The Levator Scapulae – the root of it all
The levator scapulae, often pronounced as though it were spelled “levator scapula” is another hardworking muscle that everyone has trouble with. “Levator” , think elevate, and “Scapula” think “shoulder blade.” So the name tells its job: it lifts the shoulder blade.
Trigger points in levator scapulae muscles cause pain and stiffness in the angle where the neck and upper back meet. When they are active they also refer a lesser degree of pain along the inner edge of the shoulder blade and to the back of the shoulder. A levator scapulae trigger point is what keeps you from turning your head to look behind you when you are reversing your car. You may not be able to turn your head toward the side that has the trigger point at all. When you turn your head to the opposite side it may also cause pain.
The lower end of each levator scapulae muscle attaches to the inner edge of the top angle of the shoulder blade on the same side. Its upper end attaches to the sides of the top four neck vertebrae on the same side as well.
This arrangement allows the levator scapulae to help raise the shoulder blade and in turn raise the shoulder. This function is the very one that gets the muscle into trouble. When stress and posture habits you have keep your shoulders up, you can be sure that the levator scapulae muscles are doing much of the work.
Many things make trouble for the levator scapulae, including sleeping on your side without support for your head, typing with the page you are copying from out to one side, sitting in a draft of cold air, and holding the phone clamped between your head and shoulder. Carrying backpacks and purses on shoulder straps are as bad for levator scapulae muscles as they are for the trapezius muscle. Both have to stay strongly contracted to counter the downward pull of the bag or purse.
Levator muscles are also stressed by overexercise, 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.
As a pair, the levators serve to stop the head from going too far when it hangs forward. So we really abuse them by habitually carrying the head forward. Levator scapulae and trapezius muscles can be strained beyond endurance by habitually reading with your book or e-reader flat on the desk, since all the muscles of your neck and upper back have to remain contracted all the time your head is hanging forward in that position. Prop your book up with a couple of other thick books when you read so you can keep your head up. E-readers really need an accessory such as an incline case that will allow the device to be used at an angle. Several styles of book stands can be found in any college bookstore or online.Habitually using a cellphone or smartphone held at chest level will also wear out your levator scapula muscles. Periodically lift your shoulders up toward your ears and then stretch them down to allow these muscles to fully contract and then stretch. This will help avoid trigger points when your smartphone is too much fun to put away and if you cant put down your phone.
The most accessible levator scapulae trigger point is the lower one and located just above the muscle that attaches to the upper angle of the shoulder blade. To find this place accurately, you must first be able to locate the upper, or superior, angle. To feel the superior angle move under your fingers, place the heel of your hand on your opposite collarbone. Let the fingers lie relaxed across the top of your body. Glue the hand here and don’t let it move down your back. Now swing your free arm loosely forward and back. As you do the movement, you will feel the underlying superior angle of the shoulder blade bump up under your index or middle finger. Using your hand, you won’t be able to effectively massage the trigger point that is located just above the angle here. To be most successful, use a cane or similar device.
Replace your fingers with the knob on the hook end of the tool. Apply pressure or do a tiny moving stroke across the sore trigger point you find just above the angle.
THE CENTRAL POINT
Unfortunately, the lower trigger point in the levator scapulae isn’t the one that causes most of the trouble. It is good to work this spot, but it may not get rid of all your neck pain and stiffness. The central trigger point is an important one to go after. It can be found at the base of the neck just in front of the upper trapezius. Reach across the front of your neck with your opposite hand and place your fingertips right in the middle of the angle where the neck meets the body. Press your middle finger into the base of your neck just in front of the trapezius, which is the big muscle you can feel contract when you raise the shoulder. If you strum forward to back here, you might feel a tight rope of muscle going up the side of your neck. Press this rope-like band into the underlying transverse process (side of the underlying vertebrae) at the very base of the neck. If you don’t find it at first, allow for a careful search for this very tiny point. It may surprise you that the knobby hard bumps there under your fingers are the bones of your neck. You won’t likely feel knots, only tight muscles and bone. You can massage this point with your fingertips. Support the tool hand with the other hand for additional pressure. A walking cane also works well.
If you don’t have a hook-type tool, lean forward against a door frame or convex corner to place a ball on the top of your shoulder leaning into a ball on a wall behind you also works for the lower point.