Rectus Capitis Posterior Minor Can Give You a Headache

The rectus capitis posterior minor (RCPMin) is, clinically, one of the more important muscles in the human body, so it is especially important for manual therapists to be conversant with this muscle so that effective palpation assessment and massage and stretching treatment can be performed.

Transversospinalis in the Laminar Groove

The transversospinalis musculature is extremely important functionally, and important with pain and dysfunction. It includes the multifidus, the thickest muscle of the low back; and the semispinalis capitis, the thickest muscle in the back of the neck. When working this musculature, it is extremely important to work very far medially, over the laminar groove of the spine.

herniated disc with compression of the spinal nerve in the intervertebral foramen

Pathologic Disc Conditions of the Neck

The danger with a disc bulge or herniation is that the disc can compress the spinal nerve within the intervertebral foramen, causing a pinched nerve.

posterior glide / translation motion of the spine

Motions of the Cervical Spine

Table 1 shows average healthy ranges of axial motion of the cervical spine (head and neck), from the atlanto-occipital joint through the C7-T1 joint.

Teres Major – Lat’s Big Brother

The teres major is a muscle that often does not get the respect it deserves because it is next to the more well-known latissimus dorsi (lat). The lat might cover a larger surface area of the body, but in the posterior axillary fold of tissue, the teres major is actually quite a bit larger than the lat. For this reason, I like to call the teres major “the lat’s big brother”.

The greater occipital nerve can be compressed by a tight upper trapezius or semispinalis capitis

Manual Therapy Precautions When Working the Neck

It is essential to exercise caution when working the anterior neck. However, this should not prevent therapeutic manual therapy work to the anterior neck.

Flexor Pollicis Longus – Texting Thumb

The flexor pollicis longus (FPL) is the only muscle in the human body that flexes the distal phalanx of the thumb at the interphalangeal (IP) joint. It runs from the anterior surface of the radius to the distal phalanx of the thumb, passes through the carpal tunnel alongside nine tendons and the median nerve, and is a key muscle involved in texting thumb and carpal tunnel syndrome.

Pectineus – Hip Flexor/Adductor Transitional Muscle

As a hip flexor, the pectineus is an extremely important muscle because of its involvement in the postural distortion pattern known as lower crossed syndrome. Because of the location of the pectineus medially, it is also considered to be part of the adductor group. As such, the pectineus is an excellent example of a transition muscle, being located within two functional groups.

Gluteus Medius – The Deltoid of the Hip

The gluteus medius is an incredibly important muscle. It is functionally important at the hip joint, especially with frontal-plane mechanics. And this can have implications with dysfunctional movement patterns (e.g., Trendelenburg gait) as well as postural distortion patterns of scoliosis. And just as fascinating is to see the relationship between glute medius structure and function at the hip joint and compare it to the structure and function of the deltoid at the shoulder joint. Indeed, the gluteus medius can be described as the deltoid of the hip.

Superficial anterior view of the muscles of the neck

Musculature of the Cervical Spine

To perform orthopedic manual therapy to the neck that is accurate and specific, we need to know the attachments and actions of the muscles of the neck.

cervical spinal joints - posterolateral view of the atlanto-occipital joint

Cervical Spinal Joints

The disc joint is a cartilaginous joint that is composed of outer fibers called the annulus fibrosus that encircle the inner nucleus pulposus.