Sternocleidomastoid Muscle Strain

Anatomy of the Sternocleidomastoid Muscle
Types of Sternocleidomastoid Muscle Strain
Causes of Sternocleidomastoid Muscle Strain
Symptoms of Sternocleidomastoid Muscle Strain
Diagnostic Tests for SCM Muscle Strain
Non-Pharmacological Treatments for SCM Muscle Strain
Drugs Commonly Used for SCM Muscle Strain
Surgical Options for Severe SCM Muscle Strain
Prevention Strategies
When to See a Doctor
Frequently Asked Questions (FAQs)

The sternocleidomastoid (SCM) is a key muscle located in the neck. It plays a central role in head movement, neck stability, and even in helping you breathe. An SCM muscle strain occurs when the muscle fibers are overstretched or torn due to injury, overuse, or trauma. This guide will help you understand everything from the basic anatomy of the SCM to detailed management and prevention strategies if you or someone you know is affected by a strain in this muscle.

Understanding SCM muscle strains is important because:

It is a common injury related to neck pain.
Its symptoms can affect daily activities like turning your head or lifting objects.
Knowing the causes and treatments can help you recover faster and prevent future injuries.

Anatomy of the Sternocleidomastoid Muscle

Understanding the anatomy of the SCM muscle is essential to know how a strain can affect its function. Below is an overview of its key anatomical features.

1. Structure and Location

Location:
The SCM runs on each side of the neck from behind your ear down to your collarbone and sternum.
Description:
It is one of the largest and most superficial muscles in the neck. Its long fibers are visible beneath the skin, especially when the neck is turned.

2. Origin and Insertion

Origin:
- Sternal Head: Begins at the upper part of the sternum (manubrium).
- Clavicular Head: Begins at the medial (inner) part of the clavicle (collarbone).
Insertion:
Both heads join and attach to the mastoid process (a bony prominence behind the ear) and the superior nuchal line of the occipital bone at the back of the skull.

3. Blood Supply

Main Vessels:
The SCM muscle receives blood from branches of the external carotid artery, including the occipital artery and other nearby vessels. This network of blood vessels ensures the muscle gets the oxygen and nutrients it needs to function and heal.

4. Nerve Supply

Primary Nerve:
The accessory nerve (cranial nerve XI) is the main nerve supplying the SCM, which is responsible for activating the muscle.
Additional Contribution:
Sensory input from cervical nerves (typically C2 and C3) helps the brain receive signals about the muscle’s condition and movement.

5. Six Key Functions

The SCM is a versatile muscle with several essential functions:

Head Rotation:
When one SCM contracts, it turns the head toward the opposite side.
Neck Flexion:
Unilateral or bilateral contraction of the SCM can help flex the neck (bringing the chin closer to the chest).
Neck Extension:
When both muscles work together, they help extend the neck backwards.
Lateral Bending:
The muscle assists in bending the neck to the side.
Postural Support:
It helps maintain the upright position of the head and neck.
Assistance in Breathing:
Under certain circumstances, the SCM assists in lifting the chest, helping with difficult breathing.

A sternocleidomastoid muscle strain happens when the muscle fibers are stretched too far or torn. This type of strain can result from:

Sudden trauma such as whiplash from a car accident.
Overuse from sports or repetitive activities.
Poor posture, which puts prolonged stress on the muscle.

Small tears occur in the muscle tissue, leading to inflammation, pain, and sometimes limited movement. In more severe cases, the fiber tearing may be extensive, causing significant weakness and discomfort.

Types of Sternocleidomastoid Muscle Strain

SCM muscle strains are typically categorized by the degree of injury. The classification is similar to other muscle strains:

Grade I (Mild Strain):
- Only a small number of muscle fibers are overstretched.
- Mild pain and tenderness are typical.
- Full range of motion is usually maintained, though it might be slightly uncomfortable.
Grade II (Moderate Strain):
- A greater number of muscle fibers are torn.
- Noticeable pain, swelling, and tenderness.
- Some weakness and limitation in movement can occur.
Grade III (Severe Strain):
- A complete tear or a large number of fibers are injured.
- Intense pain and significant loss of function.
- May require more intensive treatment, including possible surgery.

Other ways to classify SCM strains include:

Acute Strain: Occurs suddenly following an injury.
Chronic Strain: Develops over time due to repetitive stress or poor posture.

Causes of Sternocleidomastoid Muscle Strain

Understanding the causes of an SCM strain can help in both treatment and prevention. Here are 20 potential causes:

Whiplash:
Sudden rapid back-and-forth movement of the neck, commonly seen in car accidents.
Sports Injuries:
Contact sports or activities with high-speed impacts may lead to neck trauma.
Poor Posture:
Long hours spent with a forward head posture, particularly during desk work.
Overuse in Exercise:
Repetitive strain from weight training or improper exercise techniques.
Occupational Hazards:
Jobs that require repetitive head movements or sustained positions.
Accidents and Falls:
Any sudden trauma from falling can result in muscle strain.
Sudden Twisting Movements:
A forceful twist of the neck that exceeds the muscle’s capacity.
Heavy Lifting:
Lifting objects with poor technique may strain the neck muscles.
Sports Overexertion:
Excessive training or sudden forceful movements in sports.
Repetitive Computer Work:
Prolonged computer use in a static position.
Awkward Sleeping Positions:
Sleeping in an awkward position can put undue stress on the neck.
Stress-Related Muscle Tension:
Emotional or physical stress often leads to muscle tightness.
Trauma from Physical Altercations:
Blows to the head or neck area can strain the muscle.
Sudden Impact in Recreation:
Accidents during recreational activities such as cycling or skiing.
Improper Warm-Up:
Failing to warm up before exercise can increase the risk of strains.
Acute Onset of Muscle Fatigue:
Overexertion leading to muscle fatigue and subsequent strain.
Underlying Muscular Imbalance:
An imbalance in neck muscles can make the SCM more prone to injury.
Structural Abnormalities:
Conditions like scoliosis may alter neck mechanics.
Improper Technique in Sports:
Not using proper form in activities that strain the neck.
Direct Blow to the Neck:
Any direct impact to the neck can cause trauma to the SCM muscle.

Symptoms of Sternocleidomastoid Muscle Strain

The symptoms of an SCM strain can vary depending on the severity of the injury. Here are 20 common signs and symptoms:

Neck Pain:
Dull, aching, or sharp pain in the neck.
Muscle Tenderness:
Soreness along the SCM muscle when touched.
Stiffness:
Difficulty in moving the neck freely.
Limited Range of Motion:
Reduced ability to turn or tilt the head.
Muscle Spasms:
Involuntary contractions or twitching in the neck muscles.
Swelling:
Noticeable puffiness around the affected area.
Bruising:
Discoloration may occur if small blood vessels have been damaged.
Headache:
Tension-type headaches that result from neck muscle strain.
Pain on Movement:
Increased pain when turning the head or bending the neck.
Radiating Pain:
Pain that spreads to the shoulder or upper back.
Fatigue:
Muscle weakness and tiredness in the affected area.
Sharp Pain with Sudden Movement:
A sudden jolt can cause intense pain.
Difficulty Swallowing:
Severe strain may affect nearby structures, making swallowing uncomfortable.
Clicking or Popping Sensations:
A noticeable sound when moving the neck.
Stiffness in the Morning:
Waking up with a stiff neck is common.
Numbness:
In some cases, a tingling sensation or loss of feeling in the shoulder or upper arm.
Warmth:
The injured area may feel warm due to inflammation.
Reduced Endurance:
Getting tired quickly when performing neck movements.
Pain with Pressure:
Increased discomfort when pressure is applied to certain parts of the muscle.
Difficulty Maintaining Posture:
Challenges in keeping the head upright or balanced.

Diagnostic Tests for SCM Muscle Strain

Doctors use several tests to diagnose SCM strains. These tests help rule out other injuries and confirm the diagnosis:

Physical Examination:
A hands-on exam where the doctor checks for tenderness, swelling, and pain during movement.
Range-of-Motion Testing:
Assessing how far you can turn or tilt your head.
Palpation:
The doctor presses along the neck to locate tender or injured spots.
Manual Muscle Testing:
Testing strength by asking you to resist against gentle pressure.
X-Rays:
Imaging to rule out fractures or bone abnormalities.
Magnetic Resonance Imaging (MRI):
Detailed imaging that shows soft tissue injuries in the muscle.
Ultrasound Imaging:
A non-invasive test to visualize muscle tears or inflammation.
CT Scan:
Cross-sectional imaging to evaluate any associated bone or soft tissue issues.
Electromyography (EMG):
Measures the electrical activity of muscles to assess injury.
Nerve Conduction Studies:
Tests the speed and strength of signals in the nerves around the muscle.
Blood Tests:
Checking markers for inflammation (for example, C-reactive protein) when severe symptoms are present.
Postural Analysis:
Evaluates neck and head alignment which might reveal strain patterns.
Range-of-Motion Measurement Devices:
Tools to quantitatively assess movement limitations.
Trigger Point Examination:
Identifying specific spots where the muscle is overly tender.
Pressure Algometry:
A device may be used to measure pain thresholds on the affected muscle.
Clinical Observation:
Observing how the injury changes with movement or rest.
Functional Movement Assessment:
Looking at daily activities to see if there’s abnormal neck movement.
Dynamic Ultrasound:
Evaluates the muscle while it is moving to check for tears or impingement.
Radiographic Imaging:
Additional X-rays or imaging to rule out related cervical spine issues.
Ultrasound Elastography:
An advanced method that assesses the stiffness of the muscle tissue.

Non-Pharmacological Treatments for SCM Muscle Strain

In many cases, non-drug treatments are very effective in relieving symptoms and promoting healing. Here are 30 treatment methods:

Rest:
Avoid overusing the neck to give the muscle time to heal.
Ice Application:
Apply an ice pack for 15–20 minutes at a time to reduce inflammation in the first 48 hours.
Heat Therapy:
After the initial swelling, use a warm compress to relax tight muscles.
Physical Therapy:
Guided exercises and modalities to restore strength and range of motion.
Stretching Exercises:
Gently stretch the neck to improve flexibility and reduce tension.
Massage Therapy:
Professional massage can help reduce muscle tightness and relieve pain.
Posture Correction:
Adopt ergonomic postures during work and leisure to reduce strain.
Ergonomic Adjustments:
Modify your workspace, such as adjusting the height of your monitor and chair.
Neck Exercises:
Specific exercises designed to strengthen the SCM and surrounding muscles.
Yoga:
Gentle yoga poses help improve flexibility and reduce muscle tension.
Chiropractic Care:
Spinal adjustments and manual techniques to relieve neck strain.
Acupuncture:
Using fine needles to reduce pain and stimulate healing in the affected muscle.
Trigger Point Release:
Targeted pressure on specific points within the muscle to reduce pain.
Manual Therapy:
Techniques by physical therapists to mobilize the neck and reduce stiffness.
TENS (Transcutaneous Electrical Nerve Stimulation):
A device that uses mild electrical impulses to help relieve pain.
Cold Laser Therapy:
Low-level laser treatments that may promote tissue repair and reduce inflammation.
Ultrasound Therapy:
Applying sound waves to increase blood flow and reduce muscle spasms.
Balance and Coordination Training:
Exercises that help improve overall neck stability.
Meditation and Relaxation Techniques:
These can help reduce overall muscle tension and stress.
Breathing Exercises:
Controlled breathing techniques to help relax the neck muscles.
Use of a Cervical Collar (Short-term):
A soft collar may help reduce motion and support the neck during early healing.
Activity Modification:
Changing or limiting activities that cause pain.
Postural Re-education:
Training to develop better habits for holding your head and neck.
Biofeedback Therapy:
Techniques that help you learn to control muscle tension.
Heat Packs:
Readily available heating pads can provide consistent warmth to ease tight muscles.
Self-Massage Techniques:
Simple routines you can perform at home to ease localized tension.
Pilates:
Low-impact exercises that focus on core strength and proper alignment.
Light Strength Training:
Gentle exercises to build neck strength without stressing the muscle.
Range-of-Motion Exercises:
Gradually increasing neck movement to avoid stiffness.
Water Therapy (Aquatic Therapy):
Exercising in water reduces the load on your neck while allowing gentle movement.

Drugs Commonly Used for SCM Muscle Strain

While non-pharmacological treatments are key to recovery, certain medications may help relieve pain and reduce inflammation. Always follow your doctor’s advice regarding drug use. These include:

Ibuprofen:
A non-steroidal anti-inflammatory drug (NSAID) commonly used to reduce pain and swelling.
Naproxen:
Another NSAID effective for pain relief and reducing inflammation.
Diclofenac:
Often used topically or orally to treat muscle pain and inflammation.
Celecoxib:
A COX-2 inhibitor that reduces inflammation with potentially fewer stomach issues.
Aspirin:
Used for its pain-relieving properties and mild anti-inflammatory effect.
Acetaminophen:
Provides pain relief though it does not reduce inflammation.
Other COX-2 Inhibitors:
Similar to celecoxib, these help in reducing inflammation and pain.
Cyclobenzaprine:
A muscle relaxant that can help ease muscle spasms.
Tizanidine:
Another muscle relaxant to relieve spasm and stiffness.
Baclofen:
Helps reduce muscle tightness.
Gabapentin:
Can be helpful when nerve-related pain accompanies the strain.
Pregabalin:
Often used for nerve pain and can be helpful in severe strains.
Topical NSAIDs:
Such as diclofenac gel, applied directly to the painful area.
Topical Diclofenac:
Provides targeted pain relief with minimal systemic absorption.
Capsaicin Cream:
Derived from chili peppers, it can decrease pain signals in the affected muscle.
Oral Corticosteroids (if necessary):
Short courses may reduce severe inflammation (e.g., methylprednisolone).
Methylprednisolone (Injection or Oral):
A corticosteroid that can be injected into the area if needed.
Prednisone:
Another corticosteroid option for severe inflammation.
Tramadol:
A pain reliever for moderate to severe pain that does not respond to NSAIDs.
Combination Opioid/Acetaminophen Preparations:
In acute severe cases, a short course may be used under strict supervision.

Surgical Options for Severe SCM Muscle Strain

Surgical intervention is rare for SCM strains but may be considered if there is a severe tear or persistent dysfunction that does not respond to conservative treatments. Possible surgical options include:

Muscle Repair Surgery:
Direct repair of torn muscle fibers to restore function.
Tendon Repair:
Reattaching a torn tendon to the muscle or bone.
Debridement:
Removal of damaged tissue to promote healing.
Myotomy:
A surgical procedure to release tension when chronic shortening of the muscle is present.
Neurolysis:
The release of scar tissue around nerves if they are entrapped by the injured muscle.
Scar Revision Surgery:
Correcting problematic scar tissue that is causing ongoing issues.
Capsulectomy (if joint involvement exists):
Removing part of the joint capsule that is involved due to the proximity of the SCM to the cervical region.
Arthroscopic Procedures:
Minimally invasive surgery when adjacent joint structures are affected.
Open Surgical Repair:
A more invasive repair technique for extensive injuries.
Reconstruction of the SCM Muscle:
In cases of severe or complete muscle rupture, reconstructive techniques may be applied.

Prevention Strategies

Preventing SCM muscle strain is key to avoiding painful episodes and long recovery periods. Here are 10 effective prevention methods:

Maintain Good Posture:
Regularly check your posture and adjust seating positions to reduce neck stress.
Ergonomic Workspace:
Use an adjustable chair, monitor stand, and proper desk setup to keep your neck aligned.
Regular Exercise:
Strengthen your neck and upper back muscles to support proper posture.
Stretching Before Exercise:
Warm up your muscles with gentle stretches before any activity.
Avoid Sudden Movements:
Be cautious during sports or physical activities that require rapid neck movements.
Use Proper Lifting Techniques:
Bend with your knees and keep heavy loads close to your body to reduce neck strain.
Take Frequent Breaks:
If you’re at a computer or desk, take breaks to move and stretch your neck.
Invest in Supportive Pillows:
A pillow that properly aligns the neck during sleep can reduce the risk of strain.
Manage Stress:
Stress can lead to muscle tension. Techniques like meditation, breathing exercises, or gentle yoga can help.
Regular Physical Therapy Check-Ups:
If you have a history of neck pain, periodic consultations with a physiotherapist can help monitor and adjust your habits before a strain develops.

When to See a Doctor

While many SCM strains resolve with home care, there are times when medical attention is necessary. Consider seeing a doctor if you experience:

Severe or Worsening Pain:
If the pain is intense or does not improve with rest and basic treatments.
Limited Mobility:
If you cannot move your head or neck normally.
Persistent Swelling or Redness:
Ongoing signs of inflammation that do not subside.
Neurological Symptoms:
Numbness, tingling, or weakness in your arms or hands.
Difficulty Swallowing or Breathing:
Any signs that nearby structures are involved.
No Improvement After 2 Weeks:
If symptoms persist despite home treatment, medical evaluation is recommended.

Frequently Asked Questions (FAQs)

What is a sternocleidomastoid muscle strain?
It is an injury where the SCM muscle fibers are stretched or torn due to trauma, overuse, or poor posture.
What usually causes an SCM strain?
Causes include whiplash, sports injuries, prolonged poor posture, sudden twisting of the neck, and overexertion.
What are the most common symptoms?
Typical symptoms include neck pain, tenderness along the muscle, stiffness, limited range of motion, and headaches.
How is an SCM strain diagnosed?
A doctor will perform a physical exam, assess your range of motion, and may order imaging tests like X-rays, MRI, or ultrasound.
Are non-drug treatments effective?
Yes, rest, ice/heat therapy, stretching, massage, and proper ergonomics often help relieve pain and promote healing.
What exercises help in recovery?
Gentle stretching, strengthening exercises, and posture training directed by a physical therapist can restore function.
Can I continue my regular activities during recovery?
Light activities may be possible, but you should avoid movements that exacerbate the pain. Listen to your body and rest as needed.
How long does it typically take for an SCM strain to heal?
Recovery depends on the grade of the strain; mild strains (Grade I) may heal in a few days to two weeks, while more severe injuries can take several weeks or longer.
Is surgery ever required for an SCM strain?
Surgery is rarely needed. It is usually reserved for severe tears or cases unresponsive to conservative treatment.
What medications are commonly used to manage pain?
Non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and occasionally corticosteroids are used depending on the severity.
Can I prevent an SCM strain from occurring again?
Yes, by improving posture, strengthening your neck muscles, and using proper body mechanics during activities.
Are there risks of permanent damage?
With proper treatment, most SCM strains heal completely. However, repeated injuries may lead to chronic pain or reduced mobility.
How safe are NSAIDs and muscle relaxants?
When used as directed by a healthcare provider, they are generally safe. Always follow dosage instructions and discuss any concerns with your doctor.
What home remedies can I try?
In addition to rest and applying ice/heat, gentle self-massage, using supportive pillows, and modifying your workstation can make a big difference.
When should I seek medical help?
If your pain is severe, you experience neurological symptoms, or if the injury does not improve within a couple of weeks, consult your healthcare professional promptly.

Conclusion

Sternocleidomastoid muscle strain is a common injury that may result from a variety of causes such as trauma, overuse, or poor posture. Knowing the anatomy and functions of the SCM helps in understanding how the injury affects movement and daily activities. Accurate diagnosis involves a thorough physical examination along with imaging tests if needed. Most strains respond well to non-pharmacological treatments such as rest, ice, heat, physical therapy, and ergonomic adjustments. Medications such as NSAIDs, muscle relaxants, and in more severe cases, corticosteroids, can help manage pain and inflammation. Surgery is rarely needed, reserved only for severe injuries unresponsive to other treatments.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members

Last Update: April 14, 2025.

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