Levator Scapulae Syndrome

 Descripation 

The levator scapulae muscle extends along the back of the neck, with the function of assisting with various neck, arm and shoulder movements such as shrugging. When the muscle becomes rigid this can cause pain and reduced motion in the area.The dominant shoulder was the most commonly involved (82%). Pain radiated to the neck and shoulder, but rarely to the arm.

Causes

• Faulty shoulder biomechanics or poor posture will increase the demand on this muscle.  So, the most common causes of levator scapulae syndrome are overuse injuries and poor posture; this condition is common in those with desk jobs and a sedentary lifestyle.
• Repetitive arm motions such as in swimming, throwing, or racquet sports, these muscles can become strained and develop micro tears, leading to scar tissue adhesions within the muscle that create tightness and restricted flexibility/mobility with the muscle.  Over time, this can/will progress to more noticeable symptoms of pain and injury.
• For women, carrying bags with straps over the shoulder is another common cause of levator pain.
• In anxiety many people who experience the effects of these trigger points also complain of a shortness of breathe like that associated with panic attacks. Another similar symptom is a heightened feeling of “bearing the weight of the world on one’s shoulders,
• In athletes and others involved with physical activities, the most prominent cause of levator scapulae syndrome is overuse. This can arise due to multiple factors. Failure to warm up correctly before activity or to stretch and strengthen the neck muscles regularly is a common contributing factor.

Sign and Symptoms

• Common symptoms include severe pain in the neck, which may stretch to the head causing a headache. Other symptoms may include swelling and a restricted range of movement.

Deep, achy pain and/or tightness on the upper back along the top of the shoulder blade or neck

Pain can also occur with turning the neck

• Difficulty placing the chin on the chest.
  

Trigger points

The Levator Scapulae can harbour three trigger points, two of them located in the lower half of the muscle. The lower trigger point lies just above the superior angle of the scapula, and upper trigger point lies 1-3 inches above the lower trigger point. Both trigger points lie underneath (deep to) the upper trapezius muscle. Third present in distal half of radius .
Both trigger points refer pain to the base of the neck where it meets the shoulder, and along the inside of the shoulder blade.

Diagnosis

Radiographs and bone scans of the shoulders and cervical spine were negative

Flexibility Test

Movements that stretched the levator scapulae on the affected side aggravated symptoms.
You should be able to rotate the head approximately 90 degrees and to bend the neck approximately 45 degrees to the side.

Palpation

Place elbow onto the superior angle and medial border of the scapula and lean in - and then get client to rotate their head 45 degrees towards the opposite side, then look down.