Therapist Notes – Stiffness at the Base of the Neck When Turning

Neuromuscular therapy for releasing splenius has the classic “corkscrew” maneuver. Preparation for that technique is critical for comfort, ease of release and lasting results. The trigger point is actually near C7 at the base of the neck but does not release easily or completely when the costovertebral joint of T3 is displaced. Shearing in the lower cervical vertebrae is also important to assess and address. This post reviews sequencing for the treatment of that muscle.

Effective relief starts with an understanding of the anatomy.
About the coloring of the illustrations…

This muscle straps down other muscles while it helps to turn and bend the neck. You can read more about it in this post on splenius cervicis.


Treatment Sequencing

It is difficult to get lasting results when releasing trigger points in the lower-cervical region without preparation. First, address the upper cervical dysfunctions. You can start with atlas mobilizations or go directly to suboccipital releases.

This trigger point is governed by proprioceptive input from the third costovertebral joint. Specifically, the rib head at T3 has moved posterior and, usually, superior. So, it needs to be freed from its displaced position. Start by, reaching up under the supine client to find the third costovertebral joint. It is usually obvious. It is the harder, more protruding rib head. Then, lift the rib head until it softens. This often takes 90 seconds or so.

Now, when you use the classic “corkscrew” technique in the neuromuscular protocol, the trigger point releases more easily and with longer-lasting results.


Releasing the splenii tendons.

This routine targets the tendons but can be rough on the thumb and painful for clients without the pre-release of the rib heads and anterior cervicals. This protocol requires a little deeper penetration for the splenius cervicis.

Follow up with smoothing and stretching.

The inferior glides of the cervical lamina routine can be extended into the upper thoracics to help release this muscle.

Gently assess and stretch the splenii by rotating the head in both directions. Then rotate the head toward the side with tension and gently tilt the head away from the shoulder.

The active participation of the client makes the stretch more comfortable and with a greater range of motion. Focus on guiding the head passively while minimizing assistance.




This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


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Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.

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*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read, more accessible, and
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