Article written by Chris Branam
Finishing up this series on upper back and neck pain brings me to the deepest of the neck muscles: the multifidi and rotatores. Rather than being one large band of muscle spanning two points like the sternocleidomastoid, there are dozens of multifidi and rotatores running between each vertebra for the entire length of the spine. The mulfifidi and rotatores connect a vertebra to the vertebrae two to four segments below it. These little guys are responsible for precise movements of the head and spine.
When these muscles are overworked—not a difficult task with such a small muscle—they cause pain that seems to radiate from the spine itself. This pain can often be mistaken for problems in the disks or vertebrae of the spine. Janet Travell documented that multifidi trigger points can refer pain upward to the back of the head and down over the neck and shoulder girdle. It is possible for tension in these muscles to be severe enough to cause a minor dislocation of a vertebra, but releasing the trigger point through massage typically causes the bone to slip back into place. These muscles could be strained by the process of attempting to hold the neck rigid while lifting a weight, such as in the picture below.
Photo credit Hookgrip
Below are some example trigger point locations. (Note: Because of these muscles’ cross-hatching pattern down the spine, trigger points can be nearly anywhere right next to the spine). Also shown are example pain referral patterns (in red) of the multifidi and rotatores of the cervical spine.
Photo Credit: Myofascial Pain and Dysfunction, Travell and Simons
Massage of these trigger points will be done nearly on top of the spine itself, just to either side of the bony ridge of the vertebrae. Supported fingers work well for this massage. Place your hands behind your head like you were being arrested (some Lift Big Eat Big readers will be more familiar with this pose than others). Using the opposite hand of the side you wish to work on, curl your fingers slightly so that the tips of the fingers on one hand can be driven into the muscle you’re working on.
Use the pressure from your hand on top to perform the massage (i.e. for right side massage, left hand on bottom, right hand supplying pressure).
You can see here I’m using the heel of my right hand to put pressure on the second knuckles of my fingers.
If this doesn’t work, lying down and cupping a ball in the hands works well. Hold the ball as shown, but lie on the floor where the weight of your head can supply the pressure. To massage, you can slightly shake your head, while still applying the trigger point massage tenet: “Always massage in one direction.”
While not a prevalent muscle one trains (no one is following back and bicep day with multifidi and rotatores day), trigger points in these muscles and the resulting pain can sideline you or at the very least cause the kind of persistent pain that distracts from those big numbers we’re all chasing. Work on these trigger points to get rid of the literal pain in your neck. Sorry, these won’t help with all the figurative pains.
Davies, Clair, and Amber Davies. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief. 2nd ed. Oakland: New Harbinger Publications, 2004. Print.
Travell, Janet G., and David G. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Baltimore: Williams & Wilkins, 1999. Print.