by Joseph Kurnik, DC

A common complaint often seen in practice is pain, discomfort, and/or tightness in the levator scapula muscle. Its tendon origin is on the transverse process of the first four cervical vertebrae. It passes downward and lateral to insert on the vertebral border of the scapula above the scapula spine. Its contraction elevates the scapula, tends to draw it medial, and rotates it to lower the lateral angle. It is affected by various motions of the arm relative to attachments and tonus of the infraspinatus muscle.
Motions of the neck also affect the levator scapula muscle because of the mechanics of its attachments.

From clinical observations, this disorder has an affinity for the left side. It also appears to relate most closely to upper cervical fixation dysfunctions, and is most frequently associated with C-1/ C-2 fixations where the listing appears like LPS or LPS-RA.

In previous articles I have described the C-1 LPS fixation. The left side fixates left lateral and resists rotation from left to right. The right side also may be fixated at C-1/C-2 from going anterior to posterior. This fixation dysfunction appears to alter levator scapula function by increasing its tonus and, eventually, irritability.

This syndrome may be associated with headaches, neck pain and neck and shoulder stiffness. It can lead to increased irritability of the infraspinatus and teres muscles, or it can be exacerbated by tension in these muscles. Irritability of the levator scapula muscle can be detected by firm finger probing of the muscle or with instrumentation, such as the DSR zone finder, which can measure increased skin resistance over the muscle.
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