Longissimus Capitis

Introduction[edit | edit source]

Longissimus

The longissimus muscle is not one muscle, but a collection of three separate muscles that run up nearly the entire length of both sides of the spinal column, from the lower back up to the neck. These three muscles include:

Longissimus belongs to the intermediate column of the erector spinae group of muscles.[2]The longissimus capitis and longus colli stabilize the cervical spine anteriorly; injury to these muscles can occur with a high velocity whiplash mechanism.[3] Longissimus capitis functions in lateral rotation and extension of the neck. Longissimus literally means the longest muscle of the head, Longissimus capitis is the part of the longest muscle of the neck.[4].

Longissimus Capitis[edit | edit source]

Longissimus Capitis depicted below.

LongCap_Post_View
LongCap_Lat_View

Origin[edit | edit source]

Posterior surface of transverse processes of T1 to T5 and the articular tubercle of C4 to C7.[5]

Longissimus capitis origin.jpg

Insertion[edit | edit source]

Posterior margin of mastoid process and the temporal bone.[5][6]

Longissimus capitis insertion.jpg

Nerve Supply[edit | edit source]

Dorsal rami of cervical and thoracic spinal nerves (C6 to T4).[7]

Blood Supply[edit | edit source]

Muscular branches of the occipital artery from the external carotid artery.[7]

Action[edit | edit source]

Acting bilaterally, extends and hyperextends head; acting unilaterally, flexes and rotates the head ipsilaterally.[5]

Trigger Point Referral Pattern[edit | edit source]

Pain is usually referred around the ear, but can also refer nearby into the neck and behind the eye.[8]

Long capitis pain referral.png

Longissimus Capitis Injury/Syndrome[edit | edit source]

Joint dysfunction may cause mechanical neck pain that affects several neck and back muscles, including the longissimus capitis. Muscles in chronic neck pain often become hypertonic, but sometimes may become hypotonic. The changes in the muscles put more stress on the joints and cause the issue to worsen over time. Headaches may occur with this syndrome, and pain can spread throughout the body.[8][9]Longissimus Capitis can get strained due to a blow to the head or neck region during sports, being assaulted, or during a motor vehicle crash. Prolonged overhead activities can also result in the strain of the Longissimus Capitis muscle.[10]Use of cervical collar for prolonged periods of time can result in strained longissimus capitis muscle. Stress also plays a key role in development of Longissimus Capitis Muscle strain. [10]Acute trauma, acceleration/deceleration injury, chronic emotional stress, postural stressors, persistent neck and shoulder contraction, neck immobilization (cervical collar).[11]

Cervical dystonia, or spasmodic torticollis, is a painful syndrome that affects several cervical muscles, including the longissimus capitis. Symptoms include involuntary jerking movements of the head side to side or front to back. The cause of this disease has yet to be determined, but some hypotheses are head/neck injury or the use of anti-psychotics. One treatment available is the injection of the toxin botulinum, but many who suffer still do not receive relief. There is currently no cure.[9]

Signs and Symptoms of Longissimus Capitis Strain[edit | edit source]
  • Pain behind the ear which sometimes can also be felt behind the eyes
  • Headaches.
  • Tenderness in the back of the head and neck is one of the symptoms of longissimus capitis strain.
  • Scalp numbness or tingling.
  • Neck stiffness is also a common sign and symptom of longissimus capitis strain. [10]
Differential Diagnosis[edit | edit source]
  • Tension headaches
  • Cluster headaches
  • Degenerative disc disease
  • Herniated disc
  • Spasmodic Torticollis
  • Eye Strain
  • Mastoiditis. [10]

Management of Longissimus Capitis Strain[edit | edit source]

  • Cold therapy treatment
  • Warm therapy treatment
  • Soft tissue massage
  • Exercise therapy
Longissimus capitis exercises[edit | edit source]

Front and back isometric neck exercise

Stand with feet shoulder-width apart. Place both hands on forehead and gently push forward on the head, slowly increasing the tension. Prevent head movement by using the neck muscles. Once desired amount of pressure is reached, hold for 20-30 seconds. Repeat this procedure with hands placed behind the head with interlocking fingers.

Chin to chest stretch

Sit on the floor making sure to maintain good posture. Place hands behind the head and interlock fingers, make sure elbows face straight ahead instead of to the sides. Gradually pull head toward the chest and hold for 20-30 seconds. Remove hand placement and resume normal position with head. Slowly look up toward the ceiling or sky and hold position for 20-30 seconds. Repeat this procedure ten times daily.

Deep Cervical Flexor Isolated Activation.

The exercise starts in standing in front of mirror, to provide feedback to client re neck posture. Client has arms at 90 degrees flexions holding onto mirror with TheraBand resistance band looped behind upper neck. The action is then to retract chin backwards with a chin tuck, against the resistance band, checking all the while for good postural control. The hardest part of the exercise is the final part, getting chin back to neutral or beyond. Client performs 12-20 repeats with slow 2-4 counts, 1-3 sets.



References[edit | edit source]