The Levator scapula (LS) is a muscle whose primary job is to lift the shoulder blade. It also helps to downwardly rotate the scapula (shoulder blade). Downward rotation happens when the arm is lowered after being lifted. This muscle is often the culprit of shoulder and neck pain along with headaches. If you reach back and find your scapular spine and then follow it toward the midline, you are almost at the attachment site for the LS. From there, see if you can trace up and feel the upper-middle border of the scapula. Wiggling the shoulder or taking the arm behind your back can sometimes help you find it.

The LS also attaches the transverse processes of cervical vertebra 1-4. From looking at its attachments, you might see how this muscle could cause shoulder and neck pain. When the head is held in a forward position for long periods of sitting and working at the computer, the LS (and other muscles) get stretched and elongated. When muscles get longer, they also increase in tension. Tension typically equals pain and loss of the tensional integrity of the joint complex that it belongs to.

Scapulohumeral Rhythm

When we move our arms, the scapula should move to accommodate it in its socket. For example, when we lift the arms overhead, the scapula should upwardly rotate. When the arm is lowered back down, the downward rotation should happen. Imagine the LS being in a state of excess tension. Do you see how it would chronically lift the middle-upper corner of the scapula? A common clinical finding with individuals who have painful/tight LS is Downward Rotation Scapular Syndrome (SDRS). Along with any over-tensioned muscle, it is typically joined by a nearby muscle in a state of weakness.

If the scapula is held in a downwardly rotated position, it will have difficulty upwardly rotating as needed when the arm is lifted. This can cause problems in the glenohumeral joint (shoulder socket) as the arm attempts to lift, compression can happen in the subacromial space. This often leads to a “catchy” shoulder or the early stages of rotator cuff injury. See much more about rotator cuff injury and scapular mobility in this article.

What is the Solution?

This gets rather complicated, but there are some things you can do now to begin alleviating this problem.

1. Quit doing what is creating the imbalanced tension, or figure out a way to manage it. Minimize being in a seated, forward head position. If you work at a computer, change positions often. Even if at a standing desk, you will need to place your computer higher to avoid the weight of your head falling forward. My daughter developed this from many years of playing the flute. If you do a one-sided task for much of the day that requires you to lift/elevate one shoulder, this may be the cause of your imbalance.

2. Myofascial release of the LS. This should be a combination of stretches, therapy balls, and professional massage. Here is a quick video to show you how to stretch the LS along with the sternocleidomastoid muscle on the side/ front of the neck.

3. Strengthen the serratus anterior (SA) muscle. As the LS downwardly rotates the scapula, the SA upwardly rotates it. When the LS has excess tension, the SA is often weak. I am going to write an entirely separate article on the SA for you with suggestions for strengthening it.

4. In your yoga or other movement practices, minimize overhead reaching actions until you have regained proper scapulohumeral rhythm. If your scapula is not properly upwardly rotating, you could be setting yourself up for rotator cuff injury. Avoid doing weighted exercises that involve overhead arm motions or abduction lifts out to the side.

As always, I hope this information helps you awaken just a tiny bit more to the miraculous machine that is your body. The more we know, the. easier it is to tune in and make informed decisions about what and how we are choosing to be from day to day. Please give me your questions, thoughts, and comments.

Stacy A. Dockins

Yoga & Orthopedic Rehabilitation

Stacy owns Yoga Project Studios with her husband Dave. She is the author of Embodied Posture: Your Unique Body and Yoga, which is a complete yoga anatomy text designed with bio-individuality and the healing aspects of embodiment in mind. She is a nutritional therapy practitioner, corrective exercise specialist with the National Academy of Sports Medicine, and studies orthopedic rehabilitation at A.T. Still University. She and Dave lead programs and trainings for teachers and students of yoga across the globe.

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