Levator Scapulae Static Manual Release (Soft Tissue Mobilization)

Differentiation

1. Find the insertion of the levator scapulae at the easily identifiable superior angle of the scapulae.
2. The levator scapulae lies deep to the upper trapezius.
3. The levator scapulae is a "ropy" bundle of fascicles that twist around each other. Note, the upper trapezius is a relatively flat, sheath-like muscle. Investigating the insertion around the corner of the superior angle of the levator scapulae you should be able to identify the "ropy" fascicles under the more superficial upper trapezius .
4. Continue to trace the more vertically oriented fibers of the levator scapulae by using short horizontal strumming strokes. Note, the fibers of the upper trapezius are more horizontal as they run toward their origin on the transverse processes of the cervical spine.

Potentially Sensitive Tissues

• Providing your palpation stays posterior to the transverse processes of the cervical spine, careful palpation does not pose a risk to sensitive tissues. Note, anterior to the transverse processes the carotid arteries, brachial plexus, and lymph nodes may be affected by palpation.

Trigger Points

• The most common trigger points for the levator scapulae are at the insertion, near the superior angle of the scapula, and the center of the muscle belly at approximately the level of C5, C6.

Release Technique

1. Although this technique can be performed in sitting with the practitioner behind the patient, it is most comfortable with the patient lying supine and the practitioner sitting at the head of the table.
2. The practitioner can use the hand opposite the side of treatment to increase length and tension in the muscle with contralateral flexion, contralateral rotation, and mild flexion.
   • Note the upper trapezius is lengthened using ipsilateral rotation.
3. The practitioner uses the thumb on the side of the treatment to strum the fibers of the levator scapulae . Generally, it is easiest to start at the insertion using short horizontal strokes, working toward the cervical spine as needed to locate taut bands.
   • Palpation of the superior half of the levator scapulae : The muscle is a superficial structure of the lateral neck, just anterior to the border of the upper trapezius , and posterior the transverse processes.
4. Once a taut band is located, the length of the band is explored for a dense nodule.
5. The practitioner may move the head to increase or decrease length and tension in the muscle, and adjust the treatment hand to modify the direction of force with the intent of pinning and compressing a dense/sensitive nodule.
6. Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).