The levator scapulae (luh-VAY-ter SCAP-yuh-lee) is another hardworking muscle that
everyone has trouble with. Levator is from the same Latin root as "elevator." Scapula is Latin
for "shoulder blade." The name tells its job: it lifts the shoulder blade. (Note that the word
ending "ae" in scapulae is actually a singular form, not the more familiar plural seen in such
words as alumnae. In common usage, "levator scapulae" is often pronounced as though it
were spelled "levator scapula.")
Tony, age thirty-three, had typical levator scapulae trouble. He'd had constant pain and
stiffness in the right side of his neck ever since a fender bender three months earlier,
and couldn't turn his head to the right at all. His insurance was paying for physical therapy, but the stretching and traction only seemed to be making his pain worse. Electro stimulation helped but it didn't last.
Massage to Tony's levator scapulae muscles cut through his pain at once and gave
him his first relief. He was shown various ways to do the massage himself, which he
was encouraged to do several times a day. Within a week, his pain was gone. In three
weeks, he could turn his head again with a full range of motion.
Symptoms
Trigger points in levator scapulae muscles cause pain and stiffness in the angle of the
neck (Figure 4.18). When sufficiently active, they also refer a lesser degree of pain
along the
inner edge of the shoulder blade and to the back of the shoulder (not shown). A levator scapulae trigger point is what keeps you from turning your head to look behind you when
you're backing up in your car. You may not be able to turn your head at all toward the side
that has the trigger point. (1999: 491-492)
Causes
The lower end of each levator scapu
angle of the corresponding shoulder blade,
neck vertebrae. This arrangement allows
blade and thereby raise the shoulder. This function is the very one that gets the
muscle into trouble. When stress and bad
posture habits keep your shoulders up, you can be sure that the levator scapulae
muscles are doing much of the work. Because of the attachments to the sides of the neck bones, the levator is also
able to help turn your head to the same
side. When trigger points disable the mus-
cle, it is reluctant to contract and perform this function. The muscle also resists lengthening, which can keep you from turning your head in the other direction too. (1999: 494)
Lae muscle attaches to the inner edge of the top
Its upper end attaches to the sides of the top four
the levator scapulae to help raise the shoulder
Figure 4.18 Levator scapulae trigger points and referred pain pattern
Chapter 4—Head and Neck Pain 35
Figure 4.18 Levator scapulae trigger points and referred pain pattern
Chapter 4—Head and Neck Pain 36
Many things can make trouble for a levator scapulae, including sleeping on your side
without support for your head, typing while looking at your copy out to one side, and hold-
ing the phone clamped between your head and shoulder. Backpacks and purses suspended
from shoulder straps are as bad for levator scapulae muscles as for the trapezius. Both have
to stay strongly contracted to counter the downward pull. You'll observe that a woman who
carries her purse on a shoulder strap always has her shoulder hiked up to keep the purse
from falling off; this causes further strain on the levator scapulae.
Levator muscles are also stressed by over exercise, emotional tension, and
armrests that
are too high or too low. The levator is one of many muscles that are strained by whiplash.
Trigger points set up by an auto accident or a fall can persist undetected for years, the unknown sources of chronic pain and disability. (1999: 494-495)
As a pair, the levators serve as a checkrein for the head when it hangs forward. They
are consequently severely abused by habitually carrying the head forward. Levator scapulae
and trapezius muscles can be strained beyond endurance by habitually reading with your
book flat on the desk, since all the muscles of your neck and upper back have to
remain con-
tracted all the while your head is hanging forward in that position. Prop your book up when
you read so you can keep your head up. Several styles of bookstands can be found in any
college bookstore.
Treatment
The most accessible levator scapulae trigger point is located just above where the mus-
cle attaches to the upper angle of the shoulder blade. Unfortunately, this isn't the trigger
point that causes most of the trouble. It feels good to work this spot but it won't get rid
of all
your neck pain and stiffness. The upper trigger point is the one you have to go after.
Use the
ball against the wall for massage of both levator scapulae trigger points. The Thera
Cane also
works but may not penetrate as deeply as a small ball if the muscles are thick.