Stretching the Levator Scapulae and the surrounding muscles like the trapezius (upper and lower) are beneficial in reducing the pain, increasing range of motion and quality of life. The levator scapulae can respond well to Active Release Techniques (ART). Treatment options include postural advice to ease the demand on the levator scapulae as well as stretching exercises to relieve tension. It is also important that biomechanical problems that may be contributing to the condition, such as neck or shoulder muscle imbalances, postural problems, or thoracic mobility are identified and corrected as these are usually the cause increased demand on the levator scapulae. Primary treatment with being aimed at the dysfunction that you hypothesize to be causing the levator scapulae dysfunction i.e. The phenomenon of levator scapulae pain of cervical origin being reproduced on shoulder movement has long been clinically recognized. You must also rule out the thoracic spine and shoulder.

The muscle is also likely to be tender on palpation and may present with increased tone, especially in the region and referral pattern of the trigger points. The presenting pain is likely to be reproduced on active and passive range of movement testing of the cervical spine especially flexion and side flexion to the contralateral side (placing the muscle in a lengthened position). With this presentation of pain and trigger points in the region of the levator scapulae, it is important to complete a full assessment of the cervical spine as pain in this region is often referred from the cervical spine.

Trigger points in the Levator Scapulae are also commonly misdiagnosed as cervical joint dysfunction so careful cervical assessment is required for individuals that present with these symptoms. Both trigger points lie deep to the upper trapezius muscle and both refer pain laterally to the shoulder and along the medial aspect of the shoulder blade. The lower trigger point lies just above the superior angle of the scapula and the upper trigger point lies 1-3 inches above the lower trigger point. The Levator Scapulae can present with two trigger points located in the lower half of the muscle. Active trigger points are more frequent in patients presenting with mechanical neck pain Increased muscle tone and trigger points.Deep, achy pain and/or tightness on the upper back along the top of the shoulder blade or neck.Pain and restricted range of movement especially reduced cervical flexion and side flexion to the contralateral side.Neck pain, which may extend to the head causing a headache.Many individuals who experience the effects of these trigger points also complain of shortness of breath (similar to that associated with panic attacks). Carrying bags with straps over the shoulder.Repetitive arm motions such as in swimming, throwing, or racquet sports.Altered shoulder biomechanics or poor posture.The dominant shoulder is most commonly involved (82%) and pain radiates to the neck and shoulder, but rarely to the arm. Evidence indicates an association between mechanical neck pain (MNP) and dysfunction of the muscles of the cervical spine. This muscle often becomes tense and painful leading to reduced motion in the area. Its function is to assist with various neck, arm and shoulder movements such as shoulder elevation and cervical side flexion. The levator scapulae muscle extends from C1-4 to the medial aspect of the scapula, between the superior angle and the root of the scapular spine.

Pathological fatigue