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

Differentiation

1. The splenius cervicis and splenius capitis (splenii) are deep to the upper trapezius , and portions of the muscle are deep to the levator scapulae .
2. These muscles are thick, tube-like muscles in the laminar trough of the cervical spine.
3. The splenii can be visualized as two columns bulging under the skin and upper trapezius , during resisted extension.
4. 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 levator scapulae , upper trapezius , and deep cervical extensors.
5. It is easiest to differentiate these muscles if you start at common trigger points where the increase in tissue density during palpation.
   • Splenius cervicis can be palpated by falling of the anterior border of the upper trapezius 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 levator scapulae . Use short strokes perpendicular to the unique fiber direction (superomedial to inferolateral), in the laminar trough, to identify the muscle.
   • Splenius capitis 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.
6. 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.

Potentially Sensitive Tissues

• 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.

Trigger Points

• 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.

Release Technique:

1. 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.
2. 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.
3. Note, this shortens the fibers of the splenii, but it also serves to soften the fibers of superficial muscles that must be palpated through.
4. 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.
5. Once a taut band is located, the length of the band is explored for a dense nodule.
6. 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.
7. Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).