Splenius Capitis

Authors

Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Figure 1: Muscles of the Posterior and lateral neck¹

Figure 2: Muscles of the Neck and Back¹

Reading list

• Trigger points
  • Splenius capitis Muscle²
  • ³
• Finished
  • Gilroy⁴

Table 1: Splenius capitis muscle

Muscle	Origin	Insertion	Innervation	Action
Splenius capitis	Nuchal lig. C7-T4 SP	Lateral third of nuchal line Mastoid process	Spinal nn. Posterior rami (lateral br.) C1 - C6	Bilateral: Head and neck extension Unilateral: I/L sidebend, I/L rotation

Origin

• Nuchal ligament⁴
• C7-T4 SP⁴
  • Finando suggests that this muscle actually originates from the fascia associated with C4-T4 spinous processes³.

Insertion

The insertion is also called the “proximal attachment”³. The splenius capitis inserts proximally on:

• Lateral 1/3 nuchal line (occipital bone)⁴
• Mastoid process (temporal bone)⁴

The muscle runs deep to the sternocleidomastoid

Innervation

spinal nn. C1-C6 (Post rami, lateral branches)⁴

Action

• Bilateral: Extends C/S and head⁴
• Unilateral: I/L head SB and Rotation⁴

Note

The splenius capitis is a much more dominant axial rotator than the splenius cervicis⁵

Clinical significance

Control of upright posture is possible through constant interaction between the visual and vestibular system with short range rotators including obliquus capitis posterior inferior, rectus capitis posterior major, splenius capitis, and SCM⁶.

Muscle groups

Splenius Capitis is part of the Superficial intrinsic back muscle group

Palpation

To locate the splenius capitis first palpate these structures:

• Sternocleidomastoid
• Trapezius
• Levator scapulae

To palpate splenius capitis:

1. Have the patient in supine or seated with his/her back against the chair.
2. Locate the muscular triangle between the SCM (anteriorly), upper trapezius (posteriorly), and the levator scapulae (distally).
3. You should be able to palpate the taut bands of splenius capitis just proximal to the levator scapulae

Trigger point

Splenius capitis trigger points³

Pain pattern

Pain located at the vertex of the head³.

Splenius capitis pain pattern³

Etiology

• Overload due to postural stresses³
  • i.e. thrusting the head forward to compensate for excessive thoracic kyphosis³

Satellite Trigger Points

• Levator scapulae³
• Upper trapezius³
• SCM³
• Splenius cervicis³

Associated zones, meridians, and points

• Dorsal zone
• Foot Tai Yang Bladder meridian

Stretch Exercises

• 20 to 30° of contralateral rotation³
• Flex the head forward³
• Contralateral sidebend³

Note

This stretch should be slightly more forward than lateral³

Clinical significance

1.

Betts JG, Blaker W. Anatomy and Physiology. 2nd ed. OpenStax; 2022. https://openstax.org/details/books/anatomy-and-physiology-2e/?Book%20details

2.

Donnelly JM, Simons DG, eds. Travell, Simons & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Third edition. Wolters Kluwer Health; 2019.

3.

Finando D, Finando SJ, Finando D. Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch. Healing Arts Press; 2005.

4.

Gilroy AM, MacPherson BR, Wikenheiser JC, Voll MM, Wesker K, Schünke M, eds. Atlas of Anatomy. 4th ed. Thieme; 2020.

5.

Neumann DA, Kelly ER, Kiefer CL, Martens K, Grosz CM. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed. Elsevier; 2017.

6.

Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.