Logan Steele
The levator scapulae is a long, slender muscle that belongs to the superficial layer of extrinsic muscles of the back and neck. The name is derived from Latin, with 'levator' meaning 'to raise' and 'scapulae' meaning 'shoulder'. The muscle's primary function is to elevate the scapula, or shoulder blade, and it also plays a role in rotating the scapula downward and tilting the head. The levator scapulae muscle is prone to stiffening and chronic pain due to poor posture and can be stretched to alleviate neck and shoulder discomfort.
| Characteristics | Values |
|---|---|
| Type | Muscle |
| Location | Upper back and neck |
| Function | Elevate the scapula, stabilize the spine, extend and laterally flex the neck, stabilize the cervical spine, prevent forward head posture, and rotate the scapula downward |
| Innervation | Anterior rami of spinal nerves C3 and C4, dorsal scapular nerve (C5), and 2-3 branches of the 3rd and 4th cervical nerves |
| Blood Supply | Dorsal scapular artery, transverse cervical artery, vertebral artery, and ascending cervical artery |
| Attachments | Transverse processes of C1-C4 vertebrae, medial border of scapula, rhomboid muscles, trapezius muscles, serratus anterior, and pectoralis minor |
| Pathologies | Snapping scapula syndrome, levator scapulae syndrome, Sprengel deformity, cervical myofascial pain, fibromyalgia, and tendonitis |
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Location and structure
The levator scapulae is a large, long and slender superficial extrinsic muscle of the upper back and neck. It is one of the muscles within the floor of the posterior triangle of the neck. The upper part of the muscle lies underneath the splenius capitis and sternocleidomastoid muscles, while its lower part is covered by the trapezius. The middle part of the levator scapulae remains uncovered, and it can be most easily palpated in this area.
There are two levator scapulae muscles, one on each side of the neck, which originate from the posterior tubercle of the transverse processes of the C1 to C4 upper cervical vertebrae. The levator scapulae then travels down to the insert near the superior angle of the medial border of the scapula. It lies deep to the sternocleidomastoid at its superior aspect and the trapezius muscles at its inferior aspect. The muscles lie superior to the rhomboids.
The levator scapulae may lie deep to the sternocleidomastoid at its origin, deep or adjacent to the splenius capitis at its origin and mid-portion, and deep to the trapezius in its lower portion. The number of attachments varies; a slip may extend to the occipital or mastoid, to the trapezius, scalene or serratus anterior, or to the first or second rib. The muscle may be subdivided into several distinct parts from origin to insertion.
The levator scapulae is innervated by the anterior rami of spinal nerves C3 and C4 and the dorsal scapular nerve (C5), a branch of the brachial plexus. The dorsal scapular nerve is the predominant blood supply of the levator scapulae muscle. The vertebral portion of the muscle is supplied by the vertebral artery.
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Function
The levator scapulae is a large, slender muscle that belongs to the superficial layer of extrinsic muscles of the back and neck. The word "levator" comes from the Latin "levare", meaning "to raise", while "scapulae" is the Latin for "shoulder". As its name suggests, the primary function of the levator scapulae is to elevate the scapula, or shoulder blade.
The levator scapulae muscles are located along opposite sides of the neck. They originate from the posterior tubercle of the transverse processes of the C1 to C4 upper cervical vertebrae and attach to the medial border of the scapula. The levator scapulae muscle raises the scapula by drawing upward from the inside corner of the scapula bone to the outside of the neck, where it connects. This movement is called elevation. The scapula can also be rotated downward, a movement known as depression.
The levator scapulae also help to tilt the glenoid cavity inferiorly by rotating the scapula downward. This downward rotation of the scapula is also facilitated by the trapezius, latissimus dorsi, rhomboids, and pectoralis minor and major muscles. The levator scapulae also act with these muscles to stabilise the spine and extend and laterally flex the neck. When acting on the cervical joints, unilateral contraction of the levator scapulae produces ipsilateral flexion of the neck, while bilateral contraction contributes to extension of the neck.
The levator scapulae can be stretched by rotating the neck and shoulder in various stretches. This can help to alleviate neck and shoulder pain by allowing the muscles to loosen. However, poor posture can cause pain in the levator scapulae, as it is prone to stiffening and chronic pain due to false posture in everyday life. This can be avoided by practising good ergonomics, such as sitting up straight and adjusting computer monitors to allow the head to look straight ahead.
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Blood supply
The levator scapulae muscle is a long, slender skeletal muscle situated at the back and side of the neck. It is a superficial extrinsic muscle of the back, but functionally, it is considered a muscle of scapular motion.
The levator scapulae is innervated by the anterior rami of spinal nerves C3 and C4, as well as the dorsal scapular nerve (C5), a branch of the brachial plexus. The muscle is supplied by the dorsal scapular artery. This artery usually has a small branch that passes laterally to the supraspinatus fossa of the scapula, and in around a third of cases, this branch supplies the muscle.
A large portion of the levator scapulae muscle is vascularized by two branches of the thyrocervical trunk: the transverse cervical and ascending cervical arteries. The vertebral portion of the muscle is supplied by the vertebral artery.
The levator scapulae muscle is one of the muscles within the floor of the posterior triangle of the neck. This region is clinically important as it contains vasculature, the entire brachial plexus, cervical sympathetic ganglions, deep cervical lymph nodes, and the major vascular structures of the neck and upper extremity.
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Pathologies
The levator scapulae muscle is prone to several pathologies, including snapping scapula syndrome, levator scapulae syndrome, Sprengel deformity, cervical myofascial pain, and fibromyalgia.
Levator Scapulae Syndrome
Levator scapulae syndrome (LSS) is characterised by pain, stiffness, and discomfort in the levator scapulae muscle, located in the neck and shoulder region. The pain is likely to be reproduced on active and passive range-of-motion testing of the cervical spine, especially during flexion and side flexion. The muscle is likely to be tender on palpation and may present with increased tone, especially in the region and referral pattern of the trigger points. LSS is often caused by poor posture, muscle overuse, trauma, or as a secondary condition to another pathological state such as fibromyalgia.
Snapping Scapula Syndrome
Snapping scapula syndrome is a condition where the scapula, or shoulder blade, snaps or produces a popping sensation when moved. This can be caused by a variety of issues, including muscle imbalances, scar tissue, or bone abnormalities.
Sprengel Deformity
Sprengel deformity is a rare congenital condition where the scapula is abnormally high on the back, often accompanied by neck and shoulder pain.
Cervical Myofascial Pain
Cervical myofascial pain is a type of pain that originates in the cervical region, which includes the neck and upper back. This pain can be local or regional and is commonly caused by postural mechanics, muscle overuse, or trauma.
Fibromyalgia
Fibromyalgia is a chronic disorder characterised by widespread musculoskeletal pain, fatigue, and tenderness in the body. It can cause pain and discomfort in the levator scapulae muscle, among other areas.
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Stretches and pain relief
The levator scapulae is a long and slender muscle that belongs to the superficial layer of extrinsic muscles of the back. It is one of the muscles responsible for scapular motion, elevating the scapula, and rotating the glenoid cavity. Due to its length and attachments to different mobile areas of the body, the levator scapulae muscles are particularly susceptible to becoming strained and painful. Common causes of levator scapulae pain include carrying heavy loads, permanent lifting of the shoulders while sitting at a desk, and sleeping on one side of the body without proper head support.
To prevent and relieve pain, it is important to keep the levator scapulae stretched and flexible. One simple stretch involves sitting up straight with both hands at the sides. Then, raise your right arm forward and reach over your back with your hand grasping your right shoulder blade and applying downward pressure. This step rotates the shoulder blade downward, helping to lengthen the levator scapulae muscle. If raising the elbow above the shoulder is too difficult, this step can be skipped. While keeping everything else still, rotate your head to the left by about 45 degrees. This stretch can also be done while standing or by placing the hand and elbow on a nearby wall instead of grabbing the shoulder.
Another variation of the stretch begins in the same position, sitting up straight with both hands at the sides. This time, raise your right arm forward and place your hand on a nearby wall or door jamb above shoulder height, keeping your elbow straight. Then, lean into the wall, keeping your elbow above your shoulder, and rotate your head to the left. This variation can also be done by grasping the back of the shoulder blade instead of using a wall.
These stretches help to reduce neck and shoulder blade pain by lengthening the levator scapulae muscle and improving flexibility.
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Frequently asked questions
The levator scapulae is a long, slender muscle that belongs to the superficial layer of extrinsic muscles of the back. It is located along the outside of the neck and stretches from the cervical vertebrae to the scapula.
The primary function of the levator scapulae muscle is to elevate the scapula (shoulder blade). It also helps to rotate the scapula downward, tilt the head, and stabilise the spine.
Poor posture is a common cause of pain in the levator scapulae muscle. Sitting for long periods with a slouched posture can put undue tension on the muscle and lead to conditions such as levator scapulae syndrome.
The levator scapulae muscle can be stretched by rotating the neck and shoulder. One common stretch involves hanging one arm to the side while the other arm gently pulls the head down and towards the shoulder.
The dorsal scapular artery is the predominant blood supply to the levator scapulae muscle. It receives its blood supply from the subclavian artery or a branch of the thyrocervical trunk.
