Some of us are lucky enough to only have headaches when we’ve had a few too many the night before. But for so many people headaches and migraines are debilitating ongoing problems; severely affecting their quality of life.
Whilst there are of course medical conditions which can cause headaches and migraines we find that muscular issues account for a large proportion of headache and migraine issues. And if the muscular work can’t solve the problem completely it will usually help a significant amount.
Stress, Headaches and Migraines
Now obviously stress is a factor. The more stressed we are the more pain we feel. This goes for all muscular conditions but especially for headaches and migraines. We talk more about this connection between pain and stress in our previous article What Is Pain?
Furthermore, the muscles we find most commonly involved in the symptoms of headaches and migraines are what we could term stress muscles. These are the sternocleidomastoid and upper trapezius shown below:
The upper traps in particular are known in the general public as being stress muscles. People will commonly say they hold stress in their shoulders and point to their upper traps. Sternocleidomastoids involvement is less known but just as pertinent especially for migraine sufferers. Consider the following image of someone stressed with hunched and rounded shoulders:
You can see how upper trapezius – the muscle that lifts the shoulders – is over used. Sternocleidomastoid (SCM) pulls the head forward. So again you can see how it would be overused in this stressful posture.
But it’s stress that actually brings us into this posture. These two muscles are the only skeletal muscles that are innervated by cranial nerves that come directly from the brain. We think this is due to their important role in our immediate survival. But as a result these two muscles become effectively a stress barometer.
If you’d like further reading understanding on this I strongly recommend having a deeper dive into polyvagal theory as a more complete concept of our nervous system rather than simplistically considering only fight or flight and rest and digest.
Let’s go into more detail on just why these muscles have such an impact on headaches and migraines.
Why Muscles Affect Headaches and Migraines
Seeing as pictures are worth a thousand words first consider the following picture which is our representation of Anatomy Trains superficial back line:
You can see how the muscles of the whole back are continuous into the thin sheet of muscles over the skull and (not shown here) all the way to the eyebrows. If you get headaches above both or either eyebrow you can be pretty sure this line has a lot to do with it.
This is just one way in which muscles are continuous into the head. Both SCM fascia are continuous over the top of the head and actually loop into attach to each other.
There is also the mechanical aspect to consider here too. If our head is pulled forward by SCM and other related muscles and fasciae there needs to be an equal and opposing force holding it up. Newton says so! This will come from the muscles shown in the superficial back line above.
Migraines, Headaches And Sternocleidomastoid (SCM)
There is a further consideration here too. The top of the sternocleidomastoid runs very close to the trigeminal nerve. I’ll forgive you for not knowing this nerve so check the picture here to see where it goes. Putting two and two together here you can understand how tension in the sternocleidomastoid can affect headaches and migraines into the classic distribution on the side of the head and into the sinuses.
Jaw Clenching, Migraines and Headaches
Let’s also consider the mechanical here. What muscles are on the side of the head. For the most part it is your temple muscle. Unsurprisingly called temporalis. It’s a lot bigger that you would expect. Covering pretty much the whole side part of your skull from just to the side of your eyes, above your ear and then further back towards the back of skull. Not just next to the eyes where we often rub for relief.
This muscles function is to clench the jaw. Important for chewing but also a muscle that can get overworked in times of high stress and frustration. Or biting our lips and perhaps not saying what we really want too.
Muscular Treatment of Headache and Migraines
We’ll now outline our approach to what we do to relieve the symptoms of headaches and migraines.
Before we can consider the mechanical causes described above we need to consider our nervous system as a whole. That is we need to consider ourselves as a whole person. With stress already a known factor in headaches and migraines and with the extra insight about sensitisation we talk about above it has to be a priority.
There is very little in this world we can control, only our reaction to it. We work extensively with our clients to optimise their wellbeing. Learning to prioritise ourselves. Even if we have very little time, as is the case for most of us. Grabbing those windows or opportunity to a take moment, breath out, relax and then carry on.
We’ve collated all of our best wellbeing advice into the linked article. It’s important we don’t get overwhelmed by wellbeing! It’s best to do what we can, rather than trying to do everything. We don’t need to be perfect. We’re not all trying to be Zen Buddhas chanting around the streets. We just want to be a little better than we have been. A lot of small changes can make a big difference.
The wellbeing side can be a small or large part of what is required. Only you will know. It may require further diving into our murky pasts. It may just need a few simple life hacks. We find that people who have moved on from their original stress or traumas or have found better ways to deal with stress will respond better to the physical release we’ll now describe.
Let’s again use a picture to make things somewhat easier to understand. Consider the following representation of Anatomy Trains superficial front line.
The superficial front line pulls the body forward which means the muscles at the back pull more and put pressure on the head.
We can see that here the SCM at the top which we’ve explained above is culpable for so many headache and migraine symptoms. Potentially we can use anything on this line to help SCM release. Many of us are pulled forward through the whole of our bodies. We can check this with our client by taking a picture of them from the side (providing there are comfortable to do so!) and then we can add a ruler onto the picture. Many people will be very much forward. This gives us a clue that this whole line will need releasing.
We normally start in the stomach region on the 6 pack muscles, the rectus abdominus. What’s great about doing this is not only do we get a release of SCM but by working the abdominal region – an area that holds a lot of stress in itself – we often have the impact of calming the nervous system. Most of our clients report feeling more relaxed after having it release off. We can test tension on the SCM before and after this intervention to see if we’ve started to have the desired effect on the SCM.
We then have options to repeat this process for other muscles on the superficial front line. We can also consider the deep front line shown below:
Tension in this line can also pull you forward and ultimately hold tension into the SCM, upper trapezius and then onto symptoms on the skull. Not only that but you can see at the top that temporalis and masseter (muscle of the cheek) muscles are part of this deep front line.
We consistently find people over using these muscles as compensations for weakness in hip flexors. When we release hip flexors there is less reliance on the temporalis and masseter and so reduce its overuse and therefore impact on headaches.
Again we can test this before and after our intervention to see if we’re having the desired effect. We test hip flexor strength to start. Then again with the mouth open. Most people look at me strangely when I ask them to do this! More often than not, especially at a first session, people will be weaker with the mouth open.
We then retest after releasing the hip flexors and invariably we find that the hip flexors are stronger, even with the mouth open. Showing we have reduced the reliance on the muscles of the jaw and showing we are moving in the right direction to take pressure off those pesky headache and migraine symptoms.
Consider how we can release any structure along this superficial back line to reduce the pull on the base of the skull and beyond to the eyebrows
Consider again the superficial back line we showed you before. We can repeat the process by releasing off the most likely culprits on this line that will release tension from the base of the skull, over the head and all the way to the eyebrows.
Combining this approach on all three of the these myofascial lines we’ll normally see a significant reduction in tension within the first session and then further improvements at subsequent sessions. Then it’s over to you. Are you able to implement life changes to reduce your stress levels? Will you be able to notice your response to stress? Will you be able to take a deep breath and breathe out that stress? Can you notice where you are holding your stress and let it go? Can you change your desk set up or change your monitor position to reduce load on those neck muscles?
Migraine and Headache Conclusion
We generally find that with a combination of work to calm the nervous system and correcting the biomechanics that’s overloading the muscles in the neck and head a resolution isn’t too far away.
Especially if you’re able to make subtle changes to your life and your body and help us with the process. We can show you the way, we’ll just need a little help from you to keep you there.
If you’d like to discuss in more detail your specific set of symptoms and circumstance or to book a session to start the process please fill out the form here.