Levator Scapula Trigger Points and Referral Patterns

Levator Scapula Trigger Points

With the lower portion located deep under the upper trapezius, the levator scapula has its fibers coming out and becoming superficial as it ascends the side of the neck.

This muscle is about two fingers wide with the fibers twisting around themselves.

It attaches to the 4 transverse processes of the neck segment: C1-C4. C1 extends more laterally then other three.

A large group of nerves innervating the arm (the brachial plexus) also exits from the transverse processes of the cervical vertebrae.

Despite the levator scapulae muscle is relatively small it can cause a lot of problems when adaptively short and harboring trigger points.

The levator scapula is accessible for palpation from the side of the neck or through the upper fibers of the trapezius muscle.

If contracts unilaterally (only muscle of one side), it elevates and downwardly rotates the scapula, flexes and rotates the head and neck to the same side.

Bilateral contraction (the two muscles at the same time) extends the head and neck.

The levator scapulae, rhomboids major and minor, the latissimus dorsi together rotate the glenoid fossa of the scapula (the site where the arm attaches to the scapula) downward. Watch the video in the end of this article.

Levator Scapulae Trigger Points Chart

The levator scapula upper trigger point, which is often overlooked, seats in the middle portion of the muscle. The lower trigger point is in the much more obvious trigger area. The tenderness which is frequently found near the site of the muscle's attachment to the scapula is often secondary to a taut band tension associated with the trigger points.

Levator scapulae trigger points are likely to develop because of occupational and postural stresses, overloading and overexercising:

• typing with the head and neck turned to look at work placed beside the keyboard;
• making long telephone calls when flexing the neck and head to the side to hold the phone;
• talking for a long time with the head turned toward a person sitting to one side;
•  carrying a bag hanging from the affected shoulder;
• sleeping with the neck in a tilted position which shortens the levator scapulae (as in an uncomfortable bus seat, with the muscle’s fatigue and a cold draft aggravating the stress);
• swimming the crawl stroke losing a proper form when out of condition;
• playing vigorous tennis;
• sitting closely near the net at a tennis court and repeatedly turning the head and neck tracking the ball;
• rotating the head recurrently for a long time.

The inhibited serratus anterior function (one of the reasons for which may be the serratus anterior trigger points) can lead to an overload of the levator scapulae muscle and developing its active trigger points.

Levator Scapulae Referral Pain Pattern

The solid red identifies the essential pain pattern, and the stippled red identifies the spillover pattern. Read the referral pain patterns article to understand the difference.

Levator Scapulae Action along with Rhomboids [VIDEO]

Reaching to a back pocket normally requires a synergist work of the levator scapula, rhomboids major and minor.