the muscle box - neck, shoulder, upper & lower back
Important muscles/tendons that help YOU help others!
You could search in Internet, read blogs, and sift through lots of online videos, OR you can take a short cut and get some very good anatomy education RIGHT HERE! We have done a LOT of leg work to put this valuable information in one place.
PLUS, a lot of this comes from many years of getting results for thousands of clients. Of course, there are over 600 muscles in the body, and you'll work on more than this list, but after 30+ years of providing relief we have learned this list will give you a great start.
The "Muscle Box" - This is a list of muscles we learned to target as we perform therapy. We also list a few tendons that are important to know as we help our clients. If you learn this list, you'll have a good basic understanding of many of the tight muscles that can affect your clients.
We have been getting performance feedback from clients since 1989 so we know this list is a vital key to your capability to help your clients.
You will see:
(a) The muscle/tendon name and picture,
(b) The action of the muscle/importance of the tendon,
(c) The attachment points (We sometimes use generic descriptions.) and
(d) A "nickname" you can you use in your progress notes.
(e) Why is this important section. Information to help you provide better results for your client.
Note: Even though this course is "basic anatomy", it is the building block of both your ability to perform our therapy style, AND your ability to communicate what you are doing.
1.Levator Scapula
modified by Uwe Gille [Public domain], via Wikimedia Commons
Action
The levator scapulae is located at the back and side of the neck. As the Latin name suggests, its main function is to lift the scapula.
Actions: a) raise scapula b) rotate scapula
Attachments
Origin: hairline ( Posterior tubercles of transverse processes of C1 - C4 vertebrae )
Insertion: medial edge of scapula ( Superior part of medial border of scapula)
Nickname for chart
levator
Why is this important?
Every one of the sixty plus muscles/tendons/locations listed here can be VERY important for your client. When our clients said, "That's the spot!" we paid close attention and eventually made this list. As you learn the Muscle Box and the Nerve Box, you'll understand the Tool Box better AND be able to incorporate our training from the Secret Sauce page.
Action
The trapezius is a large paired surface muscle that extends longitudinally from the occipital bone to the lower thoracic vertebrae of the spine and laterally to the spine of the scapula .
Actions: (1) Rotation, (2) retraction, (3) elevation, and (4) depression of scapula
By sections:
a) [upper] shrugging shoulders , extend neck, tilt head
b) [middle] retract shoulder blade
c) [lower] depress shoulder blade
Attachments
Hairline to mid back & from the spine out to clavical/shoulder blade
The technical description:
Origin: external occipital protuberance, spinous processes of vertebrae C7-T12, Nuchal ligament, Occipital Bone Medial one-third of superior nuchal line External occipital protuberance Ligamentum nuchae T1-T12 spine Corresponding supraspinous ligaments (all along the spine from the hairline to the mid back)
Insertion: nuchal ligament, medial superior nuchal line, posterior border of the lateral one -third of the clavicle, acromion process, and spine of scapula (outside of the collar bone + edge of the scapula)
Nickname for chart
trap
Why is this important?
We will teach you which parts of the trap are likely to cause different client concerns.
Why is this important?
3. Pectoralis Minor
By Anatomography - Anatomography , CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=21203545
Action
The pectoralis minor is a thin, triangular muscle, situated at the upper part of the chest, beneath the pectoralis major.
Action: Stabilize the scapula
Attachments
Origin: 3rd to 5th ribs
Insertion: caracoid process of scapula ( Medial border and superior surface of the coracoid process of the scapula)
Nickname for chart
Pect minor
Why is this important?
This is a key player for several shoulder/neck/arm/back concerns. You need to know how to release the Pect Minor tightness will help you provide a more "complete" shoulder therapy.
4. Scalenes
By User:Mikael Häggström - Image:Gray387.png, Public Domain, https://commons.wikimedia.org/w/index.php?curid=8984641
Action
The scalene muscles are a group of three pairs of muscles in the lateral neck.
Actions:
1) Elevate 2nd rib & tilt neck
2) Also helps with respiration
Attachments
Origins: C2 to C7
Insertions: 1st & 2nd ribs
Nickname for chart
Scalenes
Why is this important?
Most people are too tight on the front, so the Scalenes are usually involved in neck/shoulder/head concerns. We will show you an effective (and comfortable for the client) way to release this area.
5. Sternocliedomastoid
By Image:Gray385.png modified by Uwe Gille - Image:Gray385.png, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2492590
Action
The sternocleidomastoid (SCM) muscle is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck.
Action: Rotation and flexion of the neck
Attachments
Origin: Sternum and clavicle
Insertion: Mastoid process
Nickname for chart
SCM
Why is this important?
Like the Scalenes, the SCM is very important regarding balance in the neck and upper back. It's almost always tight for neck/shoulder/upper back concerns.
6. Splenius Capitis
Action
The splenius capitis is a broad, strap like muscle in the back of the neck. It pulls on the base of the skull from the vertebrae in the neck and upper thorax. It is involved in movements such as shaking the head
Action: Extend the neck/shake head
Attachments
Origins: C7 to T3 (see photo)
Insertion: Mastoid process (hairline)
Nickname for chart
Splenius
Why is this important?
1) As you learn to help specific "areas of concern", and clients give you feedback during therapy, you will discover "patterns of tightness". It really helps to know which muscle you are targeting.
2) Clients tell us it's unusual to receive therapy on the Splenius muscles.
7. Splenius Cervicus
Action
The Splenius Cervicus is similar to the Splenius Capitis, but it inserts into the neck.
Actions: 1) Bilaterally: Extend the head & neck, 2a) Unilaterally: Lateral flexion to the same side, 2b) Rotation to the same side.
Attachments
Origins: T3 to T6 (see photo)
Insertions: C1 to C3 (neck; see photo)
Nickname for chart
Splenius
Action
The rhomboid muscles, often simply called the rhomboids, are rhombus-shaped muscles associated with the scapula.
Actions:
a) retract/rotate scapula
b) stabilize scapula
Attachments
Origins: spinous processes of the C7 to T5
Insertions: medial (inside) border of the scapula
Nickname for chart
rhomboid
Why is this important?
We have found that this area of the back is almost always tight, and will teach you several techniques to release the area.
9. Spinal erectors
Source: Wikipedia commons
- Public Domain
- File:Gray389 - Erector spinae.png
- Created: before 1858 date
Action
The erector spinae or spinal erectors is a set of muscles that straighten and rotate the back.
Actions: a) back extension
b) help rotate (turn) back
Attachments
Origins: 1) Spinous processes of T9-T12 vertebrae, 2) medial (inside) slope of the dorsal part of illiac crest - see photo.
Insertions: spinous processes of T1 and T2 vertebrae and the cervical vertebrae (see photo)
Nickname for chart
erector
Why is this important?
a) You will sometime see "unilateral" tightness of this group - that will help you understand lifestyle, sports or injury origins. b) Please note these muscles run up almost the whole length of the back.
10. Serratus Posterior Superior + Inferior
Action
The serratus posterior superior is a thin, quadrilateral muscle, situated at the upper and back part of the thorax, deep to the rhomboid muscles.
Action: Elevate the ribs
Helps breathing (inspiration)
Attachments
Origins: C 7 - T3
Insertions: 2nd - 5th ribs
Nickname
Serr Post
Why is this important?
Tightness in this area can contribute to discomfort in breathing. We will show you how to release this area. NOTE: There is also a similar group called the Serratus Posterior Inferior, which is located in the lower rib cage. Origin: L2 to T11 and Insertion: T 9 to T12, and also helps with expiration.
11. Quadratus Lumborum
Action
The quadratus lumborum muscle is a paired muscle of the left and right posterior abdominal wall.
Actions:
a) Alone - unilateral: "Hip hiker" (lateral flexion of spine)
b) Together - bilateral: depression of rib cage
Attachments
Origin: Posterior border of iliac crest
Insertion: Inferior (lower) border of 12th rib and L1-L5
Nickname for chart
Q L
Why is this important?
Another muscle that doesn't get a lot of attention. We will teach you how to palpate and work on this muscle.
Rotator cuff group
12. Supraspinatis
https://commons.wikimedia.org/wiki/File:Supraspinatus_muscle_back4.png
By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22783765
Action
The supraspinatus is a relatively small muscle of the upper back that runs from the supraspinatous fossa superior portion of the scapula to the greater tubercle of the humerus. It is one of the four rotator cuff muscles .
Actiions: a) abduct arm
b) stabilize arm
Attachments
Origin: Upper scapula
Insertion: upper arm (see photo)
Nickname
Supra
Why is this important?
This muscle is small, BUT it usually a key player in shoulder concerns. We will teach you several ways to palpate and work on the supraspinatis.
13. Infraspinatis
https://commons.wikimedia.org/wiki/File:Infraspinatus_muscle_back.png
By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22783765
Action
The main function of the infraspinatus is to externally rotate the humerus and stabilize the shoulder joint.
Actions: a) adduct or rotate arm
b) extend arm or depress shoulder
Attachments
Origin: infraspinous fossa (flat part of shoulder blade )of the scapula
Insertion: middle facet of greater tubercle of the humerus (top of arm)
Nickname
infra
Why is this important?
Another key player in the shoulder! The infraspinatis can be uncomfortable to release, so we will teach you several techniques so you can stay within your client's comfort zone during therapy.
14. Teres Major
By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22783765
Action
Actions: (a) adduct the humerus, (b) Internal rotation (medial rotation) of the humerus, (c) extend the humerus from flexed position, (d) Depress shoulder
Attachments
Origin: (Lower shoulder blade) Posterior aspect of the inferior angle of the scapula
Insertion: (Inside of upper arm) Medial lip of the intertubercular sulcus of the humerus
Nickname
teres
Why is this important?
Another important rotator cuff muscle, but hard to work on. We will teach you how.
15. Teres minor
https://commons.wikimedia.org/wiki/File:Teres_minor_muscle_back.png
By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22783765
Action
The teres minor is a narrow, elongated muscle of the rotator cuff.
Actions: a) lateral arm rotation/adduction b) stabilize arm
Attachments
Origin: ( Middle/outer shoulder blade) - lateral border of the scapula
Insertion: (Inside upper arm) inferior facet of greater tubercle of the humerus
Nickname
teres
Why is this important?
Like the Teres Major, we can show you how to palpate and work on the Teres minor.
16. The Kingpin
Anatomography [CC BY-SA 2.1 jp (https://creativecommons.org/licenses/by-sa/2.1/jp/deed.en)]
Action
The kingpin does not have an "action", rather it is a location (mostly on the blue area) where several muscles come together and over lap. Clients usually say this area feels better after you press on it with NMT.
Attachments
Several locations in the scapula, upper arm and upper ribs
Nickname
kingpin
Why is this important?
In 1988, my Massage teacher called this area "the Kingpin". We will teach you how to release this area. Clients almost always say, "That feels good."
17. Latissimous Dorsi
CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=238559
Action - 2 directions!
1) Adducts, extends and internally rotates the arm when the insertion is moved towards the origin.
2) When observing the muscle action of the origin towards the insertion, the lats are a very powerful rotator of the trunk.
Actions:
a) adduct arm b) medial arm rotation c) extend arm
Attachments
Origin: T 7 - L 5 and Illiac crest plus lower scapula & lower 3 or 4 ribs
Insertion: upper arm
Nickname
Lat
Why is this important?
Since the Lat can act upon both the arm AND the back, there are several possibilities when determining the cause of a problem. We will teach you more in the "Body Engineering" page.