Origin:  Transverse process of the first four cervical vertebrae (posterior tubercles of C3 and C4 transverse processes)


Insertion: Medial border of the scapula from pointed edge close to origin of the spine of the superior angle of the scapula .

Nerve: Primarily innervated by cervical nerves 3 and 4, via the cervical plexus. 
 
Action:
Cervical Spine: Extension, lateral flexion and ipsilateral rotation
Scapula: Elevation and downward rotation .

Integrated Function:
Stabilization: Stabilization of the cervical spine and scapula.
Eccentrically Decelerates: Upward rotation and depression of the scapulae, and flexion, contralateral flexion and contralateralrotation of the cervical spine.


Synergists:

The levator scapulae, upper trapezius, and rhomboids work synergistically during elevation of the scapula.
The levator scapulae, pectoralis minor and rhomboids work synergistically during downward rotation of the scapula
The levator scapulae may help the pectoralis minor and upper trapezius in anterior tipping of the scapula .



Fascial integration:

The levator scapulae shares an attachment on the posterior tubercles of transverse process with intertransversarii posteriores at C1 – C4, the splenius cervicis at C1 – C3, the longissimus cervicis at C2 – C4, and the middles scalenes at C3 and C4.
In essence, the motor behavior and recruitment patterns of the levator scapulae is more similar to the scalenes then the trapezius muscles at the cervical spine. 

Clinically when neck problem with restrictions of motion which results often the first range of motion lost, the last range of motion to return, and levator scapulae trigger points and over-activity are very common, in computer workers. Many times it occurs in conjunction with scalene trigger points and over-activity.

 The superficial layer of fascia of the levator scapulae runs  continuously over the root of the spine of the scapula to bind in the fascia of the supraspinatus. This is noted by Tom Myers, and which included in the Deep Back Arm Line Both muscles have a propensity toward over-activity and the treatment of both is necessary for long-term resolution of trigger points.


Postural Dysfunction:

The levator scapulae have been noted as short and over-active by many clinicians, texts and studi
The levator scapulae is most often short and over-active contributing to excessive anterior tipping and downward rotation of the scapula in those with upper body dysfunction. Trigger points in the levator scapulae are among the most commonly noted trigger points in the human body. It may be that the upper trapezius is over-active in those with shoulder girdle and cervical dysfunction, contributing to both extension of the upper cervical spine and anterior tipping of the scapula. However, it is more common to find the upper trapezius long and under-active, leading to a decrease in scapular upward rotation and clavicular posterior rotation during arm elevation. 

 

Levator Scapulae Trigger Points:       

  • Palpation results in tenderness and sometimes  result in radiating symptoms along the angle of the neck and the vertebral border of the scapula . (follow image)
  • Levator Scapulae is the second most common trigger point location after the upper trapezius in those with mechanical neck pain .

 

Referance :

 

  1. Phillip Page, Clare Frank, Robert Lardner, Assessment and Treatment of Muscle Imbalance: The Janda Approach © 2010 Benchmark Physical Therapy, Inc., Clare C. Frank, and Robert Lardner
  2. Donald A. Neumann, “Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition” © 2012 Mosby, Inc.
  3. Tom Myers, Anatomy Trains: Second Edition. © Elsevier Limited 2009
  4. Shirley A Sahrmann, Diagnoses and Treatment of Movement Impairment Syndromes, © 2002 Mosby Inc.
  5. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilkens

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