Section 01 of 20
Introduction
Longissimus capitis is the topmost part of the longissimus column of the erector spinae. It is a narrow muscle that runs upward from the upper thoracic and lower cervical vertebrae, along the side of the neck, to the back of the mastoid process of the temporal bone just behind the ear.
It lies deep to splenius capitis and sternocleidomastoid and next to semispinalis capitis. It is one of the muscles that hold the head upright against gravity and that turn the face to the same side.
Section 02 of 20
Origin
| Origin | The transverse processes of the upper four or five thoracic vertebrae (T1–T5) and the articular processes of the lower three or four cervical vertebrae (about C5–C7). |
|---|
An anatomical image for this section will be added when verified source media becomes available.
Section 03 of 20
Insertion
| Insertion | The posterior margin of the mastoid process of the temporal bone, deep to splenius capitis and sternocleidomastoid. |
|---|
An anatomical image for this section will be added when verified source media becomes available.
Section 04 of 20
Actions
No dedicated action video is currently available. This movement is explained below and video will be added when verified source media becomes available.
| Primary action | Extension of the head and neck. |
|---|---|
| Secondary actions | Lateral flexion and same-side rotation of the head. |
| Movement at the joint | Cervical spine and the atlanto-occipital region. |
| Heads / fiber groups | Single narrow muscle in the longissimus column. |
| Functional examples | Holding the head upright at a screen; looking up; turning to check over the shoulder; balancing the head during walking. |
Extension of the head and neck
Both sides together tilt the head back and help hold it upright.
Lateral flexion of the head and neck
One side tilts the head toward that shoulder.
Rotation of the head
One side turns the face to the same side.
Section 05 of 20
Nerve Innervation
| Nerve | Posterior (dorsal) rami of the middle and lower cervical spinal nerves, roughly C2–C8. |
|---|
The greater occipital nerve and the vertebral artery run close to the deep neck muscles. Headache with visual or balance symptoms, or arm pain and numbness, may reflect nerve or vascular involvement, not only muscle tightness.
Section 06 of 20
Blood Supply
| Blood | The occipital artery and the deep cervical and transverse cervical arteries. |
|---|
Section 07 of 20
Pictures and Visual Anatomy
An anatomical image for this section will be added when verified source media becomes available.
Section 08 of 20
Functional Movement
Longissimus capitis works when holding the head up while reading or working at a screen, looking up, turning to check over the shoulder, and balancing the head during walking and running. It is often active for long periods with a forward head posture.
Section 09 of 20
Synergists and Antagonists
Synergists: splenius capitis, semispinalis capitis, and the suboccipital muscles (extension), and splenius capitis and sternocleidomastoid on the same side (rotation and lateral flexion). Antagonists: the deep neck flexors (longus colli and longus capitis) and the sternocleidomastoid for head flexion, and the opposite-side muscles for lateral flexion.
Section 10 of 20
Palpation and Location
Client position and technique
The muscle is deep and cannot be felt separately from its neighbors. Position the client supine with the head supported or prone with the forehead resting comfortably. Locate the mastoid process and follow a short distance downward and behind it into the soft tissue of the upper neck, just lateral to the semispinalis. Ask for a gentle head tilt back to feel the deep neck muscles tighten.
Protect nearby structures
The vertebral artery, the occipital nerves, and the carotid vessels are close to the deep neck muscles. Use slow, light to moderate pressure, avoid sustained deep pressure near the base of the skull, avoid forceful neck extension or rotation, and stop if the client reports dizziness, visual changes, tingling, or sharp pain.
Section 11 of 20
Massage Therapy Relevance
Deep posterior neck muscles, including longissimus capitis, are often tender in people with neck tension, tension-type headache, and forward head posture. Headache has many possible causes, so careful screening is essential.
Section 12 of 20
Dysfunction: What Happens When Movement Goes Wrong
Changes in how a muscle works can change how a joint moves. The points below describe possibilities that may be associated with altered muscle function; they are not diagnoses, and one muscle is never assumed to be the sole cause of a problem.
When the muscle is weak
Weakness may reduce head control and neck endurance and may shift work to the upper trapezius and the superficial muscles.
When it is tight or shortened
Tightness may be associated with limited head flexion and rotation and with an ache at the base of the skull.
When it is overused
Prolonged forward head posture and screen work may overload the muscle and may contribute to neck and head pain.
When it is strained
A strain may cause pain at the side or back of the neck with turning and looking up; joint and disc problems can look similar.
When it is inhibited or others compensate
Reduced activation may be associated with more work by the suboccipitals and the neck flexors.
When it does not coordinate well with synergists and antagonists
Poor coordination with the deep neck flexors, the suboccipitals, and the scapular muscles may alter head position and may be associated with neck and head symptoms.
Section 13 of 20
Conditions, Pathologies, and Pain Relationships
Neck tension and forward head posture
Sustained head-forward posture may overload the deep extensors and may be associated with neck ache and stiffness.
Cervicogenic and tension-type headache
Tension in the neck muscles may be associated with a headache that starts at the base of the skull and spreads behind the ear and over the head; many other headache causes exist.
Whiplash-associated tension
After a neck injury, the deep muscles may guard and stay tight and tender.
Differential considerations
Cervical disc and facet joint problems, occipital neuralgia, migraine, and vascular problems can cause similar neck and head pain.
Section 14 of 20
Example Clinical Relationship
A client who works at a computer all day reports a dull ache from the base of the skull that spreads behind the ear by late afternoon. The deep posterior neck muscles, including longissimus capitis, may be involved, and the pattern may be associated with neck tension or a tension-type headache, but joint, nerve, and vascular problems can look similar. Gentle work along the neck may support comfort, while a sudden severe headache, dizziness, or vision changes needs referral.
Section 15 of 20
Massage and Treatment Approaches
For healthy, non-acute tissue, position the client supine with the head supported. Begin with light effleurage over the back of the neck and upper back, then use gentle kneading and slow strokes along the deep neck muscles, and consider gentle traction and a comfortable range of head rotation.
| Movement | Use gentle neck rotation and side-bending within comfort; never force the neck or hold it in extension. |
|---|---|
| Regional work | Consider splenius capitis, semispinalis capitis, the suboccipitals, the upper trapezius, levator scapulae, and the scalenes when assessment supports it. |
| Avoid | Deep pressure at the base of the skull, over the front of the neck, or at any point that reproduces dizziness, visual changes, or arm tingling. |
Section 16 of 20
Precautions and Contraindications
Precautions and contraindications
- Recent neck injury or whiplash, suspected fracture, or instability.
- Use caution with known vertebral or carotid artery disease, severe osteoporosis, or anticoagulant use.
- Avoid sustained neck rotation and extension, especially in clients with dizziness.
- Stop if pressure causes dizziness, visual changes, tingling, or sharp pain.
Section 17 of 20
Red Flags and When to Refer
Red flags and referral
- Sudden, severe (thunderclap) headache, or the worst headache of the client's life.
- Headache or neck pain with dizziness, vision changes, slurred speech, facial numbness, or weakness on one side.
- Neck pain with fever, stiff neck, confusion, or a rash.
- New headache after a head or neck injury, or with unexplained weight loss or jaw pain when chewing.
Section 18 of 20
Study Summary
Attachments
Origin: transverse processes of T1–T5 and articular processes of C5–C7. Insertion: mastoid process.
Actions
Extension, lateral flexion, and same-side rotation of the head and neck.
Supply
Posterior rami of C2–C8; occipital, deep cervical, and transverse cervical arteries.
Section 19 of 20
Instructor Narration
Open narration transcript
Longissimus capitis is the upper part of the longissimus column, running from the upper back and lower neck to the mastoid process behind the ear.
It arises from the transverse processes of the upper thoracic vertebrae and the articular processes of the lower cervical vertebrae, and inserts on the back of the mastoid process.
Both sides extend the head, and one side tilts and turns the head to that side. Splenius capitis and semispinalis capitis help it, and the deep neck flexors oppose it.
The posterior rami of the middle and lower cervical nerves supply it, and the occipital and deep cervical arteries provide its blood.
It is deep, so use slow, light to moderate pressure behind the mastoid, avoid forceful rotation or extension, and stay alert for dizziness or visual changes.
Neck tension, forward head posture, and tension-type headache are common, and disc, nerve, and vascular problems can overlap. Refer a thunderclap headache, headache with dizziness or speech or vision changes, neck pain with fever and stiffness, or a new headache after injury.
Remember: T1 to T5 and C5 to C7 to the mastoid process; head extension, side-bending, and rotation; posterior rami C2 to C8.
Section 20 of 20