Does this muscle also contribute to neck pain? Let's talk about the SCM muscle (Sternocleidomastoid)!

Have you ever heard of this special muscle in your neck? The name might sound a bit complicated – the sternocleidomastoid muscle, or SCM for short. Whatever the name, this is a muscle we all have in our neck that performs many important functions. So, today we’re going to talk about this SCM muscle in a simple, easy-to-understand way.

What is the SCM muscle? Where is it located?

Simply put, the SCM muscle is the largest muscle in the front of your neck. It's located just under your skin. You can feel this muscle by touching the right and left sides of your neck with your fingers. Amazingly, you can even feel your pulse through this SCM muscle!

This is a paired muscle , meaning we have two on each side of our neck. This muscle starts at the base of the neck, which is at the top of your chest, and runs up the sides of your neck, connecting behind your ears to the base of your skull.

Why does this muscle have such a long name?

The name SCM comes from the names of three main bones that this muscle attaches to. Let's take a look at what they are:

1. Sterno : This refers to your sternum , the flat bone in the middle of your chest. One part of the SCM muscle, which we call the sternal head, starts at this sternum.

2. Cleido : This refers to your clavicle , or collarbone as we all know it. The other part of the SCM muscle, the clavicular head, starts in the middle of these two collarbones.

3. Mastoid : This refers to the small bony protrusion behind your ear, under your skull. This is called the mastoid process. The SCM muscle comes up and eventually attaches to this mastoid process.

So, as you can see, both of these parts (the sternal head and the clavicular head) come up the neck and come together to form the complete SCM muscle.

What benefits does the SCM muscle provide us?

Okay, now let's see how important this SCM muscle is to our body and what functions it performs.

• Turning and tilting the head helps:
• When you turn your head to the right or left.
• When lowering the head to the right shoulder or the left shoulder.
• When you raise your chin and tilt your head back.
• When you tuck your chin into your chest and bend your head forward.

The SCM muscle mainly helps with all of this.

• Helps maintain posture: This muscle helps keep your neck stable and straight, even when you're just standing.

• Helps you breathe: Amazing, right? Yes, when you breathe in, the SCM muscle, along with other small muscles in your neck, helps lift your sternum and collarbone slightly. This allows air to enter your lungs better.

• Helps you chew: The SCM muscle supports the joint where your jawbone connects to your skull – we call it the temporomandibular joint (TMJ). A healthy SCM muscle is important for the TMJ to function properly.

Just think of how much this one muscle can do! That's why it's important to keep it healthy.

A little more about the location and structure of the SCM muscle

Because of the way the SCM muscle is located in the neck, it is also used as a landmark by doctors to help them find important things. This muscle acts as a boundary between the triangular areas at the front and back of the neck (the `anterior triangle` and `posterior triangle`). Within these triangles are important nerves, blood vessels, lymph nodes, and glands. The SCM muscle acts as a guide to help doctors find these during surgery.

The SCM muscle is made up of parallel muscle fibers. There are two main types of fibers:

• White `anaerobic fibers`: These are the ones that give the muscle more power and help it make stronger contractions. But they tire quickly.
• Red aerobic fibers: Although these are not as powerful as white fibers, they can stay active for longer and do not tire easily.

Typically, the SCM muscle is made up of about 60% white fibers and the remaining 40% red fibers. This ratio may change slightly as you age.

Common conditions and disorders affecting the SCM muscle

Like any other muscle, the SCM muscle can be affected by a variety of problems. Injuries, sprains, strains, muscle atrophy, and sometimes tumors can damage this muscle.

Here are some of the most common conditions associated with the SCM muscle:

• Sternocleidomastoid syndrome: This is a condition that can come on suddenly (acute) or last for a long time (chronic). It causes neck stiffness, pain , and other symptoms. This is when certain areas of the SCM muscle become tight and develop tender points (called trigger points). Because the SCM muscle is large and complex, it can be easily pulled or injured. This means that there are several trigger points (painful knots) in the muscle.

• Temporomandibular joint disorders (TMD): As mentioned earlier, this condition occurs when there are problems with the muscles and ligaments that support the temporomandibular joint (TMJ). While not all TMD is directly related to the SCM muscle, problems with the SCM muscle can increase or cause new TMD-related pain.

• Torticollis (wryneck): This condition occurs when the SCM muscle is shortened and tight, causing the head to be pulled to one side. There are many types of this, but most often it is a congenital condition (congenital torticollis).

What does SCM muscle pain feel like? Where?

When you have a problem with the SCM muscle, it's important to know exactly where and how you feel the pain. Sometimes the SCM muscle can feel like a dull, aching pain, or it can feel like a sharp, stabbing pain.

However, what often happens is something called 'referred pain'. This means that even though the source of the pain is in the SCM muscle, you feel the pain somewhere else outside the neck. Think of it like an electrical message traveling a long distance.

Pain may be felt in the following areas due to a problem with the SCM muscle:

• Face
• Forehead
• Around and inside the eyes (`Eyes`)
• Cheek
• Ears and around the ears (`Ears`)
• Sinus cavities (`Sinuses`)
• Throat (especially when you swallow)
• Shoulders and armpit area

What are other symptoms?

In addition to pain, a problem with the SCM muscle can cause other symptoms, such as:

• Headache – especially on both sides of the forehead and behind the ears
• Dizziness
• Vertigo – a feeling of spinning or spinning around you
• Nausea
• Eye changes: droopy eyelid, red or watery eyes, slightly blurred vision
• Neck stiffness: Difficulty turning the head, looking up, or looking down.

What are the treatments for SCM muscle problems?

Okay, now let's see what treatments doctors usually recommend for these types of problems with the SCM muscle.

• Hot or cold therapy: This helps reduce swelling and pain.
• Stretches: These exercises are very important for strengthening muscle fibers, increasing their flexibility, and lengthening them.
• Massage: Massage helps to relax tight muscles and release trigger points.
• Osteopathic manipulation treatment: This is a treatment method performed by specially trained doctors.
• Physical therapy: Muscles can be restored through special exercises and treatments under the guidance of a physical therapist.

The most important thing is that if you have these symptoms, you should definitely see a doctor for a proper diagnosis and treatment.

In some cases, if the simple treatments mentioned above do not help and the pain continues to be severe, doctors may recommend surgery. This may be necessary, especially if the muscle is severely damaged (e.g., torn) or if there is a tumor or other growth that is causing tissue damage.

Things we can do to keep the SCM muscle healthy (Take-Home Message)

So, how do we keep this important SCM muscle in our neck healthy and strong? Here are some simple tips you can keep in mind:

• Manage stress and anxiety well: These can cause our muscles, especially those in the neck and shoulders, to tense up unnecessarily. So try to manage stress through things like regular exercise, getting enough sleep, yoga, and meditation.
• Always maintain good posture: Especially if you work with a computer or use your cell phone a lot, keep the screen at eye level and don't keep your neck bent. Even when reading books, keep your neck in a position that doesn't strain it.
• Provide good neck support when sleeping: If possible, sleep on your back, and use a pillow that fits your neck and provides good support. Avoid sleeping on your stomach as much as possible, as this puts unnecessary pressure on your neck.
• When doing abdominal exercises like `sit-ups`, lift your head up: `sit-ups` activate the SCM muscle a lot. If you try to lift your head up suddenly with force, you can injure this muscle.
• Do neck stretches daily: Especially if you work in the same position most of the day (e.g., office work), it's a good idea to do some simple neck stretches every day. If your job requires you to stay in a position that is uncomfortable for your neck for long periods of time (e.g., violinists, painters, drivers, carpenters), ask your doctor or physical therapist about specific exercises that can help protect your SCM muscle. Doing these exercises early can help prevent future injuries and pain.

The SCM muscle is a very important part of our neck that, together with other structures deep in our neck, helps us easily move our necks, turn our heads, and maintain good posture. Therefore, taking care of this muscle and trying to keep it healthy is very important for our overall health.

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