1. Washington Physician

2. Your patient

3. Persistent neck pain Radiates to the head

4. What is your diagnosis?

5. Levator Scapular Syndrome

6. Long periods holding a telephone pinned between the ear and the shoulder can severely aggravate the levator scapulae, similar to the upper trapezius. • This and other habits must be eliminated or all the treatment in the world will do not good, and one long phone conversation with the phone held this way can undo months of treatment.

7. One of your patients

8. cause sleepless nights, irritable days and even be associated with depression and anxiety.

10. Levator Scapular Syndrome • The levator scapulae is a muscle located on each side of the neck, situated posteriorly. It is named for it's action in elevating or "lifting" the scapula and the word levator is the latin word for "to lift". • This muscle is like the over-worked back-stage prop guy of the neck. • Always in the shadow of the large sternocleidomastoid and hardly ever getting a moments rest.

11. Levator • The pain referred from TrPs in the levator scapulae muscle are some of the most common TrPs in individuals that suffer from neck pain or neck/shoulder pain. • Pain is referred to the angle of the neck where the base of the neck meets the thorax

12. Levator • originate on the four upper vertebrae of the cervical spine (neck) and insert, or attach, to the scapula, also known as the shoulder blade.

13. Levator • The levator has two distinct functions. When the neck is stabilized, the levator will elevate the scapula as a whole. • When the scapula is stabilized the levator, due to its fiber orientation, will assist in neck rotation to the same side.

14. Levator • This is an active muscle that plays a role in lifting the shoulders, rotating the shoulder girdle and many arm movements; therefore, limited movements can affect other areas of the upper body.

15. No single muscle takes more blame for the problems of bodywork clients

16. Levator • person with TrPs in the levator scapulae may complain of pain at the angle of the neck as well as a painful “stiff neck”. • A person will be unable to turn the head fully to the same side because of pain on contraction, and not completely to the other side either because of painful increase in muscle tension. • To look behind these people will turn their entire body.

18. Levator • Symptoms include pain in and around the neck, perhaps radiating down into the upper back or shoulder. • The pain usually worsens with activity. As the day progresses, the area can get stiff as swelling increases. • Symptoms may also include headaches.

19. The levator scapulae is the neck muscle frequently responsible for a stiff neck. • Trigger points in this muscle cause pain in the angle of the neck and the superior border of the scapula (inner edge of scapula). • When you wake up with a stiff neck because you "slept wrong"

20. Levator • The muscles of the neck may be the busiest muscles of the human body. • The human neck moves up to 600 times an hour. Whether you are awake or asleep. • While the very flexible cervical spine is moving around like this it has a big heavy cantilever sitting on top - your head.. • the levator scapulae muscle is one of the most problematic muscles of all.

22. Levator • Typically, this type of injury may have its origin in whiplash, prolonged bad posture or failure to stretch and strengthen the neck muscles regularly.

24. levator • The levator scapula are also involved with the muscles that stabilize the neck in flexion. • Along with the semispinaliscapitus, ceviscus, splenii and trapezi, the levatorscapule has been described as a "checkrein"2 against against flexion to keep the head from falling forward when bent downwards. • Long periods spent looking down at a book to read or to write or working at a computer can strain this muscle and activate trigger points in it.

26. Levator • Traditionally, treatment of Levator scapulae tendinosis included cortisone injections and physical therapy, basically providing temporary pain relief, not actual healing.

27. Levator stretch

28. Stretch

30. Massage

31. Posture

32. Posture

33. New technique

34. Watch the Debate for Levator Syndrome