Treating the Levator Scapulae

Levator Scapulae Muscle

Treating Levator Scapulae Trigger Points - Dr. Jonathan Kuttner

Almost all neck pain will have myofascial trigger point contributions, and levator scapulae is commonly involved

Levator scapulae is deep to the SCM and trapezius. It is named after its action of elevating the scapula.

The levator scapulae acts eccentrically to decelerate the downward forces created by the lower fibers of the trapezius and serratus anterior. The levator scapulae decelerates contralateral side flexion in the cervical spine.

Almost all neck pain will have myofascial trigger point contributions, and this muscle is commonly involved.

Pain will be experienced at the angle of the neck from the superior angle, making its way down to the medial aspect of the inferior angle, with spillover all the way along the medial border of the scapula.

Clients will often present with a stiff neck and reduced range of motion.

Dry Needling the Levator Scapulae - Paul Townley

Levator Scapulae Trigger Points

Levator Scapulae - Common Trigger Point Sites

Origin

Posterior tubercles of transverse processes of first three or four cervical vertebrae (C1–4).

Insertion

Medial (vertebral) border of scapula, between superior angle and spine of scapula.

Connections

Trapezius, rhomboids, splenius cervicis, erector spinae, scalenes, SCM.

Action

Elevates scapula. Helps retract scapula. Helps bend neck laterally.

Nerve

Dorsal scapular nerve C4, 5, and cervical nerves C3, 4.

Basic Functional Movement

Example: carrying a heavy bag.

Sports that heavily utilize this muscle

Examples: shot put, weightlifting.

Levator Scapulae - Common Trigger Point Sites and Pain Patterns

Levator Scapulae - Typical Referred Pain Patterns

Trigger Point Referred Pain Patterns

Triangular pattern from top of scapula to nape of neck. Slight overspill to medial border of scapula and posterior glenohumeral joint.

Indications

Stiff and painful neck with limited rotation of cervical spine, long-term use of walking stick, neck pain and stiffness, problems turning neck (e.g. driving).

Causes

RTA, holding telephone ear to shoulder, side sleeping with wrong pillows, backpacks, poor posture, sustained habits or occupation, TV/monitor position, stress and tension, cold/flu or cold sores, sports (swimming front crawl).

Differential Diagnosis

Scapulothoracic joint dysfunction; winging of scapula. Apophysitis and capsular-ligamentous apparatus. Shoulder impingement syndromes.

Trigger Point Treatment Techniques

Spray and Stretch	YES
Deep Stroking Massage	YES
Compression	YES
Muscle Energy Techniques	YES
Positional Release	YES
Dry Needling	YES
Wet Needling	YES

Self help

Self-massage techniques can be very helpful; especially balls and pressure tools.

General advice to patients

Hold telephone shoulder to ear. Stress. Occupation. Air conditioning. Passive stretching. Heat and warmth. Scarf in cold weather. Change walking stick position.

Links

Find a Trigger Point Professional in your area

NAT 5-Step Shoulder Technique

Online Store

Trigger Point Tools and Accessories

Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

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NAMTPT AWARD 2017

We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

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Award Winning Instructors

Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.