Rotating Migraines and Other Bumps on the Ligamentum Nuchae Highway

Feeling around for trigger points all day, I am most impressed with the Ligamentum Nuchae. It has such abundant thickness, depth and tension. I marvel at the cummerbund design featuring what I feel is an actual forest of referring trigger points. It could be called the secret garden. There, all sorts of things grow in total seclusion.

I first started spending time on the ligamentum because of how it felt to massage people suffering with migraines. The migraine is by most accounts in the medical literature is a phenomenon of stress-dilated blood vessels. That said the recommendation is to do a general massage to release stress and avoid the pain zones.
But the dense thicket of TrPs in the posterior cranium has always pointed me straight to the ligamentum as the origin of pain.

Following where my fingers lead, I find that the root of migraines often land in the convergence of two muscle tendons – the twining fascicles of the rubbery sternocleidomastoids and the tough-as-nails suboccipitals right in the heart of the ligamentum.

Slowly rotating the head to the affected side, the SCM fascia pops up, usually leading clients to say I am on target. Moving the cranium in a slight nod, the dense fibers of the suboccipitals cross and intertwine with the SCM. This zone is a perfect storm of adhesed, anaerobic connective tissue. That is usually when clients volunteer that I have found “ground zero.”

If my hands can suppose what is going on during a migraine, I would turn away from the dilated blood vessel model and instead look to chronic, cumulative TrPs, activated by stressed posture. As the connective tissue tightens, the TrPs activate and begin to send impulses to the pain zones associated with migraines – usually the unilateral area near the temples.

This zone is a literal highway of headache and stiffness.