Anatomy of the Indian Head Wobble

The man in this diagram conveniently has a flap 

on the back of his neck that lifts away

to show us his suboccipital muscles.

A year ago I returned from a month-long adventure in India with an old friend. Among the intriguing cultural habits and customs my traveling companion and I became fond of, the infamous Indian head wobble brought the most pleasure. This delightful alternating atlanto-axial side-flexion gesture can mean anything from a friendly greeting to "I completely understand", "I'm not sure", "the deal is done", "what do you think?" or it can be used in combination with a smile to buy some time while you figure out a situation. You can imagine the confusion we experienced trying to decipher the meaning of this common and complex gesture as we bumbled our way through the incredibly culturally rich and already overwhelming environment that is India.

If you are unfamiliar with the head wobble, this video captures the diversity of this classic Indian gesture quite well.

And this video helps to decipher the many meanings and variations.

Now let's explore this unique custom from a more scientific vantage point, shall we my fellow anatomists?

The Anatomy

The bony components of the area responsible for the aforementioned head wobble include the bottom of the skull (or occiput), and the uppermost segments of the cervical spine. Muscles and ligaments intricately lash together these bones in all directions, overlapping and crisscrossing to make this one of the most mobile areas of the body. The sub occipital muscles have some of the most densely concentrated proprioceptive receptors in the entire body (second in sensitivity only to the fingers and lips). This density of nervous supply allows for the brain's very careful monitoring of where the head is in relation to the body, making delicate head motions and adjustments for balance possible.

Now that I'm thinking about some of the amazing features of the neck I have to point out just how much is going on in this area. Not only do we have a highly mobile stack of joints that surround the spinal cord (keep in mind that when a joint has

There's lot's of important tubes and wires in the neck.

great mobility, it sacrifices its stability) we also have massive blood vessels and the body's only vessel for air intake, the trachea.

Damage or disfigurement to any one of these structures can lead to death or at least significant bodily dysfunction. Since we are so vulnerable in this area, consider what I am saying and be mindful of how you treat your neck; it is the superhighway to the mother ship that is your brain. Tight neck muscles and poor posture are not to be ignored, they could be compromising your nervous, circulatory, and joint health!

Because of the complexity of the anatomy in the neck, there is not one muscle for each plane of movement. Instead, we are dealing with layers of muscles that work synergistically to the achieve combined actions of flexion, extension, side flexion, and rotation to execute the subtle gestures of the neck.

Muscles of the neck by Frank Netter, my favorite anatomical artist.

The Indian head wobble is a combined movement, primarily of alternating side flexion, between the two uppermost joints of the spine: the atlanto-occipital and atlanto-axial joints while the following muscles have influence in the co-ordination of the wobble.

• Sub-occipitals
• Middle scalenes
• Splenius capitis & cervicis
• Levator scapula
• Upper trapezius
• Sternocleidomastoid 

That last one is one of my favorite muscles to treat. Ask me about it when you're next in for treatment. 

See you in the clinic,

Dana

Sources:
http://en.wikipedia.org/wiki/Suboccipital_triangle
http://filsheadsculpts.blogspot.ca/2013/02/muscle-references.html 
http://medwitness.doereport.com/generateexhibit.php?ID=2424&A=63380 
http://www.britannica.com/EBchecked/media/119197/Bony-framework-of-the-human-head-and-neck