The sternocleidomastoid has a fascial-tendinous component between its sternal and clavicular heads in the lower neck, visible as a distinct triangle (the lesser supraclavicular fossa). This tendinous intersection contributes to the muscle's two-headed nature and is palpable in thin individuals.
The SCM tendinous intersection at the clavicle level is a landmark for internal jugular vein cannulation via the lateral approach, where the needle enters lateral to the SCM at the level of the lesser supraclavicular fossa. SCM tendinopathy at the sternal or clavicular insertion produces anterior neck pain reproduced by head rotation against resistance. Torticollis from SCM contracture involves the tendinous and muscular components.
Degenerative tendinopathy at the sternocleidomastoid clavicular head insertion producing anterior neck pain with head rotation, managed with physiotherapy and injection at the tendinous insertion.
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