Levator Scapulae Syndrome
Descripation [edit | edit source]
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%).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Pain radiated to the neck and shoulder, but rarely to the arm. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Causes[edit | edit source]
- 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 lifestyleCite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title. - 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.Cite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - 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,Cite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - 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[edit | edit source]
- 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.Cite error: Invalid
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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[edit | edit source]
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 .Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
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[edit | edit source]
Radiographs and bone scans of the shoulders and cervical spine were negative
Flexibility Test[edit | edit source]
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[edit | edit source]
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. [1]
Treatment[edit | edit source]
In general, levator scapulae syndrome can often be treated conservatively, first by ceasing any physical activity that could exacerbate the condition and taking rest until the symptoms have diminished.
Limiting arm and shoulder movements can be beneficial. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Anti-inflammatory pain medication can help to reduce aching and any swelling,
while icing the area approximately 3 times per day can provide non-medicinal relief.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Electrotherapy[edit | edit source]
Medium frequency appears to be most effective, but any current which can tire and sedate the muscle is effective. This is done to relax the muscle and soften fibers.
Pulsed ultrasound (0.8 to 1.8 w/cm2) using Ibuprofen ointment, or other sedative and anti-inflammatory gel.
Rehabilitation[edit | edit source]
As long as there are no complications and you rest appropriately, the injury should soon begin to clear up. When you are pain free, you will be able to commence physical therapy with the doctor's approval. This stage is important for gradually replacing the lost strength in the neck and building up flexibility in the area before attempting to return to activity.Levator Scapulae Syndrome responds very well Active Release Techniques (ART), which is very effective in breaking up the scar tissue adhesion formation in Levator Scapulae and surrounding muscles, allowing the muscles to stretch and contract normally again (keep in mind it is these scar tissue adhesion that are causing the muscle to be tight and restricted in the first place).
It is also important that biomechanical problems that may be contributing to the condition, such as neck or shoulder muscles imbalances, postural problems, or upper back mobility are identified and corrected as these are usually the causes of increased stress on the Levator Scapulae in the first place. addressing these mechanical problems provides a long term solution of the problem and minimize the chances of reoccurrence
