Healthcare and Medicine Reference
In-Depth Information
Obliquus capitis
superior
Rectus capitis
posterior minor
Obliquus capitis
inferior
Rectus capitis
posterior major
Fig 3.26 The small but central suboccipital set of muscles is the
functional centerpiece of the SBL.
Rectus capitis
lateralis
Rectus
capitis
lateralis
SCM
Splenius
capitis
Obliquus
capitis
superior
Semispinalis
capitis
Trapezius
Rectus capitis
Rectus capitis posterior major
posterior minor
Fig. 3.27 An oblique view of the suboccipitals gives a much better
sense of how the muscles relate to each other and to head
movement. The OCI, running between the SP of C2 and TPs of
C1, is a fundamental modulator of rotation in the spine.
Fig. 3.29 A view looking up at the skull from below. The three
middle fingers of each hand usually correspond 'handily' to the
origins of the three suboccipital muscles at the deepest level of the
upper spine.
Rectus capitis
posterior minor
Rectus capitis
posterior major
Obliquus capitis inferior
Though treatment of these muscles can be a complex
process of unwinding, for the reasons given above, we
can facilitate palpation. Once again, your supine client's
head rests in your hands, but this time the occiput is
cradled in your palms, so your fingers are fully free.
Curl your fingers fully up under the occiput (so that
they point toward you, not toward the ceiling), and
'swimming' in past the trapezius and semispinalis to
these deep little muscles. Leave the little fingers on the
table, and let your ring fingers touch at the client's
nuchal midline, so that six fingertips are arrayed along
the bottom of the occiput (Fig. 3.29). With adjustments
for differently sized hands and heads, your ring fingers
will be in contact with the RCPM, your middle fingers
on the RCPMaj, and your index fingers on the OCS.
Strumming back and forth with the middle finger will
often (but not always) reveal the more prominent band
of the RCPMaj, and the two other fingers can be placed
evenly on either side of it (DVD ref: Superficial Back Line,
1:02:20-1:04:22).
To reverse the common postural problem of the
occiput being held forward on the atlas (occipital pro-
traction or axial flexion), you need to create length and
release in the muscles under your index and ring fingers.
To combat postural hyperextension of the neck, you
need to release the slightly more prominent RCPMaj
Obliquus capitis
superior
Fig. 3.28 A lateral view of the suboccipitals shows us how the
RCPM and OCS pull the skull down and forward, whereas the
RCPMaj tends to pull the skull down and just a little back. In
extreme cases, they all work together, but in 'fine tuning' a head-
neck relationship, differentiating among them is essential to the
best work.
pull the atlas posteriorly because the dens of C2 pre-
vents this motion.)
The most lateral of these three, the obliquus capitis
superior (OCS), runs down and forward again from the
posterolateral part of the occiput, this time to the large
TPs of the atlas. This muscle, which runs on a parallel
course to the RCPM, will have the same effect - pulling
the occiput forward on the atlas (as well as helping to
create a postural rotation in the O-A joint if it is tighter
on one side than the other).
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