The levator scapula, or as I will refer to it…levator scap,
runs from the upper cervical spine (neck) to the scapula (shoulder blade). As you can imagine by the name, its main
function is to elevate or lift the scapula.
The plural of levator scapula is levator scapulae. So if you shrug one shoulder, you are
activating the levator scapula. If you shrug
both shoulders simultaneously, you are activating the levator scapulae. When the neck is fixed, the levator scap
elevates and rotates the shoulder blade.
When the shoulder is fixed, it rotates and bends the neck to the side. Do it with me! Turn your head to one side then drop your
nose towards your hip.
Congratulations!!! You just used
your levator scap!
Trigger points seem to be the biggest problem I am faced
with in practice. The patient typically
presents with pain at the base of their neck or just above their shoulder
blade. Once you know all the different
causes of a trigger point here, you will understand why!
1.
Whiplash.
When you are involved in a car accident, your head is whipped in many
different directions. The most forceful
depends on where the impact occurs. When
the head is thrust in an unnatural direction with such force, the levator scap tries
to counteract that force and becomes injured, creating trigger points. The same type of injury could occur from a
hard fall as well, such as diving for a baseball, landing wrong on a
trampoline, etc.
2.
Sleeping on your stomach with your head
turned. As a chiropractor, I must say that
sleeping on your stomach is the worst position for your spine in general
because it increases the lordosis or extension of the lumbar spine which leads
to back pain and, since you can’t sleep with your head in a neutral position
face down, you have to turn your head one way or the other. This is where the levator scap comes into
play. Turning your head and bending
sideways into the pillow activates that muscle for as long as you’re in that
position, thus causing a trigger point to form from overuse.
3.
Working at a computer. Ergonomics play a large role in the
protection of the levator scap. If you
are using a computer for long periods of time and have to turn your head to do
so, you are overusing the levator scap.
So make sure that the computer is directly in front of you. Also, if the computer screen is below your
eye level, it causes a prolonged flexing of the neck which over stretches the
levators adding to the problem. Propping
the screen up to eye level is recommended to prevent this.
4.
Holding a phone between your shoulder and
head. Many office jobs involve you being
on the phone while still requiring the use of both hands. This leads to the quintessential held tilt
and shoulder hike to hold the phone.
Both of those actions activate the levator scap and when the phone
conversation continues for long periods of time, the muscle suffers…and frankly
so do you. It is highly recommended to
switch to a wireless headset if your job requires you to multitask while
talking on the phone.
5.
Carrying a heavy bag on one shoulder. Do you travel by plane and refuse to pay the
ridiculous prices to check your bags? I
know I do! This leads to cramming tons
of stuff into one bag and for a lot of people that is a duffel bag or another
bag without wheels. Carrying that
overstuffed bag through the airport and while waiting in the dreaded security
line causes a downward force on that shoulder thus overstretching the levator
scap. Do yourself a favor…invest in a
rolling carryon! J
6.
Emotional and mental stress. This one is very common. When you’re feeling stressed, where do you
hold that stress? For me, and frankly
most women, it’s in the shoulders. The
more stressed we get, the closer our shoulders get to our ears. It really is a subconscious thing, but I
often find myself in this posture and have to actively relax my shoulders and
take a deep breath. So if you’re like me
and can’t wear dangly earrings because they catch on your clothes, take stock
of your posture and shoulder position a few times today and notice the release
of tension through the neck and shoulders.
7.
Using crutches that are too tall. This one is close to my heart as well, as I
am less than 4 weeks from yet another knee surgery. Luckily for me, I have my own trusty set of
crutches that I’ve used for years so I know they are fitted well. But not everyone is as lucky…or maybe unlucky…as
I am. So keep in mind when you are
purchasing crutches that the top pad shoulder not rest directly in the armpit
when standing. The pad should be a few
inches below and the hand grip placement should be at a height where the elbows
are slightly bent when standing straight up.
If the crutches are not fit properly, the tendency is to shrug your shoulders
to support yourself during use. Having
them fit by a professional will eliminate a lot of that overcompensation and
make the use of crutches more comfortable.
There are a few easy ways to treat these dreaded trigger
points. The first is moist heat. Applying moist heat to the back of the neck
and top of the shoulders helps to relax the muscle tissue and stimulate blood
flow to the affected area which promotes healing. Doing this for 15-20 minutes is all you
need. After you heat, move on to
stretching. As you can see in the
picture on the left, to stretch the levators, turn your head away from the
affected side and drop your nose toward the hip on that side. Apply light downward pressure as shown and
hold for 6-10 seconds. You want to feel
a light stretch without pain. If you
feel pain, back off on the stretch. Make
sure to stretch BOTH SIDES!!! If heat and
stretch doesn’t seem to quite help enough, self-myofascial release is always a
great alternative. As shown in the
picture on the right, placing a tennis ball under the affected shoulder while
lying down can help apply pressure to the trigger point which helps to release
it. You can also perform this technique
standing against a wall. Doing
self-myofascial release for 1-3 minutes on each side 3 times a week can help
relieve chronic tension in these muscles.
Lastly, seeing your chiropractor will definitely help relieve pain associated
with these muscles. Not only can we do
different myofascial release techniques, we will adjust the neck and upper back
to make sure the spine is aligned and there isn’t added tension on the muscles
do to misalignments of the spine. Also,
the adjustment will relieve pressure and irritation on the nerve that
innervates the muscles allowing them to function properly. At Pro Chiropractic, we also offer corrective
care to restore the natural curvature in the neck and reduce forward head
carriage that can irritate the levators.
If you or someone you know in the Gallatin Valley area is
looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at
406-219-2462 to schedule an
appointment in our Belgrade, Manhattan, or Bozeman office. Dr. Stark is a
board certified chiropractor and the author of this blog post. To learn
more about Dr. Stark and the many benefits of chiropractic care, please visit
our website: www.prochiromt.com.