Levator scapulae muscle pain & trigger points

The levator scapulae is the first one to check if you have a stiff and painful neck.

You may be a couch potato, an office worker or even a pretty fit rock climber. This muscle does not discriminate when it decides to give you a sore neck.

Most people who have trouble with this muscle suffer from a stiff and/or painful neck on the affected side.

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1. Pain patterns and symptoms

1.1 Pain patterns

When trigger points are present in your levator scapulae, they can give you pain right at their location and send it to other, seemingly unrelated areas of your body.

The main pain zones of the levator scapulae are the side of your neck and your upper shoulder.

But this muscle is also capable of sending pain to your shoulder blade and along its inner border – which is called margo medialis –.

It can contribute to the following aches:

In the picture, the red colour will show you the pain zones.

The darker the red, the more common it is to experience pain in the respective area when your levator contains trigger points.

1.2 Impaired or painful movements

If you overstress this muscle, it will let you know.

You will have a hard time turning your head fully to the side without pain. This is what most people experience when they are complaining about a stiff and painful neck.

Lying on a sofa or in bed and lifting the neck can be so painful that you have to support your head with your hands.

This is especially annoying when you want to change the position of your head on the pillow in order to get a comfortable sleeping position.

Tilting your head forwards in order to read a book also can become painful.

2. Attachment points

The levator scapulae attaches at the top corner/angle of the scapula – called the angulus superior – and at the first four vertebrae of your cervical spine.

3. Levator scapulae functions

The duties of this muscle are many.

First, as the name suggests, it helps to elevate your shoulder.

Furthermore, it rotates your neck and bends it to the same side that is active.

When the levators of both shoulders are activated, they help to bend your neck backwards and to stabilize it when you look downwards.

1

Shoulder neutral

2

Elevation at the shoulder

3

Lateral flexion at the neck

4

Extension at the neck

5

Rotation at the neck

4. Levator scapulae trigger point activation

As you have already learned, bending the neck sideways and shrugging your shoulders are functions of
the levator.

This is exactly the way you use the muscle when you hold your phone ‘hands free’. This is a very unnatural position.

Although at the time it might not seem to overstress your neck, after a while it does your levator no good.

This static tucking position, especially if you do not have well trained shoulders and do it often and for long times, it will become just too much.

Switching sides does not necessarily help. By doing so, you are prone to develop an overworked levator on both sides of your body.

Lifting and carrying heavy weights is not kind to the shoulders and the levator scapulae.

Both tasks pull your shoulders downwards. As the levator wants to stabilize them, it contracts to keep them in place.

It will do a good job as long as it can, but if the weight becomes too high or the duration of the stress too long or frequent – e.g. carrying your purse every day on the same side – the muscle reacts.

It starts to tighten up permanently. This is its way of withstanding the stress you are placing on it.

Looking upwards for a long time is very unnatural too and is a difficult task for your neck muscles. If you do it – like a belayer in rock climbing – the levators have to work hard and start to cramp and tighten up.

Do it too often and the tightness may become a permanent condition. This is when the trouble starts.

Reading with your head facing downwards is the opposite stress.

The levators have to stabilize your neck and prevent it from tilting forward too much. Usually this does not trouble your levators a lot, but forcing them to do this for several hours is just too much for most people.

Thus a seemingly easy task becomes damaging.

Here it is not the immediate task itself that causes trouble, but its duration.

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5. Levator scapulae palpation

Like most muscles in the area of your upper back, your levator is also covered by the trapezius muscle.

This makes it hard to feel it, but you can locate the place where it attaches at your scapula.

Just reach with your hand over your opposite shoulder, searching for the upper part of your shoulder blade.

You should feel a bony and spiky landmark. This is the angulus superior and the place where the levator scapulae attaches at your shoulder blade.

6. Levator scapulae self-massage

I recommend massaging this muscle with the Trigger Fairy or a massage ball. Of course, you could also use your hands, but this can be quite hard on them.

On this page I will describe the massage with the first two tools.

I divided the massage into two areas, namely the area at your neck and the one at your upper shoulder blade (where the muscle originates from).

If you suffer from a stiff neck, you should concentrate on the area at your neck, as this is where the problematic muscle fibers and trigger points are located.

Massaging the area at the angulus superior is “comfortable” and feels good, but will not help to free your neck.

6.1 Self-massage at the neck with the Trigger Fairy

In this area there is no better tool than the Trigger Fairy. You can massage all the muscles very precisely without putting any stress on your fingers.

As a massage technique you can use precise massage strokes or the pressure-motion technique.

Before you start, know that the muscles of your neck contain a lot of receptors for your orientation in space.

If you start you massage too intense, your nervous system might get irritated, and leave you with some dizziness for some days.

So make sure to keep the pressure and duration of your massage short, and only slowly increase those two variables.

Always listen to the reactions of your body.

Precise massage strokes

  • Place the Fairy at the upper end of your cervical spine, right below your skull.
  • Hold its handle in front of your face.
  • Gently exert some pressure and search for tender muscle tissue.
  • Massage each tender point by strokes a few times over it.

Pressure-motion technique

  • Place the Fairy on the upper part of the levator scapulae.
  • Search for tender spots by pressurizing the muscle and simultaneously moving your head.
  • To massage these areas, just stay there and keep moving your head.
  • Concetrate your massage on the painful ranges of motion.

Exemplary massage positions

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6.3 Self-massage at the neck with a ball

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Although at the neck the ball cannot match the precision of the Fairy, you still get decent results.

For example you can relieve some muscle tension with the ball, and afterwards work the tiny muscle knots in your levator with the Fairy.

  • Place the ball at the side of your necck and lean against a wall.
  • Slowly roll over its area and search for tender points.
  • Massage each of them with about 10 strokes.
  • Again, do not overdo it here and listen to your body.

6.3 Self-massage at the shoulder blade with the Trigger Fairy

In this area I recommend using the pressure-motion technique.

  • Place the Fairy at the upper border of your shoulder blade (angulus superior).
  • Search for tender points by pulling the Fairy downwards.
  • Massage each point by executing slow circular shoulder motions.
  • Alternatively you can lift and lower your shoulder.

Exemplary massage positions

1
2

6.4 Self-massage at the shoulder blade with a ball

  • Place the ball at the area of your upper shoulder blade (angulus superior).
  • Lean against a wall and make sure to place your hips and feet far enough away from the wall.
  • Only this way you can create enough pressure for the massage.
  • Search for tender spots by rolling over this area …
  • … and massage each of them with slow strokes.
1
2

6.5 Self-massage with your hands

  • Form your hands like a shovel.
  • Place your finger tips in the area you whish to massage.
  • Execute slow massage strokes by pulling skin over the muscle.
  • This way search for tender areas in the muscle.
  • Massage each tender spot with a few short and slow massage strokes

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print