Flex the patient’s shoulder to approximately 30–45 degrees with the elbow flexed. Treatment position: With the patient supine, side-bend the neck toward the side of the tender point. Referral pattern: Pain is felt in the posterior neck through the shoulder, with referral pain in the occipital area (see Fig. When the spine of the scapula ends, hook your fingers up and onto the superior medial border of the scapula and press posterior to anterior and medial to lateral against the medial edge of the scapula. Slide your fingers medially over the scapular spine and move laterally to medially. Tender point: This point is located at the superomedial border of the scapula between the scapula and the nape of the neck ( Fig. A hint that the levator scapulae is in need of treatment comes when a patient holds his or her contralateral hand over the area between the shoulder and neck and rubs the upper back with his or her fingers. This condition is seen in people with tension and anxiety (chronic shoulder shrug), those who work extensively with a keyboard, or those who regularly hold a telephone between the ear and the shoulder. Treatment consists of stretching and strengthening exercises for the individual muscle and correction of the precipitating cause.Ĭhronic contraction within the levator scapulae muscle can be a frequent source of pain in the shoulders and the posterior neck, with radiation of pain into the occipital area. swimming, where frequent neck rotation is required.

Levator scapulae myofascial pain is often precipitated by using a keyboard in an abnormal position with the neck rotated but can occur in sports, e.g. Tenderness is maximal over the angle of the neck along the line of the muscle. Associated with this will be some restriction of neck movements and pain on stretching the levator scapulae muscle. Levator scapulae pain is at the angle of the neck and may radiate down the medial border of the scapula or out to the posterior aspect of the shoulder joint. The levator scapulae muscle, in conjunction with the other shoulder muscles, has an important action in stabilizing and moving the scapula and is associated with movement of the shoulder. The muscle extends from the upper medial border of the scapula to the transverse processes of the first four cervical vertebrae. The levator scapulae muscle is one of the more common muscles that has myofascial pain symptoms. Rodger Laurent, in The Musculoskeletal System (Second Edition), 2010 Levator scapulae myofascial pain

Levator scapulae stretch