Dooley Noted: 10/20/2015
The Levator Scapula (LS) is a neck and scapular muscle that is short and powerful – not unlike the author of this article.
LS attaches to C1-C4 vertebrae at the transverse processes, making it a fine lateral neck flexor (same side bender) of the scapula is fixed.
LS also attaches to the superior angle of the scapula, right where most of my patients have what I affectionately deem a “perma-knot.”
If the neck is fixed, LS elevates and slightly retracts the scapula, contributing to downward scapular rotation.
LS is Innervated by the dorsal scapular nerve C4-C5, as well as a separate Innervation from C3-C4 ventral rami branches. This muscle is quite secure, with its dual innervation and connections.
LS forms part of the floor of the posterior neck triangle, where it’s covered in a fascia that connects it to the posterior layer of the thoracolumbar fascia. Thus, when abdominal pressure is lost, LS kicks in as an assist for lateral spinal flexion.
Shoulder hiking (via trapezius and LS) is a major compensation for lack of abdominal stability in ipsilateral lateral flexion, particularly with quadratus lumborum or internal abdominal oblique inhibition.
LS is linked to cervical instability, especially in cases of improper extension hinging patterns in the cervical spine. LS locks the cervical spine to try to prevent its movement.
People with LS tightness often try to mobilize it, creating more instability. This causes LS to reflexively tighten more, creating more of perceived need to stretch and mobilize an unstable cervical segment.
Just because something is tight, it doesn’t mean you should stretch it.
Often times, things will be tight in attempt to stabilize nearby structures.
In the cases of cervical spine instability, the areas in need of mobilization are often the upper and lower cervical segments, otherwise known as transitional areas.
The midcervical spine actually seeks stability, not excessive mobility. When it is asked to mobilize for immobile segments, it creates instability.
So, all that self-neck adjusting and LS stretching may be making your condition worsen.
Elevation of the shoulder can be compromising to the rotator cuff structures, particularly supraspinatus.
If excessive anterior scapular tilting is permitted, the structural integrity of suprapsinatus may be compromised.
Because of LS’s ability to downwardly rotate the scapula, people with hiked shoulders may trade the power of latissimus dorsi (lat) for LS overuse. Since the lat internally rotates the humerus with LS recruitment, the lat becomes unavailable for humeral extension.
(See in this pic my right hike and lateral flexion as LS inhibits my lat on the right.)
If your pull-ups and abdominal stability drills are lacking in power, your posterior neck may be too involved in the movement patterns.
Down-regulating LS recruitment may result in less rotator cuff injuries and less cervical spinal instability and neck pain. It may also result in core and lat engagement.
Consider the LS in all unilateral coronal plane stability issues of the cervical and lumbar spine.
As always, it’s your call.
– Dr. Kathy Dooley