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Dr. Brian Abelson

The Levator Scapulae – An MSR Approach

Updated: Aug 5


Levator Scapulae Treatment Image

The levator scapulae muscle is integral to neck and shoulder mechanics, playing a key role in scapulocervical movement and stabilization. This article will dissect the detailed anatomy and biomechanics of the levator scapulae within the Motion Specific Release (MSR) framework, emphasizing its crucial role in the dynamics of the cervical spine and scapular positioning.


We will examine the levator scapulae's influence on cervical extension, lateral flexion, and neck rotation and its role in elevating the scapula. We will also explore the consequences of levator scapulae dysfunction on overall musculoskeletal health. Moreover, we will present MSR techniques specifically developed to optimize the function of this muscle, thereby enhancing interventions for conditions impacting the neck and shoulder girdle.


Article Index:


 

Levator Scapulae Anatomy Image

Anatomy & Biomechanics


The levator scapulae muscle is essential in scapulocervical biomechanics, enabling the nuanced movements of the neck and shoulder girdle. This slender muscle plays a pivotal role in the stability and motion of the cervical spine and scapula.


Origin and Insertion:

  • The levator scapulae originates from the posterior tubercles of the transverse processes of C1 to C4 vertebrae. The muscle fibers then descend laterally to converge on the medial border of the scapula, inserting between the superior angle and the root of the scapular spine.


Innervation:

  • The levator scapulae is innervated by the dorsal scapular nerve, which arises from the C5 nerve root, and occasionally receives additional innervation from the C3 and C4 cervical nerves. This innervation pattern is crucial for scapular elevation and the proprioceptive feedback necessary for neck movements.


Biomechanical Role:

  • As the name suggests, the primary biomechanical function of the levator scapulae is the elevation of the scapula. It also contributes to the downward rotation and tilting of the scapula, as well as extension and lateral flexion of the neck.


Biomechanical Dynamics:

  • The levator scapulae work in concert with the muscles of the upper back and neck, particularly the upper trapezius and rhomboids, to coordinate scapular movement and cervical postural adjustments. The muscle's length-tension relationship and its leverage on the cervical spine and scapula are critical for efficient motion and load distribution during neck and shoulder movements.


MSR Perspective:

  • From an MSR standpoint, the levator scapulae are approached as a key muscle in the kinetic chain linking the cervical spine and the shoulder. MSR techniques are developed with a sophisticated understanding of its anatomical and biomechanical nuances. The interventions aim to improve the muscle's functional capacity, addressing myofascial restrictions and enhancing neuromuscular control that is imperative for the correct alignment and mobility of the neck and shoulder regions.



 

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Motion Specific Release (MSR) Treatment



Initial Setup:


  • Patient Position: The patient is seated to allow the practitioner full access to the scapula, with attention to the levator scapulae muscle.

  • Practitioner Stance: The practitioner assumes a stance that facilitates optimal reach and leverage for the application of MSR techniques to the levator scapulae muscle.


Basic Technique:


  • Treatment: The practitioner uses their forearm, thumb or fingers to apply pressure and engage the levator scapulae muscle from its insertion at the superior angle and the medial border of the scapula to its origin at the transverse processes of C1 to C4.

  • Support Hand: The practitioner utilizes the opposite hand to provide stabilization and aid in the application of traction and circumduction to the targeted muscle.

  • Synchronization: Techniques are executed with synchronized movements to effectively navigate the muscle fibers of the levator scapulae, ensuring a comprehensive treatment.

  • Pressure Application: The practitioner carefully increases pressure to facilitate a deep, yet comfortable, engagement with the muscle tissue, maintaining an open line of communication for patient feedback.


Technique:


  • Contact: This involves the practitioner applying a downward force with the contact hand while simultaneously moving the patient’s head to optimize the angle of muscle engagement. In the superior portions the contact hand will require thumb or finger tension to achieve sufficient release.


Combining Procedures:


  • The practitioner combines supination and pronation of their own arm with traction and circumduction, enhancing the release of the levator scapulae muscle. This dynamic movement helps in addressing the fascial connections and muscle fiber orientation.


Levator Scapulae Release - MSR Demonstration

In this video, Dr. Abelson demonstrates Motion Specific Release (MSR) procedures for releasing the Levator Scapulae Muscle. The levator scapulae muscle is principally involved in elevating the scapula and plays a role in its downward rotation, aiding in the positioning of the glenoid cavity. It also assists in neck extension and, when the scapula is fixed, contributes to lateral flexion and rotation of the cervical spine.


Best Practices:

  • Time should be allocated to allow a meticulous and comprehensive approach to the mobilization of the levator scapulae muscle.


Kinetic Chains:

  • The role of the levator scapulae within the kinetic chain is considered, recognizing its impact on neck and shoulder function.


Precautions:

  • Safety is paramount. The practitioner ensures that all MSR techniques are performed without contraindications and with the patient’s informed consent.

  • Gentle and responsive techniques are employed, with constant monitoring of patient feedback to adjust pressure and movements for a tailored MSR experience.

Comparative Analysis:

  • Post-treatment, the practitioner assesses changes in muscle tension and mobility compared to the untreated side to gauge the effectiveness of the MSR intervention.


 


Kinetic Chain Image

Functional Kinetic Chains


The levator scapulae's integration into functional kinetic chains is vital for the coordinated movement of the neck and shoulder. To comprehend its role fully, an exploration of its myofascial connections and interactions with surrounding structures is indispensable.


Direct Myofascial Connections:


  • Cervical Fascia: The deep cervical fascia forms a continuous myofascial sleeve that provides structural support for the levator scapulae, facilitating force transmission between the neck and the shoulder girdle.

  • Nuchal Ligament: The levator scapulae interacts with the nuchal ligament, which provides a stable anchor for the cervical extension and contributes to the scapular elevation and control.


Synergists:

  • Splenius Capitis and Cervicis: These muscles work synergistically with the levator scapulae in extending and rotating the cervical spine.

  • Upper Trapezius: It collaborates with the levator scapulae in elevating and stabilizing the scapula during upper limb and neck movements.


Stabilizers:

  • Rhomboids: These muscles act as stabilizers for scapular retraction, supporting the levator scapulae in maintaining scapular positioning.

  • Serratus Anterior: It stabilizes the scapula against the thoracic wall, allowing the levator scapulae to function effectively during neck and shoulder movements.


Antagonists:

  • Lower Trapezius: This muscle opposes the scapular elevation function of the levator scapulae by facilitating scapular depression and upward rotation.

  • Sternocleidomastoid (SCM): During cervical movements, the SCM acts in opposition to the levator scapulae, especially in flexion and contralateral rotation of the neck.


Understanding the levator scapulae's myofascial and kinetic connections is crucial for MSR application. This comprehensive anatomical knowledge allows for targeted MSR interventions that address the complete scope of factors affecting scapulocervical dynamics. By doing so, MSR can correct dysfunctions within this chain, enhancing the efficiency of movement and the functional integrity of the neck and shoulder region.


 

Exercise


Exercise plays a crucial role in myofascial therapy, which aims to improve flexibility, strength, and proprioception. Tailored exercises are chosen to match each individual's unique requirements, and the accompanying videos provide examples of potential exercises that may be recommended depending on the case at hand.


PNF Stretching - Levator Scapulae

PNF (Proprioceptive Neuromuscular Facilitation) stretching is a great way to restore or increase neck motion. PNF is a stretching technique that increases Range of Motion (ROM) and flexibility. It increases ROM by increasing the length of the muscle and increasing neuromuscular efficiency.


PNF Neck Stretches

Welcome to this video highlighting the incredible benefits of PNF Neck Stretches - Mobility, Strength, and Power. Numerous studies have shown that PNF stretching techniques enhance and maintain flexibility, amplify muscular strength and force, and elevate overall athletic performance. In this video, we will explore various PNF neck stretches that target specific movements, starting with increasing flexion at 01:35, then enhancing left lateral flexion at 02:40, right lateral flexion at 03:23, and increasing extension at 04:00.


Neck Strengthening Exercises That Work

Strengthening your neck is crucial for maintaining a healthy posture, preventing future injuries, and resolving existing ones. By incorporating these exercises into your routine, you should obtain significant improvements in your overall posture. Introduction at 00:00, followed by the commencement of the routine at 01:15. Finally, at 06:35, we'll provide you with a curated playlist of neck exercises to support your journey towards a stronger and more mobile neck.


 

Conclusion


In conclusion, the levator scapulae emerges as a fundamental muscle in orchestrating neck and shoulder mechanics. Clinicians who focus on the scapulocervical area must grasp its structural and functional characteristics in depth. Recognizing the levator scapulae's role in postural dynamics and movement, as well as its place in the broader kinetic chain, enhances our capacity to sustain musculoskeletal equilibrium.


This review emphasizes the importance of a holistic approach in musculoskeletal care, considering the body's complex kinetic chains. Motion Specific Release (MSR) is an effective method for addressing these intricate connections and releasing restrictions. Our goal is not only to provide y pain relief but also to enhance the body's functional capacity.


 

References 


  1. Abelson, B., Abelson, K., & Mylonas, E. (2018, February). A Practitioner's Guide to Motion Specific Release, Functional, Successful, Easy to Implement Techniques for Musculoskeletal Injuries (1st edition). Rowan Tree Books.

  2. Chaitow, L., DeLany, J. (2002). Clinical Application of Neuromuscular Techniques: The Upper Body (Vol. 1). Churchill Livingstone.

  3. Clark, M. A., Lucett, S. C., & McGill, E. (2012). NASM Essentials of Corrective Exercise Training. Lippincott Williams & Wilkins.

  4. Hammer, W. I. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods (3rd ed.). Jones & Bartlett Learning.

  5. Hertling, D., & Kessler, R. M. (2006). Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods (4th ed.). Lippincott Williams & Wilkins.

  6. Jull, G., Moore, A., Falla, D., Lewis, J., McCarthy, C., & Sterling, M. (2012). Grieve's Modern Manual Therapy: The Vertebral Column (3rd ed.). Churchill Livingstone.

  7. Levangie, P. K., & Norkin, C. C. (2011). Joint Structure and Function: A Comprehensive Analysis (5th ed.). F.A. Davis Company.

  8. Neumann, D. A. (2016). Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation (3rd ed.). Mosby.

  9. Page, P., Frank, C. C., & Lardner, R. (2010). Assessment and Treatment of Muscle Imbalance: The Janda Approach. Human Kinetics.

  10. Sahrmann, S. (2002). Diagnosis and Treatment of Movement Impairment Syndromes. Mosby.

  11. Travell, J. G., & Simons, D. G. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual (Vol. 1, 2nd ed.). Lippincott Williams & Wilkins.


 
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DR. BRIAN ABELSON, DC. - The Author


Photo of Dr. Brian Abelson

With over 30 years of clinical practice and experience in treating over 25,000 patients with a success rate of over 85%, Dr. Abelson created the powerful and effective Motion Specific Release (MSR) Treatment Systems.


As an internationally best-selling author, he aims to educate and share techniques to benefit the broader healthcare community.


A perpetual student himself, Dr. Abelson continually integrates leading-edge techniques into the MSR programs, with a strong emphasis on multidisciplinary care. His work constantly emphasizes patient-centred care and advancing treatment methods. His practice, Kinetic Health, is located in Calgary, Alberta, Canada.


 


MSR Instructor Mike Burton Smiling

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1 Comment


A great article for those of us who spend endless hours in front of a computer, and need to release our eternally tight neck and shoulder muscles. This is a good one to share with your MSK practitioner, and a great one to experience a treatment from these amazing practitioners.😏

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