Almost all neck pain will have myofascial trigger point contributions, and levator scapulae is commonly involved.
Levator scapulae is deep to sternocleidomastoideus 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. Patients often report a stiff neck and reduced range of motion.
Posterior tubercles of transverse processes of first three or four cervical vertebrae (C1–4).
Medial (vertebral) border of scapula, between superior angle and spine of scapula.
Elevates scapula. Helps retract scapula. Helps bend neck laterally.
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 - 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.
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).
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).
Scapulothoracic joint dysfunction; winging of scapula. Apophysitis and capsular-ligamentous apparatus. Shoulder impingement syndromes.
Trigger Point Treatment Techniques
Spray and Stretch
Deep Stroking Massage
Muscle Energy Techniques
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.