Longus Capitis Muscle Anatomy

What is Longus Capitis Muscle?

• Longus capitis is a deeper anterior neck muscle that travels in front of the cervical spine. Combine with rectus capitis anterior, rectus capitis lateralis, longus cervicis, or the anterior scalene muscle, it creates the prevertebral layer of neck muscles. These muscles are wrapped or rolled up in the prevertebral layer of the cervical fascia.
• Bilateral contraction of longus capitis muscle flexes the combined head or the neck, while the unilateral contraction creates the ipsilateral or same side head rotation.

Relations of Longus Capitis Muscle

• Longus capitis is the more superficial muscle of the prevertebral muscle group. Its superior aspect is situated in front of the rectus capitis anterior muscle, while the inferior part slightly surfaced the longus cervicis muscle. The retropharyngeal lymph nodes are situated on the lateral border of the longus capitis muscle. The anterior vertebral vein or the adjacent ascending cervical artery crosses via the interval between the joining of the scalenus anterior muscle or the longus capitis muscle. 
• Combine with the other prevertebral muscles, the cervical spine is surfaced in a tubular sheath made of the prevertebral layer of cervical fascia that enlarges from the base of the skull to the body of the third vertebra of the thoracic. The longus capitis muscle or the other muscles in the prevertebral layer of the neck are rolled in the prevertebral layer of the cervical fascia, hence the name says it all.

Origin of Longus Capitis Muscle

• Longus capitis is a large flat muscle of the anterior neck. It travels up the length of the cervical spine, adjoining the vertebral bodies. 

• Longus capitis muscle arises from its inferior aspect, as 4 small muscle straps that travel from the anterior tubercles of transverse processes of the 3rd, 4th, 5th, or 6th cervical vertebrae. From these straps, the muscle fibers travel superomedially, diverging into a single enlarged muscle belly. 

Insertion of Longus Capitis Muscle

• The muscle has 1 ending on the basilar part of the occipital bone, anterior to the end of the rectus capitis anterior muscle, or the lateral to the pharyngeal tubercle.

Nerve Supply

• The longus capitis muscle is a nerve supplied by the anterior rami of the spinal nerves C1 to C3 or rarely C4, which are the branches of the cervical plexus. 

Blood Supply

• Longus capitis is vascular supplied from the muscular branches of the ascending cervical artery or the inferior thyroid artery. Venous blood is ejaculated by the vertebral vein which joins in the suboccipital triangle from many muscle branches from the internal vertebral venous plexuses.

Action

• It works as Bilateral contraction – head flexion;
• It also works as Unilateral contraction – head rotation (ipsilateral)

Functions of Longus Capitis Muscle

• Working synergistically with the different prevertebral muscles or the sternocleidomastoid muscle, the longus capitis muscle works as a weak flexor of the head or the cervical spine. The prevertebral muscles are the more important antagonists of the extensors of the head (e.g. trapezius muscle or the levator scapulae muscle), thus having a major role in the stabilization of the cervical spine. When the head is in a straight position, longus capitis’ flexion action escorts the head back into a normal or neutral position. 

Clinical Significance

• Whiplash injury- It is commonly injured in rear-end whiplash injuries, which usually occur from a car crash.
• These muscles are in front of the spine or it is thought that it may create some whiplash patients have an unwanted or unnatural lack of curvature in the patient’s neck.
• Tendinitis – Acute calcific tendinitis of the longus Colli muscle will also occur. This presents with acute onset of neck pain, stiffness, dysphagia, or odynophagia, or must be differentiated from the retropharyngeal abscess or other sinister conditions. Its diagnosis is by CT or MRI, illustrating calcification in the muscle adjoining to retropharyngeal edema. Treatment is curative or supportive, with non-steroidal anti-inflammatory drugs.

Longus capitis exercises

Strengthening Exercise for the Longus capitis Muscle

Anterior stabilization lying head lift and rotation

• Lie flat on the back & then place the fingers slightly beneath the jaw till you feel the front neck muscles.
• Smoothly tuck in the chin or slightly lift the head about 1cm off the floor. Then slightly rotate the neck a few cms to each side slowly.
• Depending on the individual type of fitness, maintain the position for a minimum of 2 secs up to 5 secs per rep. Aim for 5 to 10 reps at a time in sets of 2 to 3.

Superman Exercise

• Do this exercise on a mat or a firm floor. Sleep down flat on the stomach while the arms extended outside straight of the body.
• The legs should be maintained flat on the ground, as well as the arms.
• Lift the arms or the legs simultaneously like you are trying to fly. squeeze the lower back. Make sure to respiration occur properly.
• Depending on the individual type of fitness, maintain the position for a minimum of 2 secs up to 5 secs per rep. Aim for 5 to 10 reps at a time in sets of 2 to 3.
• Individual fitness levels will determine how many reps or sets the individual is capable of doing at a single time or in a single day.

Chin to chest Exercise

• Get into a sitting position on the ground. Put 2 hands at the base of the head with fingers interlocked.
• Staring the thumbs down or the elbows extended ahead.
• Do the head down to the chest or just hold it for 20 to 30 secs.
• Do ten reps of this exercise.

Theraban Rows

• First Place the theraband around a doorknob & tie a knot in the theraband & close it in the door.
• The band is at chest level.
• You are standing tall with each end of Theraband in your hands & knee joint slightly bent, abdominal muscles tight.
• Must be Maintained the tight trunk muscles & pull arms back while squeezing the shoulder blades and neck muscle contraction together.
• You are trying to focus on squeezing the shoulder blades without shrugging the shoulder joint up towards the ears.
• Then return to starting position but Do not lean back.
• Hold this exercise position for 10 seconds.
• Perform the 10 times in 1 session & 3 sessions per day.

Head lifts

• You are Lie flat on the back with the arms stretched to the sides.
• Nod the head & tuck in the chin.
• Hold this exercise for a few seconds before releasing back to a neutral position.
• Hold this exercise position for 10 seconds.
• Perform the 10 times in 1 session & 3 sessions per day.

Seated Clasped Neck Stretch

• You are sitting comfortably on the floor & in a chair.
• Must place your body in proper alignment.
• Then Clasp the hands & bring both palms to the back of the head.
• Try to slowly press the hands down toward the thighs & tucking the chin into the chest.
• Maintain this stretching position for 30 secs.
• Perform the three times in one session and three sessions per day.

Tucked in Exercise

• The patient’s position should be Sitting straight & look straight ahead with the ears level parallel over the shoulders joints.
• Place 3 to 4 fingers on the chin.
• Maintain the finger, pull the chin & head extended beside up to a slowly stretch is felt at the bottom of the base of the head & top of the neck.
• Maintain or hold for 5 to 10 secs. Repeat seven to ten times.

Neck flexion Exercise (Neck tilt)

• In Relax sitting position flex the head down to rest the chin on the chest (Flex the neck fully).
• Gently tense the neck muscles & hold for 4 to 8 secs.
• Return to the initial position & repeat seven to ten times.

Neck retraction exercises

• Sit on soft ground or a chair & then engage the core to help stabilize the spine.
• Brace the posterior muscles in the neck to bring the head back into a steady position while having the chin slightly downward.
• Maintain the position briefly.
• Relax & then repeat.
• Start with 1 set of 5 reps and work the way up to ten reps in total.

Isometric Neck extension exercise

• In Relax sitting position without arching the back, slowly move the head backward so you are looking upward.
• Hold for 5 to 10 secs. Return to starting position.
• This is a good exercise to do during working hours to prevent neck strain.
• Gently tense the neck muscles & hold for 5 to 10 secs.
• Return to a neutral position & repeat 10 times.

Neck flexion Exercise (side to side)

• Flex the head down towards the shoulder, & try to touch the shoulder with the ear (Without elevating the shoulder).
• Gently tense the neck muscles & hold for 8 secs.
• Return the head to a neutral position & repeat in the opposite direction.
• Repeat 10 times on both sides.

Isometric Neck Rotation exercise

• Begin this exercise by doing a rotation of the head towards 1 side, keeping the chin at the same level & moving within normal limits.
• Slowly stretch the neck muscles & hold for eight secs.
• Back the head to the neutral position & repeat in the other direction.
• Repeat 10 times on each side.

Revolved Triangle Exercise

• Begin this exercise by standing with the feet about four feet apart.
• Face the right toes forward & the left toes out at a slight angle.
• Square the hips & face forward in the same direction the right toes are pointing.
• Lift the arms up at the sides so they are parallel to the floor.
• Slowly hinge at the hips to fold forward, stopping when the torso is parallel to the floor.
• Place the left hand to the leg, the floor, or a block, up to you can reach.
• Straighten the right arm straight up with the palm seeing away from the body.
• Turn the gaze to look up close to the right thumb.
• Exhale to rotate the neck to look down at the surface.
• Inhale as you back the gaze upward.
• Maintain the rest of the body stable & continue these neck turns as you stay in the pose for up to one min.
• Do on the alternate side.

Upward Plank Exercise

• This pose allows you to passively hang the head back & down, releasing tension in the neck & shoulders. This lengthens & stretches the longus capitis, SCM, chest, & shoulder muscles.
• Make sure the back of the neck is fully relaxed to avoid compressing the spine. If it is uncomfortable for you to let the head hang back, you can tuck the chin into the chest & lengthen the back of the neck. Precise on engaging the neck muscles without straining.
• You can also allow the head to rest back on some type of support such as a chair, a wall, or stacked blocks.
• How to do- Come into a seated position with the legs straight in front of you.
• Press the palms to the floor alongside the hips.
• Lift the hips & bring the feet under the knees.
• Deepen the pose by straightening the legs.
• Open the chest and & let the head drop back.
• Hold for up to 30 secs.
• Do this pose up to three times.

Prone Cobra Exercise

• This exercise is start by lying face downwards on the ground & assists gravity as resistance in the process.
• Put face downwards on the floor, and put the forehead on a wrapped-up hand towel for support.
• Put the arms by the side, & palms downwards on the surface.
• Drag the tongue onto the upper palate of the mouth.
• Squeeze the shoulder blades combine & elevate the hands off the ground.
• Roll the elbows inside, palms outsides, & thumbs upside.
• Smoothly raise the forehead about an inch off the towel maintaining the eyes looking ahead forward at the ground
• Maintain the position for seven to ten secs.
• Do seven to ten reps.

Isometric Neck Exercise

• Isometric neck exercises assist to strengthen the neck muscles. This exercise is mostly prescribed by Physiotherapists from day one to relieve Neck pain.
  Isometric Neck Exercise
  How to perform this exercise In a sitting alignment,
• keep the Body steady and straight, Place both hands beside the neck (as seems in the images), & try the neck to push compress on the hands & At the same time Resist the neck muscles, both hands steady and align pattern for 4 to 5 secs & then relax.
• The first day does 8 reps & the 2nd day does 10 reps. Do some exercise on the forehead & each side of the neck.
• Do the exercise by compressing the side of the head. Repeat 8 times, then opposite sides.

Prone Rows Exercise

• Lie down on the stomach with the arms dangling off the side of the bed (just angling the body so the head is turning the corner of the bed).
• Use a pillow below the stomach for comfort. Start by pulling your arms back while bending elbows & contracting the shoulders blades together then gently back to the initial position.
• Do not raise your head up while pulling the arms back.
• Repeat twenty times. Perform two times a day.

Standing pushups exercise

• Stand about an arms-length down from the wall with the bases spread piecemeal.
• Place the hands on the wall, making sure that they parallel with the shoulders.
• Keeping the reverse straight, sluggishly bend or flex the elbows, bringing the upper body toward the wall.
• Extend the elbows & back to the initial position.
• Repeat twenty times. Perform two times a day.

Lateral extension exercise

• Begins by looking forward ahead. Gently lean the head to the left side. Use the left hand for resistance, use the muscles in the neck to press against it. Hold for 5 to 10 secs, then return to the initial position.
• Then, slowly lean the head to the alternate side. Hold for 5 to 10 secs.
• Return to the initial position. Do 10 repetitions. This is a good exercise to do while in working hours, especially if you have to keep the head in a steady position for prolonged periods, as in working at a computer.

Tilted forward flexion exercise

• Sluggishly lean the head to the leftism. Using the left hand for resistance, use the muscles in the neck to press against it. Hold for 5 to 10 secs, also return to starting position.
• Also, sluggishly lean the head to the other side. Hold for 5 to 10 secs.
• Return to starting position. Do 10 repetitions. This is a good exercise to do during work, especially if you have to keep the head in a steady position for a prolonged time as in working at a computer. Do this exercise every partial hour to help with the prevention of neck tightening.

Stretching Exercise for Longus Capitis Muscle

Longus Capitis Forward and backward stretches

• Sitting on the edge of a chair with the back straight & the chin should be parallel to the floor.
• Tilt the head forward gently until the stretch is felt in the back of the neck. Hold for 5 secs.
• Lift the chin & then tilt the head back until the stretch is felt in the upper neck.
• Hold for 5 secs.
• Perform the exercise for ten reps periodically throughout the day to relieve a longus capitis neck strain.

Suboccipital Muscle Stretch

Manual Stretching
Patient position & the procedure: Sitting

• How to do:
• Identify the spinous process of the second cervical vertebra & then stabilize it with the thumb or with the 2nd metacarpophalangeal joint (or with the thumb or the index finger surrounding the transverse processes).
• Tell the patient gently nod, doing just a tipping motion of the head on the upper spine. Guide the motion by putting the opposite hand across the forehead of the patient.
• You can hold for 30 secs & then do three reps.

Patient position and procedure: Supine

• How to do:
• Sitting on a stool at the head of the treatment table while the forearms are resting on the table. 1 hand stabilizes the C2 vertebra by grabbing the transverse processes between the proximal part of the thumb or the index finger; the opposite hand assists the occiput.
• Nod the head of the patient with the hand below the occiput to take up the slack of the suboccipital muscles; then tell the patient to roll the eyes upside.
• This creates a gentle isometric contraction of the muscles of the suboccipital. Afterward maintaining for 6 secs, tell the patient to roll the eyes downward.
• As the suboccipital muscles easy, take up the slack by passively nodding the head through a new range of motion. The only movement should be happening between the occiput or the C2.
• The contraction is slow in order to not cause the overflow into the multi-segmental erector spinal muscles or the upper trapezius muscles.
• You can hold for 30 secs them repeat three reps.

Self-Stretching

• How to do:
• Patient position & the procedure: Supine or sitting. Explain to the patient to nod the head, and place the chin nearer to the larynx till a stretch is felt in the suboccipital region. Just gave a minor pressure beneath the occipital area with the palm of the hand while tipping the patient’s head forward will reinforce the motion.
• You can hold it for 30 secs & then repeat three reps of it.

Longus Capitis Muscle Stretch

• The longus capitis muscle (of the transversospinalis group) is stretched by flexing the head & the neck at the spinal joints.
• Prefix in lateral flexion (not seems in the accompanying demonstration) will be increasing the efficacy of the stretch for the different-side longus capitis muscle.
• You can hold for 30 to 40 secs & the three to five reps.

Capitis Muscle Stretch

• The left side rectus capitis lateralis muscle is stretched by flexing, the right laterally flexing, & the right rotating the neck at the spinal joints, while the left side of the shoulder girdle is signed to raise.
• You can hold for 30 to 40 secs & the three to four reps.

Table Longus Capitis Stretch

• Sitting in front of a table.
• Keep the chin in & down throughout this stretch.
• Place the left fist on the left side of the chin.
• Place the left elbow onto the table in front of you.
• Rest the weight of the head onto your fist.
• Tilt the head to the left.
• Apply more pressure to the chin to gear up the stretch.
• The goal is to feel a firm stretch on the right side of the neck.
• Hold for 30 secs.
• Perform on the alternate side.

Stretch to Capitis Muscle

• Tuck the chin in & downwards.
• Tilt the head to the right.
• Put the right hand on the opposite side of the head.
• Apply downward compression.
• Slowly turn the head to the left.
• The goal is to feel a firm stretch on the left side of the Rectus Capitis muscle.
• Hold for 30 secs, 3 rep.
• Repeat on the alternate side.

Longus Capitis Stretch Alterations

• Place the fingers on top of the left side collar bone.
• Pulling the skin down.
• Tuck the chin in & down.
• Slowly turn the head towards the left side.
• Tilt the head towards the right side.
• The goal is to feel a stretch on the left side of the Rectus Capitis muscle.
• Hold for 30 secs, 3 rep.
• Repeat on the alternate side.

Chair Lean Stretch

• Sitting down on a chair.
• By using the right hand, grab onto the side of the chair.
• Keep the shoulder completely relaxed.
• Leaning the body completely towards the left side.
• Then tuck the chin in & downwards.
• Tilt the head towards the left.
• Place the left hand on the right side of the head.
• Apply downward compression.
• The goal is to feel a stretch on the right Rectus Capitis muscle.
• Hold for 30 secs, 3 rep.
• Repeat on the alternate side.

Neck Elongation Stretch

• Tuck the chin in & downwards.
• Now Slide the head towards the right side.
• Then Elongate the right side of the neck in an upwards direction.
• The goal is to feel a stretch on the right side of the neck.
• Repeat on the alternate sides.
• Perform 30 reps, 3 rep.