Trigger Points & Weightlifting: Sternocleidomastoids

Photo credit: Hookgrip

Disclaimer: Consult your doctor before embarking on any treatment. The following advice is not meant to replace any physician’s recommendations. Be safe and if any technique causes you extreme discomfort, cease what you are doing and consult a professional.

Article written by Chris Branam
The name is a mouthful, but the job of the sternocleidomastoids is relatively simple. This pair of muscle fibers on either side of the neck helps in turning the head and stabilizing it while the body is moving (think of a linebacker keeping his head up while he strafes across the field). The sternocleidomastoids are located on the front and sides of the neck and makes up two sides of the anterior triangle of the neck (the third side being the underside of the jaw). In the picture below, you can see the sternocleidomastoid beginning just behind the ear canal and running diagonally to attach to the sternum.

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Photo credit: www.muscular-system.blogspot.com

So, what’s this muscle have to do with weightlifting? Well, for one thing, it’s one of the muscles keeping your head still during your pull. Additionally, and more importantly, because of these muscles’ location, they can take a beating during the rack phase of a clean.

Photo credit: Hookgrip

Photo credit: Hookgrip

In this picture, you can see the bar making contact with Huang WenWen’s sternocleidomastoids. Most weightlifters will occasionally rack a clean roughly against their neck, causing some trauma to the neck.

You may never feel pain in the front of your neck, but the trauma can lead to other issues. In the article “Trigger Points: Diagnosis and Management,” David J. Alvarez and Pamela G. Rockwell state, “Occupational or recreational activities that produce repetitive stress on a specific muscle or muscle group commonly cause chronic stress in muscle fibers, leading to trigger points” (i.e. keep hitting, pulling, or working a muscle long enough, and you’ll get trigger points). What are trigger points, though?

Dr. Janet G. Travell first coined the term “trigger point” in 1942. She describes trigger points as “a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender when pressed and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena.” All this means is that a trigger point is a spot in a muscle where the sarcomeres (i.e. the little units that make up your muscles) have contracted tightly and formed a spot that is painful when pressure is applied; you might refer to these areas as “knots.”

Now, back to the sternocleidomastoid; as I stated, you might not feel pain in the front of your neck, so you might think your sternocleidomastoids are fine. However, one of the distinguishing characteristics of trigger points is that they cause “referred pain,” meaning that it doesn’t necessarily hurt where the trigger point is located. Below is a chart showing the referred pain pattern for sternocleidomastoids, where the red dots represent areas of pain.

Photo credit: Myofascial Pain and Dysfunction, Travell and Simons

Photo credit: Myofascial Pain and Dysfunction, Travell and Simons

As you can see, the knots in your sternocleidomastoids can be a real headache (pun absolutely intended).

Within the aforementioned article, Alvarez and Rockwell mention the industry standard for treating trigger points: “spray and stretch.” The “spray and stretch” method involves spraying the skin with a refrigerant spray and manually stretching the muscle containing the trigger point. This isn’t recommended for at-home use, and if you’re like me, you’re too cheap and too busy picking up heavy stuff to schedule another doctor’s visit. Luckily, there’s a very easy way for strength athletes to take care of trigger points.

Clair Davies, Nationally Certified in Therapeutic Massage and Bodywork (NCTMB), and author of The Trigger Point Therapy Workbook, discovered that trigger points can be treated through self-applied massage. The sternocleidomastoid happens to be one of the easiest muscles to access for massage, and the only tool you’ll need is your hand.

First, some guidelines for massage:

  • Massage in one direction as if you were trying to squeeze toothpaste from a tube.
  • Go slow, take your time with each stroke.
  • 6–12 strokes per trigger point is plenty. We’re not trying to kill the muscle. Get some blood flowing, then move on.
  • Use short strokes, just a few inches per stroke, one trigger point at a time.
  • Aim at a pain level of 7 out of 10. If it’s excruciating, you need to lighten up. Our goal is to work on the trigger point to get the pain level to about a 3 (a 0 being no sensation at all). If you find a trigger point and it’s already at a 3, congrats! That trigger point is doing okay and doesn’t need your attention at the moment.
  • Work on trigger points 3–6 times a day.
  • Drink water after a trigger point session. You’re going to be releasing a lot of stuff from your muscles that you’re going to want to flush out with some high quality H2O.

The trigger point sites in the sternocleidomastoid are shown below along with referred pain patterns.

Photo credit: The Trigger Point Therapy Workbook, Davies

Photo credit: The Trigger Point Therapy Workbook, Davies

The best way to discover where these points are on your body is to start under the jaw just behind the ear and squeeze with your thumb and index finger near each point shown. The best way to massage these points comfortably is to use your right hand to massage the left sternocleidomastoid and vice versa. Make sure you don’t feel a pulse where you are squeezing—that’s your carotid artery, and we don’t really want to squeeze that guy. If you feel something light you up or some sensation in the shown referred pain patterns, that’s a trigger point. Hang out at that spot and massage it by squeezing with your thumb and index finger, sliding the thumb up toward the head each stroke.

There you have it. Next time you have pain in your eye, tongue, ear, jaw, or head, make sure your sternocleidomastoids are healthy.

Sources:

http://muscular-system.blogspot.com/2013/05/sternocleidomastoid-muscle.html

http://anatomyzone.com/tutorials/musculoskeletal/muscles-of-the-neck-anterior-triangle/

http://www.med.nyu.edu/pmr/residency/resources/injections%20and%20procedures
/trigger%20points%20Am%20Fam%20Phys.pdf

http://www.jaoa.osteopathic.org/content/104/6/244.full

Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 2nd ed. Oakland: New Harbinger Publications, 2004. Print.

Travell, Janet  G., and David G. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore: Williams & Wilkins, 1999. Print.