Student work: Case study for tight neck muscles by Leslie Stephens

Michelle Burns
February 16, 2016

During the course of attending massage school at A New Beginning School of Massage, students are given a number of assignments that requiring research and writing. Some of these assignments result in very insightful and  well thought out information and  decision-making outcomes. I am happy to share some of their assignments for you to enjoy.

My client has suffered from many symptoms due to tight neck muscles. neck-painI decided to write the case study on his condition because I see him often, he has been suffering for years, and I finally feel I have a chance to help him. He used to suffer from anxiety and high stress. His symptoms included headaches, neck tightness, dizziness, jaw pain and tension, brain fog, sharp eye muscle pain, and nausea. His symptoms have come and gone in the last few years and he has learned how to manage his anxiety and stress which has helped tremendously. He's visited chiropractors and massage therapists in the past who have seemed to help alleviate some of the pain but the tightness in his neck and shoulders have never gone away. Since starting massage therapy school, I have learned so much about the human body. I normally use him to practice my palpation and massage techniques. I've started working on his neck and shoulders using just a relaxation massage technique. The SCM on the right side of his neck is extremely tight and when I apply a little pressure, he tenses up and tells me it hurts in his collarbone and in his face muscles. Since receiving this assignment, I have been researching tight SCM conditions and here is what I have found: Tightness of the SCM can create a lot of pain such as...

  • Headaches
  • Facial pain
  • Jaw pain and tension
  • Dizziness
  • Brain fog
  • Blurry vision

He has all of these symptoms except for the blurry vision.

It's the only muscle that creates such widespread problems. In severe cases, sudden stretching can cause fainting. Dizziness can last for seconds or hours. It can create nausea, but not vomiting. 1

There are many causes that can contribute to tight SCM muscles. They include...

  • Overhead activities
  • Keeping head turned to one side
  • Forward head posture
  • Holding a phone with shoulder
  • Stomach sleeping
  • Heavy lifting
  • Falls and whiplash
  • A short leg or awkward posture
  • Stress and muscle tension
  • Chronic cough or asthma
  • Chest breathing

Massage treatment for a tight SCM begins by locating it. Once you have located the muscle, grasp it between your fingers and thumb and knead it gently. Just a couple of minutes each side daily. Also massage along the length of the muscle. 2

In my treatment plan I will laterally tilt head toward the shoulder, and slightly flex the head forward. I will grasp the SCM close to the shoulder side, starting at the head and knead down toward the sternum and clavicle. Depending on how tender the muscle is, I will apply deep transverse friction or apply circular friction. If it is too tender, I will apply light friction. Another method I can use will be to jostle the length of the muscle, and work the muscle fibers between my thumb and index finger. This is a good way to find some trigger points. The muscle will then need to be stretched after the treatment. I decided to use this method of treatment because it was recommended in my Kinesiology book for treatment of the SCM muscle.

I found a research article whose objective was to investigate the effects of massage therapy on chronic nonmigraine headaches. I chose this article because my client continues to have headaches that are not migraines. The method of the study is: sufferers received massage therapy directed toward neck and shoulder muscles. Headache frequency, duration, and intensity were recorded and compared with baseline measures. The result: headache frequency was significantly reduced within the first week. Duration of headaches tended to decrease during massage treatment period. However, headache intensity was unaffected. The conclusion stated: muscle-specific massage therapy technique used in this study has the potential to be a functional, nonpharmacological intervention for reducing the incidence of chronic tension headaches. 3

My expected outcome for this treatment plan is to get the SCM and upper trapezius muscle on the right side of his neck to become less tight and for him to experience fewer headaches. I'm glad I have the opportunity to work on his neck as often as needed and to continue to learn the information I need to give him some relief.

Follow up: It has been roughly 2 months since I started the treatment plan for the tight SCM. The first month I massaged the neck 3-4 times during the week. The second month I tapered off due to his busy schedule. His right SCM seemed to loosen up a little. However, his neck muscles are still tight and he still gets headaches every now and then.

My new plan will be to implement the same techniques and to get back on track with the massage. We need to make a set schedule for a neck massage 2-3 times a week.


  1., copyright 2009-2015
  2. The Trigger Point Therapy Workbook, Clair Davis, NCTMB & Amber Davies, NCTMB, second edition, copyright 2004
  3. Christopher Quinn, Clint Chandler, and Albert Moraska. Massage Therapy and Frequency of Chronic Tension Headaches. American Journal of Public Health: October 2002, Vol. 92, No 10, pp 1657-1661

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