Treating Trigger Points in the Levator Scapulae

The Lavator Scapulae Muscle

The name of this muscle comes from the Latin;  levare meaning “to lift”; scapulae, “of the shoulder blade.”

Origin:  Posterior tubercles of transverse processes of frst three or four cervical vertebrae (C1–C4).

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

Lying deep to the Trapezius and SCM it elevates the vertebral side of the shoulder blade.

Dry Needling of the Lavator Scapulae Trigger Points - Paul Townley

What is the purpose of the levator scapulae?

The levator scapulae is involved when you shrug your shoulder; it is also affected if you feel as though you have the weight of the world on your shoulders. This muscle lives under, and works with, the trapezius. Together they elevate and retract the pectoral girdle and keep it elevated against a downward push. Contraction of the levator scapulae on both sides causes the neck to extend; contraction on one side causes the other side of the neck to flex. These muscles help stabilize the shoulder blade. It’s attached to the upper neck vertebrae, and trigger points here may be involved with vertebral misalignment and subsequent disc deformity.

Trigger points in the levator scapulae;

Trigger points referred pain;

You can see above the triangular pattern from the top of the scapula to the nape of neck. There is a slight overspill to the medial border of the scapula and posterior glenohumeral joint.

Although often caused by whiplash or static muscle overload, these trigger points have many possible initiating or perpetuating factors.  Trigger points in this muscle result in a stiff neck and reduced ROM, and may contribute to headache and/or shortness of breath.

When severe, these trigger points can cause pain, even when the muscle is at rest.  Trigger points can tighten this muscle so much that a shoulder-bag strap slides right off. These trigger points can cause what is described as “wry neck,” but if the head is tilted strongly to one side, the culprit is more likely to be SCM trigger points.

What can cause trigger points in the levator scapulae?

Neck immobility; watching television or reading with the light displaced to one side; using a cane that is too high for the body; using the neck to hold a phone to your ear; postural stresses of computer work or other static jobs; emotional stress; head-forward position; hiked shoulders; inadequate vision correction; using too many pillows or a pillow that is too thick; drafts blowing on the neck; swimming overhand for too long, especially when the muscles are tired and the water is chilly; carrying a heavy shoulder purse or bag (letter carriers often develop these trigger points); short upper arms; watching a long tennis match; neck trauma; body asymmetry; and gait irregularity. In the early stages of a respiratory or other area infection (oral herpes, tonsillitis, tooth abscess, etc.), this muscle is much more vulnerable to trigger point activation. The period of sensitivity may start several days before symptoms set in, and last for weeks. 

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