The Suboccipital muscle group is one of great importance. When these are hypertonic it is usually because of postural reasons. They are usually not just tight but in a chronically shortened state which locks down the upper cervical region. They are very much connected to chronic headaches and migraines. Also, when shortened down, they will limit the amount of cervical rotation which is possible.
The problem with trying to stretch these muscles is that it is very difficult to single them out. The solution to this is using resistance or an active technique. In order to do this, we will “block” the occiput which will act as an anchoring point to allow for us to use active extension of the cervical spine to pull the inferior attachments away from the superior ones. In other words, we will open up the superior segments of the cervical spine (stretching the suboccipitals) by actively extending the inferior levels.
The stretch itself actually mimics the common chin retraction exercise done by most physical therapists for decreased forward head posture and for disc pathologies.
Rectus Capitis Posterior Major and Minor
- Begin with the neck slightly flexed forward and chin tucked into the chest.
- Interlock your fingers behind the head in order to block the occiput with your hands.
- Actively begin to extend your cervical spine while maintaining the position of the head and occiput by firmly resisting with your interlocked fingers. Keep your chin tucked.
- Add slight rotation away from the side being stretched to focus on rectus capitis major and minor.
- A mild stretch will be felt in the suboccipital area and upper cervical spine. Once it is felt, pull a bit more firmly with your hands and tuck your chin slightly more to maximize the stretch.
Oblique Capitis Superior
- Repeat the first three steps above.
- Once in this position, add rotation to the same side and slight lateral flexion away while maintaining the tucked chin. This will elongate oblique capitis superior.
Oblique Capitis Inferior
- Repeat the origin first three steps
- Add increased rotation away from the side being stretched.
- Add slight lateral flexion away from the side being stretched.
Note: The amount of starting cervical flexion can be varied depending on preference. However, If too much flexion is used, the active extension in this position can put extra pressure on the cervical discs so it is not recommended (especially for those with disc injuries).
Another Note: The amount of force needed in resistance/ active extension can be more than expected especially if this area is chronically locked down.If no stretch is felt after attempting a couple times, try using stronger active resistance to create more pull.
Another Another Note: The amount of distance needed to achieve a stretch in the suboccipitals is small due to their short length anatomically. If done correctly only a small amount of movement is needed during the stretch.
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