(Photo 2) Trigger points in the upper portion of the muscle refer into the ear and posterior to the ear. On rare occasion, the pain extends across the forehead. Trigger points in the mid level of the clavicular division of sternocliedmastoid refer pain to the forehead. Attachment trigger points at the lower end of the sternal division can refer into the upper chest. Trigger points at the upper end of the sternal division commonly refer pain to the occipital ridge and to the top of the head (vertex). Trigger points at the midlevel of the sternal division of sternocliedmastoid refer pain in an arch over the eye into the forehead, deep behind the eye and into the cheek. The claviclar division will be shortened on the high shoulder side. (Photo 1 & 2) This muscle is shortened bilaterally with a forward head posture. Typically, neither division refers pain into the neck, however each refers pain to the face and cranium. (Photo 1)Įach division or muscle belly of the sternocleidomastoid muscle has its own unique trigger point patterns. These are areas of pain experienced by some, but not all, patients outside of the essential pain zones.
The red dots indicate spillover pain zones. Solid red areas indicate an essential pain zone or area of pain experienced by nearly every patient that had that trigger point activated. When a trigger point is activated during treatment, it will produce referred pain, which is shown in red. For example, in photo 1 "X" indicates the common location of trigger points within a muscle. Read Headaches: Trigger Points and Practice Building ( MT, August 2010) and Practice Building: Getting Inside Your Patient's Head ( MT, January 2011). Trigger point charts are available in travel flip size or wall versions. This type of visual education also uniquely sets your practice apart from the competition. They educate your patients, provide you with a quick review of the trigger points and help you customize a logical treatment plan. Using visual aids like trigger point charts, provide multiple advantages. It is important that each patient understands that you are not pressing on a nerve when treating a trigger point. For example, trigger points in the Sternocleidomastoid muscle, located in the front of the neck, can refer pain into the forehead (Photo 2). When you stimulate a trigger point during treatment, it can produce referred pain to other areas of the body. Most forms of bodywork treat trigger points. The muscles are: Sternocleidomastoid (clavicular head), Sternocleidomastoid (sternal head), Semispinalis capitis, Frontalis and Zygomaticus Major. Travell and Simons', the common location of the trigger points in each of those muscles and their referral pain patterns. This article will review the five muscles that produce frontal headache pain based on the research of Drs.
A fundamental key to treating the muscular component of most pain, regardless of the modalities and techniques you specialize in, is to know which muscles to treat based on the location of the patient's pain.