Splenius Capitus and Cervicis Muscles: Location, Actions, and Trigger Points

By Ground Up Strength

The splenius muscles are broad and thin, getting their name from the Greek word splenium, meaning bandage. Capitus comes from the Latin word for head, caput which refers to the origin of the splenius capitus on the mastoid process and adjacent occipital bone of the skull, underneath the sternocleidomastoid. Cervicus derives from the Latin word cervix which pertains to the neck, referring to the splenius cervicus having its origin on the cervical spine. 1,2

The splenius muscles make up one layer of four layers of posterior cervical muscles. The most superficial of these layers are the upper trapezius muscles, which form an inverted V at the back of the neck. The splenius muscles are just underneath the upper trapezius at their upper insertion and deep to the rhomboids at their lower origin. These flat and thin muscles form a regular V shape, unlike all the other layers, which form inverted V's except for the vertically oriented semispinalis capitis, which the splenii overlies. The splenius cervicis is more vertical than the capitis and moves around the neck superolaterally.

Origin

  • Splenius cervicis: originates at the spinous processes of the third though sixth thoracic vertebra.
  • Splenius capitis: originates from the lower half of the spinous processes of the seventh cervical vertebra and the upper three or four thoracic vertebra.

Insertion

  • Spenius cervicis: inserts on the transverse processes of the first three cervical vertebrae. The splenius capitis inserts on the mastoid process and the occipital bone.

Action of the Splenius Muscles

When both sides of the splenius muscles contract together, extension of the neck occurs. When one side contracts alone rotation and lateral flexion to the ipsilateral (same) side occurs.


splenius capitis and splenius cervicis muscles of the neck

Figure 1: The Splenius Muscles



Splenius Trigger Point Causes and Symptoms

Trigger points in these muscles are one of the many causes of headache of myogenic origin. TrP's in the splenius capitis and cervicis muscles can be caused by sudden direct trauma, often as a result of whiplash injury. Any postural stress that holds the head in an extended and rotated position for a long period of time can also lead to trigger points in these muscles. A cold draft on these muscles, especially if already fatigued, can also help activate Trp's, especially when the muscles are already fatigued. Sleeping on a pillow underneath the neck and upper back, so that the neck is extended, can also be a problem.

During strength training, performing pullups, lat pulldowns, or similar exercises while looking up with the head cocked forward, chin projected and neck extended may be likely to irritate these muscles.

Splenius Capitis Trigger Points

The main symptom of trigger points in the splenius capitis is referred pain at the top of the head, close to the crown or vertex. See figure 2 below for trigger point locations and referred pain pattern.


splenius capitis trigger points and referred pain pattern

Figure 2: Splenius Capitis Trigger Points and Referred Pain Pattern



Splenius Cervicis Trigger Points

The primary symptom of TrP's in the splenius cervicis is pain in angle of the neck, head and especially the eye. The pain is often reported to seem to shoot through the head to the back of the eye but may also be present in a band around the side of the head leading to the eye. A feeling of pressure in the eye may also be involved. Splenius cervicis trigger points, in addition to causing pain around the orbit of the eye, may blur the vision.

Splenius cervicis TrP's can also be a cause of stiff neck, which limits rotation of the head, along with the levator scapulae. Splenius involvement alone will cause less stiffness then levator scapulae involvement alone, which is the main "stiff neck" muscle. When both muscles are involved, rotation of the head may be completely restricted due to pain. When stiffness remains after treatment of levator scapulae TrP's it is likely due to leftover TrP's in the splenius cervicis. The sternocleidomastoid and upper trapezius can also be associated with stiff neck. See figure 3 below for trigger points and referred pain patterns.


splenius cervicis trigger points and referred pain pattern

Figure 3: Splenius Cervicis Trigger Points and Referred Pain Pattern


Main Symptoms Summarized

  • Pain inside the head leading to the eye
  • Pain at the top of the head
  • Pain at the angle of the neck
  • Neck Stiffness and pain upon rotation
  • Blurry vision

Associated Satellite Trigger Points

It is highly unlikely that trigger points will occur in the splenius muscles alone. Associated trigger points should be expected in the levator scapula and any of the posterior cervical muscles such as the semispinalis capitis and cervicis; and the multifidi.

TrP's in the splenius capitis may give rise to satellite trigger points in the temporalis and semispinalis (which may also be caused by upper trapezius TrP). Trigger points in both the splenius muscles may be spawned from TrP's in the upper trapezius. 2, 5

Self-Treatment of Splenius Muscle Trigger Points

The splenius muscles are difficult to palpate due to their being located beneath other muscles. However, the muscles in this area are thin so some success can be had by massaging the cervical muscle area in general. A thera cane, knobble, or tennis ball can be used but the fingers may still be the best tool to get in deep to the splenius muscles. Treatment by a qualified professional with trigger point experience may be best in the case of whiplash injury due to a rear-end car collision or intractable problems with this area such as severe stiffness and pain that cannot be solved by self-treatment.

To self massage the splenius muscles it is best to lie on your back so that the neck is relaxed. Using the arm opposite of the side you intend to treat, bring your hand around the back of your neck, feel for the mastoid process behind and below the ear and the occipital protuberance and spine of the cervical vertebrae below it. The groove-like area between these two features is where you want to begin massaging. Dig your fingers into the fibers close to the mastoid process while rotating your head and flexing it slightly to the opposite side. Rub along the orientation of the fibers or use cross strokes. You may need to use your other hand to lend support to the working fingers. Alternatively, you may want to use the non-working, same-side hand to help position the head.

Work your way down, along the spine in this groove which is known as the lamina or laminar groove, feeling for the very tight and painful areas. A hook like motion, that simultaneously presses and stretches the muscle, can also be employed. Your neck should feel more fluid and free to rotate and bend after a good massage of this area. Again, professional treatment is always recommended and it is best to use self-treatment as an adjunct to the services of a therapist. These muscles are difficult to completely palpate and spray and stretch or dry needling may be needed in some instances. 2,4

References
1. Arnold, M. A. "Arnold's Glossary of Anatomy." Discipline of Anatomy and Histology- The University of Sydney. Web. 04 July 2011. <http://www.anatomy.usyd.edu.au/glossary/>.
2. Simons, David G., Janet G. Travell, Lois S. Simons, and Janet G. Travell. "Chp. 15: Splenius Capitis and Splenius Cervicis Muscles." Travell & Simons' Myofascial Pain and Dysfunction: the Trigger Point Manual. Baltimore: Williams & Wilkins, 1999. 295-304. Print.
3. Dvořák, J., et al. "Chp. 17: Muscles of the Posterior Regions of the Neck and Back (Splenius Muscles)." Musculoskeletal Manual Medicine: Diagnosis and Treatment. Stuttgart: Thieme, 2008. 634. Print.
4. Chaitow, Leon, and Judith DeLany. "Chp. 11: The Cervical Region." Clinical Application of Neuromuscular Techniques. Philadelphia, PA: Churchill Livingstone Elsevier, 2008. 284-85. Print
5. Chaitow, Leon, and Sandy Fritz. "Chp. 3: Different Trigger Point Characteristics." A Massage Therapist's Guide to Understanding, Locating, and Treating Myofascial Trigger Points. Edinburgh: Churchill Livingstone/Elsevier, 2006. 43. Print.
6. Davies, Clair. The Trigger Point Therapy Workbook: Your Self-treatment Guide for Pain Relief. Oakland, CA: New Harbinger Publications, 2004. Print.

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This page is provided by Ground Up Strength for information purposes only and should not take the place of professional medical advice. Although we have done our utmost to provide accurate and safe information, we are not medical professionals and the information on this page should not be taken as professional medical advice, or any other kind of medical advice.

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This page created 04 Jul 2011 21:16
Last updated 22 Sep 2012 16:08

This page contains affiliate links to Amazon.com. We have not been compelled in any way to place links to particular products and have received no compensation for doing so. We receive a very small commission only if you buy a product after clicking on one of these affiliate links.

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