Assessment of a cervicogenic headache is quite involved. Forward head posture is common, which may indicate weak muscle tone, specifically in the deep neck flexors, though this requires more research. Muscle tightness is often present across the neck, chest, and shoulders. Electromyography (EMG) shows high responsiveness in the sternocleidomastoid muscle, the largest muscle in the neck, responsible for flexion and rotation to the opposite side, and a decreased response from the deep neck flexors.

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