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Suboccipital Muscles – Massage Therapy Notes

Treatment of the suboccipital region is probably the single most important area to treat.

Upper cervical treatment is the focus of many bodywork practices. It has been a strong focus of practice for chiropractors for more than 70 years. In the early 40s, John Grostic pioneered atlas analysis and treatment. Since then, a multitude of practitioners has implemented variations on his approach. It changes the pelvic balance, digestion, polyvagal regulation, Forward-Head Posture, and much more.  These approaches vary from precise, research-driven approaches to intuitive based emotional release work.

Anatomy – Throacic Outlet

The anatomy of these structures is important to understand the syndrome. This post walks through the structures one at a time.

This post has illustrations of each muscle including the anterior and lateral muscles.

Entire bodywork practices are built on treating the upper cervical region because it impacts the entire body.

Sub-occipitals strap the head on to the first 2 vertebrae. They have a direct bearing on and are strongly affected by the atlantooccipital joint and the atlanto-odontoid joint.

Upper cervical function and alignment strongly influence muscle tension, pain patterns, visceral function, and postural alignment throughout the body. This area should be addressed early in the session so that other areas respond well and have longer-lasting results.

Before directly using any muscle work, gentle mobilization of the joint can be very effective in making the work less painful, quicker, and longer-lasting.

The atlantooccipital and atlantoaxial joints need to mobilize for a lasting release of suboccipital trigger points. That can happen in the NMT routine but can be more direct and effective through direct techniques. The atlas commonly moves anteriorly and to the right. This is more difficult to correct with suboccipital techniques that focus on pressing into the back of the head.

Bodywork Protocols

This post, from Integrative Craniosacral – Transition to Integrative Techniques offers an intra-oral and transverse process approach to mobilizing the atlas.

This post has a routine for treating the area with joint mobilizations and then an NMT protocol.

This area has difficulty stabilizing when Forward-Head Posture or other chronic cervical or cranial imbalances are present. This collection on FHP is helpful to pinpoint other patterns that might be perpetuating suboccipital

I find that treating this area, followed by other cervical approaches and then returning to this for additional work is sometimes needed for stabilization.

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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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