head posture; this sets up the foundation for kinetic chain pain and postural changes, leading to compensation, change of gait, and decompensation.

Rounded shoulders often have their roots in a short sternocleidomastoid.



SCM - Common Trigger Point Sites


Trigger Point Referred Pain Patterns

Sternal head: pain in occiput, radiating anteriorly to eyebrow, cheek, and throat (eye and sinus). Clavicular head: frontal headache, earache, mastoid pain (dizziness and spatial awareness).


Tension headache, whiplash, stiff neck, atypical facial neuralgia, hangover headache, postural dizziness, altered SNS symptoms to half of face, lowered spatial awareness, ptosis. Associated with (existing) persistent dry, tickling cough, sinusitis and chronic sore throats, increased eye tearing and reddening, popping sounds in the ear (one sided), balance problems, and veering to one side when driving.



The scalenes are a group of three pairs of muscles in the lateral neck: scalenus anterior, scalenus medius and scalenus posterior (see below). Sometimes a fourth muscle, the scalenus minimus is present behind the lower portion of the scalenus anterior.

Myofascial trigger points causing short psoas muscles can lead to adaptations in the scalenes, resulting in a short contracted state, thereby pulling up the ribcage and affecting respiratory efficiency.


Scalenes - Common Trigger Point Sites


Trigger Point Referred Pain Patterns

Anterior: persistent aching, pectoralis region to the nipple. Posterior: upper medial border of scapula. Lateral: front and back of the arm to the thumb and index finger.


Back/shoulder/arm pain, thoracic outlet syndrome, scalene syndrome, edema in the hand, phantom limb pain, asthma, chronic lung disease, whiplash, “restless neck,” irritability, hyperventilation syndrome, panic attacks.


John Gibbons is a qualified and registered osteopath with the General Osteopathic Council, specialising in the assessment, treatment, and rehabilitation of sport-related injuries. Having lectured in the field of sports medicine and physical therapy for over 12 years, John delivers advanced therapy training to qualified professionals within a variety of sports.











This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 





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