Not all Ear Aches are due to an infection

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Sternocleidomastoid
What Does the “Dizzy Muscle” Have to Do With Your Child’s Ear Infection?writtenby

Parents!  This issue is especially important for your young ones.  Please enjoy and make use of this information!

Unfortunately, ear infections are a prevalent and painful experience for young children.  According to the National Institutes of Health, three out of four children will have one or more ear infections by the age of three years old.  Ear infections are the number one reason parents bring their children to the doctor.  More frustrating is the fact that these infections often recur, sometimes up to 6 times per year.  To parents of these children, any sign of an earache is bad news.

 

However, not all earaches are due to infection!  A very important head and neck muscle highlighted in this issue of Muscle News can cause referred pain right inside and around the ear!  This muscle is the Sternocleidomastoid, or SCM for short (shown in green below).  



The referred pain the SCM causes in and around the ear is shown in red.  Note that headache above the eye is also caused by trigger points in the SCM.  There are other areas of referred pain, such as the back and top of the head, depending which section of the SCM contains the trigger point, but we will focus on the earache pain in this issue.  



As a result of this referred pain to the ear, an earache caused by trigger points in the SCM can be mistaken for signs of an ear infection.



Most importantly, using the self-care techniques below can greatly reduce this type of earache and may even help with lymphatic drainage due to the chains of lymph nodes that lie on top of and beneath the SCM.  Parents often report that these techniques have helped their children immensely with incidents of earache.  

Note:  These techniques DO NOT treat or evaluate ear infection.  If your child is experiencing the signs and symptoms of ear infection, please contact a qualified physician right away.

 The SCM is also given the nickname the “Dizzy Muscle”.  This is due to its tendency to cause vertigo.  Dr. Janet Travell, president Kennedy’s personal physician and pioneer in the field of Myofascial Trigger Point Therapy, found that trigger points in the SCM frequently cause the following symptoms:

  • Dizziness with movement of the head
  • Vertigo (sensation of spinning)
  • Loss of balance
  • Poor judgment of spatial relationship
  • Nausea
  • Neck pain and stiffness

There are several other causes of these above symptoms, as well, including serious illness.  So make sure you are evaluated by a qualified medical professional if you are experiencing any of these symptoms.  However, if the cause is trigger points in the SCM, the following self-tests and self-care techniques may help considerably!

 

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.

(3) Quick Self-Tests to Tell if You have Trigger Points in Your Sternocleidomastoid (SCM):

Follow the instructions below to test whether trigger points in your SCM might be causing ear pain or other symptoms:

TEST 1:  Head Rotation



       

           PASS                                 FAIL



Standing or sitting upright, turn your head to the side as far as you are able without straining or causing pain.  A Passing result is when the head turns without pain far enough so that the nose is over the shoulder (80-90 degrees rotation, as shown).  A Failing result occurs when the head is unable to rotate far enough or there is pain while trying to turn the head.

This indicates there are trigger points and myofascial dysfunction in the SAME SIDE SCM as you are rotating toward.  In other words, if you have difficulty turning your head fully to the right, it is the right SCM that would have trigger points.

TEST 2: Lateral Flexion



       

           PASS                                  NOT PASSING



Standing or sitting upright, tilt your head to the side (lateral flexion) as far as you are able without straining or causing pain.  Do not elevate the shoulder while performing this test.  A Passing result is when the head tilts to the side without pain far enough so that the ear is almost touching the shoulder (over 45 degrees of lateral flexion, as shown).  A Not Passing result occurs when the head is unable to tilt at least 45 degrees or there is pain on lateral flexion.This indicates that the OPPOSITE SIDE SCM from the direction you are laterally flexing has the trigger points.  If you have trouble bending your head to the right, it would indicate the possibility of trigger points in the left SCM.

 

TEST 3:  Sternocleidomastoid Palpation

As always, palpation (the medical term for pressing, feeling and squeezing to evaluate body tissue) is often the most effective test to identify myofascial trigger points in your SCM muscles.   



One of the best ways to palpate the SCM is to turn the head to the opposite side (this shortens the muscle making it easier to grab hold of) and pinching it between your thumb and middle finger (pincer contact).  



The Sternocleidomastoid muscle gets its name from the three bones it attaches to:  1.)  The Sternum (‘sterno’);  2.) The Clavicle (‘cleido’); and The Mastoid Process (a bony prominence behind the ear).  Feel for taut bands and tender spots all along the muscle from the mastoid process behind the ear down to the sternum and clavicle.  It is the portion of the SCM attaching to the clavicle that cause most referred pain to the ear.  



If you find taut bands of muscle and tender spots, you have trigger points in your SCM.


Simple Self-Care Remedies

Here are simple self-care tips for relieving myofascial pain and dysfunction in your SCM:

 

Step 1:  Warming Up with Moist Heat

To relax and warm up the fibers of the SCM, take a warm shower or place moist heat such as a Fomentek bag over the front and side of the neck for 10-15 minutes.  With a child, a warm moist towel might be most comfortable.  Be careful to test the temperature on yourself first before placing any heat on a child.

Step 2:  Compression

Whenever you are performing trigger point therapy techniques on children, it is best to perform them on yourself first to understand what they feel like.  We are going to first start with self-care on yourself and then show you how to perform these techniques on your child.

The best method for compressing trigger points on yourself might be to use a Jacknobber or continue using the pincer contact you used during palpation.  When you find a tender spot, press into the muscle to pain tolerance (“good pain” – not sharp pain).  Hold for 10 seconds while completing at least two full breaths in and out.  Then continue searching for more trigger points.

For Children
For children, practice what you are going to do on yourself first to see what it feels like.  Here is the best way to treat the SCM for your little ones:

 Have your child lying face up with your hand gently supporting the back of the head.  Position your child’s head so it is turned toward the same side as the SCM you are going to gently compress and tilted away from the same side shoulder (as shown).

Begin lightly and slowly stroking the muscle along the length from the top toward the bottom.  Be sure not to push in too much as the area may be very sensitive, especially during an earache.  A small amount of hypoallergenic massage lotion might be helpful.

Always ask the child if what you are doing feels ok.  If the child withdraws from your touch that can be a sign of too much pressure or too fast of a stroke.  If the child is ticklish, you can broaden your contact by adding more fingers.

Also, keep your strokes to short lengths of time (4 to 5 seconds max).  Pressing anywhere near someone else’s throat area can make them nervous about choking if you press too long at one time.  Cover the entire muscle on both sides until the muscle softens and pain reduces.  Spend no more than 10 minutes per side to avoid overworking the muscle.  You can repeat this 2-3 times per day, monitoring to make sure you aren’t causing soreness – gentleness is the key!

Step 3:  Stretching Your SCM

There are two stretches for the SCM for adults to perform.  For your child, the stretching is occurring during the compression, so additional stretches are not usually necessary.

1.)  Lateral Flexion:

This stretch is similar to the Lateral Flexion test we just performed above, only with 2 added steps.

Using a stretching strap or jump rope, step on one section of the rope and hold the other end with your hand so that the rope is taut (as Shown).  You should feel a gentle pull on your shoulder down toward the floor.

Now, tilt your head toward the opposite shoulder, as you did in the Lateral Flexion test.  Gently rest your opposite hand on the top of your head and stretch gently down toward the shoulder a little further.  Hold this stretch for 20 seconds to tolerance.  Repeat 3 times and alternate to the other side.  This stretch can be performed 2-3 times per day or more as needed.

2.)  Rotation Stretch

As in the rotation self-test above, rotate your head to one side.  This will stretch the same side SCM.  For an additional stretch, gently use two fingers to press on the cheek bone, encouraging the head to rotate slightly more.  Do not strain, but stop at a comfortable stretch.  This stretch can also be performed 2-3 times per day or more as needed.

If you follow these steps, you have a great opportunity to alleviate earache caused by referred pain, improve lymphatic drainage, and lessen or eliminate vertigo symptoms that may all be caused by the “Dizzy Muscle”! 
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