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Muscle Name: Levator Scapula

Muscle Group: Head, Neck & Upper Back

Symptoms and Referred Pain:  
The pain referred from trigger points in the levator scapulae muscle are some of the most common trigger points for individuals who suffer from neck pain or neck/shoulder pain. Pain is referred to the angle of the neck where the base of the neck meets the thorax.

If you have trigger points in the levator scapulae, you may feel pain at the angle of the neck as well as a painful “stiff neck”.

You may be unable to turn the head fully to the same side because of pain on contraction, and not completely to the other side either because of painful increase in muscle tension. In order to look behind yourself, you may turn your entire body.

Muscle Description: Scapular Elevator: Levator Scapulae

The levator has two distinct functions. First, when the neck is stabilized, the levator will elevate the scapula (shoulderblade) as a whole. Second, when the scapula is stabilized the levator, due to its fiber orientation, will assist in neck rotation to the same side.

Self Treatment:
  • Backnobber II and Thermophore moist heating pad
  • When talking to people or watching a movie or TV be sure that the head and body are facing the same direction.
  • Lower keyboards that are too high or elevate the chair – refer to proper ergonomics.
  • Use a bookstand at the workplace to put materials on that are being typed onto a computer to avoid strain.
  • Employment of a headset when using the phone will remove excessive strain from the levator and free up the hands to complete work more efficiently. A speaker phone will work as well.
  • Have a cane that is too long be properly fitted.
  • Use a scarf to keep the neck warm in cold climates or in places prone to drafts, including airplanes.

How You May Have Injured This Muscle:
  • Secretarial work
  • Typing while looking to one side and down to copy information from another source
  • Using a computer, in which the monitor is deviated to one side or another, allowing the body to face forward and the head to be deviated for long periods of time
  • Carrying of a heavy purse on the affected side
  • Sitting at a table and talking to a person off to one side (the body forward and head turned)
  • Sleeping with the neck in a tilted position
  • Exposures to cold drafts
  • Watching a movie from the left or right sides
  • Watching TV where the TV is off to one side verses the direction the sofa/chair is facing
  • Sitting in a chair with armrests that are too high
  • Walking with a cane that is too long that forces unnatural elevation of one shoulder
  • Playing vigorous tennis
  • Swimming the crawl stroke
  • Rotating the head repeatedly as when watching a basketball game – “spectator neck”
  • A motor vehicle accident
  • Asymmetries in the lower body, such as lack of a normal push off during walking
  • Some viral and bacterial infections may activate trigger points in the levator

Activities to Avoid: By avoiding the listed of activities, you will decrease the stress placed on this muscle and allow it to heal faster.

In general, you should be pain free for 2 weeks before slowly introducing these activities again. If you have any questions, please consult a licensed health care provider.


  • When in bed pillows should be used to keep the head from deviating to one side or the other and should also keep the head and neck level in relation to the body.

Other Possible Disorders: This is a partial list of common medical conditions that may cause similar pain to what you are experiencing. It is important have a health care professional rule out these conditions prior to treating only this muscle group.

  • TrPs in the splenius cervicis
  • Scapulocostal syndrome
  • Referred pain from facet joints around the C4-C5 level
  • Articular dysfunction of C3, C4, C5, or C6 or several of these segments
   

References : 
Simons DG, Travell JG, Simons LS, Myofascial Pain and Dysfunction: The Trigger Point Manual, vol 1, 2nd Ed. Baltimore: Williams and Wilkins, 1999.
Travell JG, Simons DG, Myofascial Pain and Dysfunction, vol 2. Baltimore: Williams & Wilkins, 1992.