Every day we see the forward head posture and neck dysfunctions. Yes, there are many reasons that people get headaches. But one of the main culprits is the sub-occipitals. Exaggerated forward head posture creates increased cervical lordosis and to keep the eyes from looking down the client must hyperextend at the Occipital Atlanto joint or O-A joint. We also discuss this in a previous blog and have a short video on assessing the O-A joint. This creates the sub-occipitals and sternocleidomastoid or SCM to stay in a state of hypercontraction and when they are held in this isometric contraction problems arise like Hypertonia of the rectus capitus and unilateral hypertonia of the obliques capitis which are sub-occipital muscles. The apex of the exaggerated lordotic cervical curve in the forward head posture is usually at the C4-C5 junction so of course this area is usually the most hypermobile and dysfunctional.
As therapist or clinicians, it is important to understand the 8 muscles of the sub-occipitals and their relation to neck dysfunction. When a client presents with the upper cross syndrome it is important to work these tight sub-occipitals. When left unchecked and treated the increased cervical curve will cause these muscles to return to a hypercontracted state in an attempt to raise the eyes. In other words, treat the dysfunction and the cause of the neck dysfunctions and be sure to offer home training exercises to train the client and the brain to use the posterior muscles rather than the flexors to help restore balance and create long term pain relief. The sub-occipitals are usually always worked on in my practice. Simply because of their function and their correlation with C1-C2. A lot of clients have dysfunction with these vertebrae and in the treatment room it is very important to bring balance to the occiput on the vertebral column. As well as having a level sacral base. C2 in particular is crucial for balance. With the Levator Scapula, splenius cervicis, semispinalis all determine balance at C2. Research is now showing that the sub-occipital muscle rectus capitis whose primary job is to resist flexion efforts actually has firm attachments not only to the occiput but the dura matter in the brain. This leads researchers to believe the rectus capitis muscle may bind down the dura matter creating neck and head pain. This also correlates a direct connection between the musculoskeletal and the cranial sacral systems. So, you can see bringing balance to the sub occipitals can be very helpful with neck pain and bringing balance back to the body.