Longus Colli

By Christy Cael
[Functional Anatomy]

The longus colli is a deep cervical muscle located on the anterior surface of the vertebral column, deep to the thyroid, trachea, and esophagus. This relatively flat muscle spans the anterior surfaces of the vertebral bodies between the atlas (C1) and third thoracic vertebra. The deepest of the anterior neck muscles, the longus colli is long and primarily vertical with multiple segments. The superior oblique portion originates on the anterior tubercles of the transverse processes of C3–5, ascends obliquely and medially, and narrows to insert onto the anterior arch of the atlas.
A middle vertical portion originates on the anterior bodies of C5–T3, ascends vertically, and inserts on the anterior bodies of C2–4. A third inferior oblique portion originates on the anterior bodies of T1–3, ascends obliquely and laterally, then inserts on the anterior tubercles of C5–6. Together, these segments create an interconnecting network between the anterior surfaces of the cervical and upper thoracic vertebrae.
The longus colli is a strong flexor of the head and neck when both sides fire, as it spans all of the cervical vertebrae and is segmented. It is often associated with the rectus capitis anterior and rectus capitis lateralis as the paravertebral group. This group helps stabilize the anterior neck during high-intensity activities like sneezing and rapid arm movements like throwing. It also actively stabilizes the front of the curve of the neck—counteracting the lordotic curvature of the cervical spine due to the weight of the head—and keeps the head from falling back.
Longus colli is clearly divided into right and left sides with a gap at the midline of the vertebral bodies. This creates some leverage for lateral flexion. Oblique fiber orientation in its superior and inferior segments generates slight rotation to the opposite side when longus colli fires unilaterally.

Weakness in the longus colli is common, and this muscle is often affected by whiplash injuries. Poor postural control and cervical stabilization may result and contribute to chronic hypertonicity of the sternocleidomastoid and anterior scalene muscles as they attempt to compensate. In extreme cases, cervical instability and symptoms of vertigo may occur. Dysfunction of the longus colli is observed as forward-head posture with associated hypertonicity, adhesions, and trigger points in the compensating muscles. Clients also demonstrate difficulty or inability to perform segmented cervical flexion against gravity without thrusting the chin forward. Manual techniques that address the compensatory pattern, as well as the underlying injury to the longus colli, help restore function. In some cases, referral for neuromuscular retraining and therapeutic exercise may be necessary for maximal recovery.

Longus Colli
• Origin: Anterior tubercles of transverse processes of C3–5         and anterior surface of bodies of C5–T3
• Insertion: Anterior arch of atlas (C1), anterior bodies of C2–4,         and anterior tubercles of transverse processes C5–6
• Flexes the head and neck (bilateral action)
• Laterally flexes the head and neck (unilateral action)
• Rotates the head and neck toward same side (unilateral action)
• Cervical spinal nerves 2–7

Palpating Longus Colli
Positioning: client supine.
1. Sitting at the client’s head, locate the sternocleidomastoid with the fingertips of one hand.
2. Slide the fingertips medially into the space between the sternocleidomastoid and the trachea. (Caution: the thyroid gland and carotid arteries are located in this region. To avoid causing the client discomfort or damaging these structures, be careful to palpate just medial to the muscle.)
3. Curl the fingertips and palpate deep against the vertebral body to find the vertical fibers of the longus colli (between C1 and T3).
4. Have the client gently resist flexion of the neck to ensure proper location.

Client Homework:
Deep Flexor Activation
1. Lie on your back with your knees bent, feet flat, and head slightly supported.
2. Keep your neck elongated and your jaw relaxed as you tuck your chin and look downward.
3. Attempt to lift the head by leading with the forehead and keeping the chin tucked.
4. Hold the position for a few seconds, then gently lower your head back down.
5. Completely relax the neck muscles, then repeat.

Liu, Xiao-Ming et al. “Does the Longus Colli Have an Effect on Cervical Vertigo? A Retrospective Study of 116 Patients.” Medicine 96, no. 12 (2017): e6365.
Physiopedia. “Deep Neck Flexor Stabilisation Protocol.” Accessed July 2017. www.physio-pedia.com/Deep_Neck_Flexor_Stabilisation_Protocol.

 Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at christy_cael@hotmail.com.
Editor’s note: The Client Homework element in Functional Anatomy is intended as a take-home resource for clients experiencing issues with the profiled muscle. The stretches identified in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists, in order to comply with state laws and maintain scope of practice.