the end of the line: suboccipitals

In my last post I confessed that I have some tight muscles trying to get my attention. One of these groups of muscles is called the suboccipitals. As I’ve massaged hundreds of people’s suboccipital muscles, I’ve nicknamed them the end of the line. If all other muscles get tired and fatigued, these little workhorses will keep your head up.

They are tiny, but mighty. The 8 individual muscles form a triangle of sorts at the base of the skull (4 on each side).

Muscle Mapquest: take your hands and place them behind your head at the base (where head meets neck). Deep under layers of skin and muscle, your suboccipitals are hard at work. They connect the base of the head (the occiput bone) to the first & second vertebrae, and the first vertebra to the second vertebra. If you are lying down, it’s easier to sink your fingers in deep enough to feel them. If you’re sitting or standing, it’s hard to penetrate the more superficial muscles to feel these muscles distinctly because all the muscles are engaged and active.

Little muscles, big names: What they lack in size, they make up for in their super long names: rectus capitis posterior major (extends & rotates head), rectus capitis posterior minor (extends head), obliquus capitis inferior (rotates first vertebra), oliquus capitis superior (extends & bends head laterally).

Why they hurt: One can argue that the muscles that extend the head (this means to tip the head back), also must eccentrically contract to hold the head in place when we are bending forward or flexing the head. I would argue that this is why they get fatigued, sore and cranky! Our heads are heavy and often forward of where they should be. Because the suboccipitals are postural muscles they tend to become hypertonic (super tight) when they are overused or fatigued (Orthopedic Massage, Lowe 2009 p. 222). “Suboccipital trigger points cause pain that feels like it’s inside the head, extending from the back of the head to the eye and forehead.” (The Trigger Point Therapy Handbook, Davies 2004 p. 62)

Massage care and self-care: If you’re due for a massage and you think these are tight, ask your therapist (hopefully that’s me!) to devote some extra time to these workhorses. Here are some tips to self-massage them. Lie down on your back without a pillow. If you can heat the muscles first with some kind of heating pad, that will enhance your efforts. After heating them for about 5 minutes, scoop your hands under your head. You can press into the muscle bundle right at the base of the skull. You can tilt the head so that pressure is applied to one side for 30 seconds and then the other side for 30 seconds. Take a break and simply rest your head on the bed or floor. If you need a small support under your neck, use a rolled up hand towel. Resume massaging by gliding fingers from the base of the skull towards the neck. Glide up and down with a satisfying amount of pressure applied. You can push your fingers into the muscles from both left and right sides toward the vertebrae in the center. Rest. Tuck your chin, rotate your head side to side. Finish with more heat or try a few minutes resting on a flexible ice pack. Ice can be very soothing to muscles. These are great muscles, so let’s take good care of them! Let me know if you have any questions. 626-660-6856


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