Upper Trapezius, Levator Scapulae, Splenii and Rhomboid Vibration Release

Key Practical Points from Effects on Local Vibration

• Pre-exercise local vibration reduces functional signs and chemical markers of delayed onset muscle soreness (DOMS) and may improve performance in subsequent frequent workouts.
• Local vibration is effective for reducing acute muscle pain (and can be added to a home program via the devices like the Hypervolt by Hyperice® or similar devices).
• Local vibration alone may be sufficient to increase strength in deconditioned muscles/individuals.
• Current research implies that adding vibration to self-administered release techniques (SMR) (e.g. foam rolling) enhances benefits for DOMS, pain pressure sensitivity, and increasing proprioception. Further research is needed to refine protocols and determine whether adding vibration to SMR enhances benefits for increasing range of motion and improving power performance when used as a warm-up.

Protocol for Using Percussion Massage Device

1. Start with a higher setting and superficially (with gentle pressure) trace the entire surface of the muscle.
   • Setting 3 is likely appropriate for the lower body.
2. Take a mental note of dense or sensitive points. Manual therapists may use the opposite hand to palpate for taut bands and nodules (trigger points).
   • Stay away from areas where the bone is superficial. Using percussion massage devices over bone may be uncomfortable, painful, and/or cause bruising. Placing a finger or thumb over bony protuberances will prevent accidental contact.
3. Using a piece with a smaller surface area and lower setting (setting 1), return to the dense/sensitive points using deeper compression.
   • It may be helpful to add tension or slack by shortening or lengthening the target tissue
4. The Brookbush Institute recommends 30 seconds to 2 minutes per muscle group, and 5 minutes as an upper limit even in the case of multiple trigger points.

Best Body Position:

• Seated with scapula protracted (hands in lap) and cervical spine flexed (head down)

Bony Areas: (Block with a thumb or finger when approaching these areas)

• Acromion
• Occiput
• Spinous Process
• Spine of the scapula
• Vertebral border of scapula

Muscles:

• Upper trapezius runs laterally from the spinous process of the cervical spine and external occipital protuberance to the spine of the scapula, acromion, and distal third of the clavicle.
  • Common Trigger Point: Posterior aspect of the superior portion of the middle of the muscle.
• Levator scapulae are deep to the upper trapezius , coursing from the insertion at the superior angle of the scapula to the transverse process of the upper cervical spine
  • Common trigger point: Near the insertion on the superior angle of the scapula
• Splenii can be visualized as two columns bulging under the upper trapezius , just lateral the spinous process, during resisted extension, running from the upper thoracic spine to the mastoid process.
  • Common Trigger Point: At the levels of C7 and C2
• Rhomboids lie deep to the lower trapezius in an area boxed in-between the muscles origin from the C7 to T5 spinous processes, to the muscle's insertion along the vertebral border of the scapula.
  • Common Trigger Point: Along the vertebral border of the scapula