Name: Splenius Cervicis and Splenius Capitis Static Manual Release (Soft Tissue Mobilization)
Uploaded: 2023-04-26T01:02:18.000Z
Duration: 19 min 13 s

English captions

https://stream.mux.com/jS9fOr6qNLdmXRu3Dtri9hrj75zElxOOXLownAkc4E8.m3u8

Learn the proper technique for splenius cervicis and splenius capitis static manual release (a.k.a. soft tissue mobilization, ischemic compression, trigger point release) in this comprehensive step-by-step instructional video from the Brookbush Institute. This evidence-based video provides detailed guidance on assessment, positioning, tissue differentiation, and pressure application to release trigger points, decrease muscle tension, and improve cervical spine mobility and posture. Ideal for clinicians and movement professionals, including physiotherapists, registered massage therapists, athletic training students, and occupational therapists, seeking to enhance their manual therapy skills for neck health, rehabilitation, and posture.

Introduction to the Manual Technique

Understanding the Splenii Muscles

Identifying Trigger Points

Performing the Splenius Cervicis Release

Executing the Splenius Capitis Release

Practicing Manual Techniques Safely

Splenius Cervicis and Splenius Capitis Static Manual Release (Soft Tissue Mobilization)

This is Brent of the Brookbush Institute, and in this video we're bringing you another manual technique. Now if you're watching this video I'm assuming you're watching it for educational purposes, and that you are a licensed manual therapists following the laws regarding scope of practice in your state or region. That means athletic trainers, chiropractors, physical therapists, osteopaths, licensed massage therapists, you are likely in the clear to do these techniques. Personal trainers this probably does not fall within your scope of practice, although you might be able to use the palpation portion of this video, to aid in learning your functional anatomy in an educational setting supervised by a licensed manual therapists. Now before we place our hands on a patient or client it is important that we assess, and have a good rationale for doing so. And of course if we're going to assess, then we should be reassessing to ensure that the manual technique we're using is effective, and we have a good rationale for continuing to use that technique. In this we're going to go over static manual release of the splenii muscles, that's the splenius cervicis and the splenius capitis. I'm going to have my friend Melissa come out she's going to help me demonstrate. Now we're going to use the same four step process we've done in other static manual release videos. We're going to talk about how to palpate and differentiate the splenii from the other structures proximal to it on the posterior lateral neck. We're going to talk about any structures that might be proximal to the splenii muscles that we could insult or abrade with compression. We need to talk about trigger points a little bit because that will help the efficacy and accuracy of this technique, and we're going to talk about client and practitioner positioning, so that I am in a position that I can comfortably hold this technique. and my client can relax in the position they're in so that we can actually get a release. Now step number one of this technique is by far the hardest, it helps to know a little bit of functional Anatomy. We have to figure out how we're going to differentiate the splenii from the upper trapezius and the levator scapulae which it lies in between. Now it is important to be able to differentiate this structure because the upper trap, splenii, and levator scapulae don't all rotate the head in the same direction. So for example if I assessed Melissa she came in with some cervical dysfunction, maybe even some cervicogenic headache, and I noticed that she could not rotate her head completely in this direction, I need to know which of those muscles I should release on this side, and which I should release on this side. So let's talk about functional Anatomy a little bit. My splenii and this is splenius cervicis and splenius capitis together, originate from the spinous process of T6 up through the ligamentum nuchae to the spinous process of C3, and then they kind of run off in this direction, so from inferior medial to superior lateral, towards the mastoid process of the temporal bone, and you guys can feel that little bump that's behind your ear, that little point right that's where these fibers are heading to. You can imagine if I'm on this diagonal that when these muscles shorten, they'll create ipsilateral rotation. So the rotation the splenii muscles create matches the levator scapulae, but opposes the upper trapezius which rotates this way. So for example, if I had Melissa here and she had great rotation this way, we couldn't rotate this way very well, lets say she's stuck right there. What I would probably want to do is release levator scapulae and splenii on this side, but upper trapezius and deep extensors of the neck on this side. The more accurate I can be the better chance I have of getting good outcomes. So how do I get to this structure. Well we need to skip to step three real quick. Knowing where the common trigger points are, where we're likely to find those increases in tissue density is going to help. So trigger points are commonly just in line with the C7 spinous process, which is usually that most prominent spinous process of the base of the neck. So you guys can look for that and think ok, I got one trigger point that's going to be in here somewhere, and then the other one just happens to be in line with C2 which is the first spinous process I can feel underneath the head, It's nice and convenient so at least we have two nice landmarks we can kind of line up with. Now although I said that this this trigger point here which happens to be the trigger point for the splenius cervicis, is in line with the spinous process of C7 I can't just go ergh that's not going to work. It might leave a nice bruise but I'm probably not going to get to the splenii muscles, I actually need to get deep to the upper trapezius, and the only way I can do that is by finding the anterior border of the upper trapezius and falling off this way. So I don't know if you guys can kind of see my finger there fall off in front of the trapezius. Now we have to take another step here and get a little bit more technical and find the lamina trough, which is the trough between the transverse process and the spinous process here. So between the spinous process and the transverse process of a vertebra you have this little little divot, you guys can even kind of feel that if you kind of palpate in the neck here. The only difference is we need to find this trough while anterior to the trapezius, and heading down towards C7 spinous process. You guys got that, anterior to the trapezius, into the lamina trough, towards C7 spinous process and then we hit the levator scapulae, darn it, okay we're almost there. So what we're going to do is we're going to laterally flex, that's going to help soften up the upper trapezius a little bit, and then we're going to ipsilaterally rotate. And although this is going to shorten our tissues a little bit, for the splenius cervicis here it's going to allow me to get my thumb in between the upper trapezius and the levator scapulae which is just anterior, into that trough so that I can start doing my short stroke strumming perpendicular to the splenii fibers,which remember these fibers go up this way. So I'm actually going to be kind of doing these tiny little strums out this way in the trough with her head in this position, until I find the most dense fascicles. I'm going to look for a nice nodule once I find those fascicles and it's right there. All right and then I can use her head if I need to add a little tension to kind of stabilize that nodule, so I'm not playing the finger on top of the marble game, I can do that here. Now the other trigger point which is going to be our splenius capitis trigger point, all I need to do is start searching in through here and look for fibers that are heading from the spinous process out towards this mastoid process. The splenii muscles have a unique fiber direction which is kind of what I mentioned before, is why we need to be able to differentiate these tissues. They rotate differently than the deep extensors of the cervical spine underneath them. So i can have Melissa to do all sorts of things to help with my palpation, right like I can kind of get my fingers in the right place and I can go, hey do you mind rotating towards me against my thumb, right and then extend your head and turn lateraly towards me, and then if I do my my short strokes here, right so I'm going to come down this way, I can kind of see alright so I got her contracting the right muscle; can I get them, can I feel the ones that are going in the right direction heading in the right direction, and I can actually right here. And then once I find those tight fascicles is there any nodule or point of acute density that i can press on. Now a couple little things here guys; take your time, this isn't a race, nobody's expecting you to just put your finger right down on a trigger point in a muscle that's fairly deep and hard to palpate. That doesn't show proficiency to just kind of go aah, it shows maybe carelessness more than anything else. Your patient doesn't know whether this should take you 15 seconds to find, or three minutes to find. So if you know your functional Anatomy you can think of those fiber directions, you need your client you need to move your clients head around a little bit, you need to have them contract the muscle, that's all fine, that's all fine. Take your time. I'd rather you took three minutes to find the right point than to spend 15 seconds and be totally wrong, and not get any outcomes whatsoever. Now although we don't have too much issue here with sensitive structures, as long as you don't jab your finger up in towards the occiput that you kind of stay going posterior to anterior, you shouldn't run into any structures that are particularly sensitive to compression. You do have to be a little careful with the splenius cervicis point, because if you press down real hard, real fast, and you're not real careful, you could stretch the brachial plexus. So if you get any burning, searing, tingling they get that little jolt, right if they get any numbness, or funky pins and needles and their fingers, guys move, take your time, move your fingers around get off the brachial plexus. See if you can mess around with some ipsilateral flexion to get that brachial plexus out of the way, and still get to the muscle you're looking for. Now last we do need to talk a little bit about patient and client position. This is not a good idea all right, this is kind of weird, but I'm not I'm not just like palming people's foreheads and jabbing my thumbs in places where I can't see, especially because I can't see this trigger point here. This is all for you guys to be able to see a little bit of the anatomy, and how my hands are placed relative to some other structures. If I was going to do this in a seated position which you can, I would have Melissa swing her legs over the end of the table here and I would come sideways,and then I would probably use that that kind of quasi headlock position. I'll drop the table down here a little bit, but we talked about putting the forehead and the crease of your elbow on another one of our manual release techniques for the neck. If I do this, I can now move her head comfortably and she feels nice and stable. I can use my body against her shoulder, right like my rib cage and my torso here a little bit, and then I can take this thumb and get right where I need to get. This particular technique doesn't take a whole lot of pressure so you might be okay. It's not ideal body mechanics I can't really get my forearm perpendicular to, or parallel to the direction of force, but we're close to a good position here. I personally prefer to do this in supine, so i'm going to have Melissa swing all the way around here. I think supine is much more comfortable for both the patient and the client, and I think you guys will agree if I just slip this hand underneath the occiput, I now have total control of her head, and Melissa is very relaxed right now because we've done a lot of these videos and she trusts me, poor thing. She has had her neck worked on with me before. It might take a second to get your patients to completely relax, but you do have really nice control this way, and then I can take this hand and I'm going to use kind of this technique of reaching underneath her neck, and I can see her trap right here drop my hand ,and right anterior to it I'm going towards that laminar trough, and since I can feel C7 with these fingers, I can drop my thumb right down in that direction. Move her head however I need to, I can start doing my strumming out perpendicular to those fibers. Find the tightest fascicles, find my tight nodule, add a little tension so that I have that nodule pinned, and then wait for a release. And believe it or not the splenius capitis trigger point is even easier because all i have to do is move my fingers like this, right so i leave these digits kind of facing up, and i'm just going to use the weight of her head. I'm going tofind C2 which is that first by the spinous process I feel underneath her occiput. I'm going to look for the fibers that go in the right direction and I might have her like, okay can you rotate into this side here. I might have her rotate a little bit and then try to strum those fibers, find the most dense fibers, find the most dense nodule, and then once again just have her totally relax. The nice thing here is like my hand is curled, and then I just have the weight of her head hold for me until we get a release. Stay tuned for the close-up recap. So now for a close-up recap of the splenii static manual release. We're starting here with the splenius cervicis manual release. You can see my thumb is actually just anterior to the anterior border of the upper trap here, that my hand is wrapped underneath. I'm going to fall off the anterior border down into the lamina trough, which is the space between the transverse process and the spinous process on the posterior aspect of the cervical spine. I know that my common trigger point is down near the C7 spinous process. So i can even palpate the C7 spinous process with these two fingers and give myself an idea of where that is, and then kind of push my fingers towards one another. But unfortunately the first thing I run into actually is my levator scapulae. So the way I get my levator scapulae out of the way is I do a little ipsilateral rotation, and although this takes some tension off my splenius cervicis, it's the only way for me to sink my finger down between my upper trap and levator scapulae. Once I've sunk my finger down in there I can then use my short strokes, kind of this lateral to medial stroke, and these are very short strokes just a couple fascicles at a time, to find anything to me that feels overactive, feels tauter than it should be. Once I find those taut fascicles I can kind of move inferior to superior, superior to inferior to try to find the densest nodule, and then i can actually once i've located that nodule go back into a little contralateral rotation, contralateral flexion to add some tension back in those tissues and help me pin that point of hyperactivity. Once I get a release, of course I can move on and of course this is the more complicated of the two release techniques for your splenii muscles. The splenius capitis muscle has a trigger point that's commonly at the level of your C2 spinous process, which your C2 spinous process is the first spinous processs you feel underneath the occiput. So that's fairly simple, and we know that the splenii have this kind of unique fiber arrangement thats this way. So all we have to do is kind of go just to the side of C2 spinous process here, and look for fiber direction this way. Find her tightest fascicles by strumming this way, kind of from in the same direction that her shoulder to her ear would be. So we're strumming perpendicular to those fibers. Once we find them -find the tightest fibers that is, we can kind of go lateral to medial to see if there's a nodule and point of hyperactivity. And then I'm just using that kind of curved hand position and the weight of her head to do all the work, and once i get a release we're good to go and I would reassess. So there you have it knowing your functional Anatomy will definitely help your manual technique. It will help you differentiate structure so that you can place your hands where they need to be. As well as make you aware of these sensitive structures around the tissue that you're trying to target. Things like nerves, and lymph nodes, and arteries. Make sure that if you're going to place your hands on a patient that you have done an assessment, and have a good rationale for placing your hands on that patient. And if you're going to assess, make sure you reassess to ensure that your technique was effective and you have a good rationale for using that technique again. Now with manual therapy one-on-one live education is incredibly important. Please be looking for opportunities like workshops, and mentorships, and maybe even classes at your local university that can get you some one on one individual instruction. Or at least some live classroom instruction so you've had a chance to be critiqued and mentored, by somebody senior to you with some experience in manual therapy techniques. And before you bring this stuff back to your rehab, fitness, or performance setting, please practice on colleagues. There is no substitute for practice, and it is going to take a while to get accustomed to some of the techniques that we show in these manual technique videos. Don't expect to learn them in two, or three,. or even five minutes. You want to have hours of experience under your belt working on various different body sizes and shapes. So that when you do get that first paying client, first paying customer, and you're really trying to make a good positive impact, really trying to promote better outcomes, you feel comfortable with that technique. I look forward to hearing about your outcomes and hearing your questions in the comments section of this video, I'll talk with you soon. you

Home

Videos

Manual release techniques for the commonly overactive muscles of the cervical spine. Soft tissue release techniques for the upper trapezius, levator scapulae, and splenii. Advanced soft tissue, massage, trigger point palpation, and mobilization techniques to inhibit antagonists. The reliability and validity of manual release techniques for forward head, shoulders elevate, neck pain, shoulder pain, headache, and upper body dysfunction.

Static Manual Release: Upper Trapezius, Levator Scapulae and Splenii (for Upper-Body Dysfunction and Cervical Dysfunction)

The splenius cervicis and splenius capitis (splenii) are deep to the 

 , and portions of the muscle are deep to the 

These muscles are thick, tube-like muscles in the laminar trough of the cervical spine.

The splenii can be visualized as two columns bulging under the skin and 

These muscles have a fairly vertical fiber orientation with an obliquity opposite to other muscles of the cervical spine. The origin of the splenii are from the spinous processes of C7 - T6, and the insertion is the transverse processes from C1 - C3 and the mastoid process. The fiber orientation is vertical with an obliquity from inferomedial to superolateral, opposite the obliquity of the 

It is easiest to differentiate these muscles if you start at common trigger points where the increase in tissue density during palpation.

 can be palpated by falling of the anterior border of the 

 and pressing into the tissues of the lateral neck toward the laminar trough of C7. It helps to ipsilaterally flex and rotate the neck to soften the fibers of the 

 . Use short strokes perpendicular to the unique fiber direction (superomedial to inferolateral), in the laminar trough, to identify the muscle.

 can be palpated by placing your fingers between the spinous process of C2 and the mastoid process. Visualize the fibers running between those attachments. With the other hand, resist ipsilateral rotation, ipsilateral flexion, and extension to feel the fibers become dense and active under the thumb. Noting the unique fiber direction of this muscle, use short strokes perpendicular to the fiber direction (superomedial to inferolateral), in the laminar trough to identify the muscle.

The rest of the splenius cervicis and splenius capitis can be palpated by moving from cranial to caudal or caudal to cranial, and carefully identifying the fibers with the correct fiber angle.

Providing your palpation stays posterior to the transverse processes of the cervical spine, careful palpation does not pose a risk to sensitive tissues. Note, anterior to the transverse processes the carotid arteries, brachial plexus, etc., may be affected by palpation.

The most common trigger point for the splenius cervicis is approximately in line with C7, and the most common trigger point for splenius capitis is approximately in line with C2.

Although this technique can be performed in sitting with the practitioner behind the patient, it is most comfortable with the patient lying supine and the practitioner sitting at the head of the table.

The practitioner uses the hand opposite the side of treatment to gently move the head as needed, generally in the direction of ipsilateral flexion, ipsilateral rotation, and extension.

Note, this shortens the fibers of the splenii, but it also serves to soften the fibers of superficial muscles that must be palpated through.

The practitioner uses the thumb on the side of treatment to strum the fibers of the splenii. Generally, it is easiest to strum from just lateral the spinous process in an inferolateral direction.

Once a taut band is located, the length of the band is explored for a dense nodule.

The practitioner may then move the head to control the amount of tension and adjust the treatment hand to modify the direction of force with the intent of pinning and compressing a nodule.

Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).

Splenius Cervicis and Splenius Capitis Static Manual Release (Soft Tissue Mobilization)

Infraspinatus and Teres Minor Static Manual Release (Soft Tissue Mobilization)

Rhomboid Static Manual Release (Soft Tissue Mobilization)

Pectoralis Major and Subclavius Static Manual Release (Soft Tissue Mobilization)

Erector Spinae and Multifidus Static Manual Release

Levator Scapulae Static Manual Release (Soft Tissue Mobilization)

Deep Cervical Extensor Static Manual Release (Soft Tissue Mobilization)

Sternocleidomastoid Static Manual Release (Soft Tissue Mobilization)

Scalene Static Manual Release (Soft Tissue Mobilization)

Suboccipital Manual Static Release (Soft Tissue Mobilization)

Quadratus Lumborum Manual Static Release

Comments

Guest