Interested in Improving Your Balance? Treat the Suboccipital Muscles.

Suboccipital triangle

Image via Wikipedia

There are two groups that I think are more interested in balancing on two feet than anyone else.  Athletes and the elderly.  The athlete is on one end of the spectrum, trying to push the limits of physical activity and improve center of gravity.  The other end of the spectrum are the elderly, who are usually just trying to keep that brain-body proprioceptive loop functioning enough to prevent possible fall or other injury. Both parties can benefit from gaining a more stable foundation to sustain and encourage movement.  Therefore, athletes and the elderly can benefit from “tuning up” the balance “sensors” of their bodies.

One important set of balance “sensors” are a group of muscles called the suboccipitals.  The suboccipitals are a group of 4 muscles (rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis superior, and obliquus capitis inferior) located inferior to the base of the skull.  These suboccipital muscles are literally sensors for positioning and orienting the head in 3-dimensional space.  In fact, the muscles contain a much higher density of muscle spindles than most muscles in the body.  The inordinate amount of muscle spindles in the muscle tissue substantiate the idea that the primary function of the suboccipital group is to send spatial data to the brain and the secondary function of the suboccipital group is movement of the head.

Now, if we look at the suboccipital muscles as we would any other muscle group in the body, we can assume that fatigue, tension, and strain can occur from overuse and/or neglect.  Tightness and tension of the muscles can present with symptoms of dizziness, visual disturbances, and balance problems.  The above symptoms occur because the brain interacts with both the suboccipitals and the eyes in such a way that both organs work to help you focus on objects, track objects, and predict motion of objects relative to your body position.  (In a football example, what this means is that when your suboccipitals are functioning correctly, you can better “lock in” the football’s trajectory with your eyes and move your arms and feet towards catching it.)  Also, a group of nerves pass through the suboccipital area (suboccipital triangle) on their way back into the spinal column.  Compression of the nerves tend to compound the above said symptoms and, if severe enough, can cause occipital neuralgia.  Another interesting fact is that cervical vertebrae C2 and C3 are connected to the dura mater of the spinal cord in this location.  So, if the muscles attached to these vertebrae are pulling to one side or the other, the spinal cord is affected and could trigger headache and migraine symptoms.  Needless to say, the suboccipital muscles are important structures that contribute heavily to proper balance.

Recommendations for treating these muscles are stretching, manual therapy, and some form of alternative therapy, and some self-care tools.  Stretching will keep the musculature limber and promote good blood flow.  A manual therapy such as massage or trigger point therapy will usually result in reduction of headache and dizzy spells.  A trained massage therapist will be able to address these muscles very successfully as well as point out other issues with the surrounding musculature.  Craniosacral therapy is also a very beneficial technique that can release the suboccipital structure and realign the cervical vertebrae.  Acupuncture is a very effective alternative therapy that can assist in the treatment and prevention of proprioceptive and visual problems that may occur with tight suboccipital muscles.  Well-placed needles are able to access the muscular trigger points deep into the neck and results can be similar or more effective than that of massage.  Lastly, a self-care tool should always be in the home for when a recurrence of pain from strain or overuse arises.  We promote an August Point Wellness tool for this, the Sciaticare Ball.  It’s an intuitively simple tool with a wide variety of uses.  Releasing trigger points in the suboccipital area is just one of the uses for this physical therapy tool.  Please read our Sciaticare Ball technique for the Suboccipital Squeeze at

Proprioception – the awareness of the position and movement of the body in 3-dimensional space.

Suboccipital triangle – triangular pattern comprising 3 of the 4 suboccipital muscles.  Rectus capitis posterior major, obliquus capitis superior, obliquus capitis inferior comprise the triangular formation.

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