This blog post contains the exercises, stretches and strategies to help fix Levator Scapulae pain.

Levator Scapulae pain (also be referred to as “Levator Scapulae Syndrome”) is usually associated with a strain and/or tightness in the muscle.

Area of Pain

Pain in the Levator Scapulae is experienced in the region between the upper/inner portion of the shoulder blade and/or on the side of the neck.

(This muscle attaches from the superior angle of the Scapula to the posterior portion of the C1-4 Transverse Processes of the Cervical Spine.)

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How To Fix Levator Scapulae Pain

STEP 1: Stop Aggravating Activities
STEP 2: Symptomatic Relief
STEP 3: Releases
STEP 4: Gentle Movements
STEP 5: Stretches
STEP 6: Strengthening Exercises
STEP 7: Ideal Shoulder Blade Position
STEP 8: Scapula Stability
STEP 9: Over-Reliance On Levator Scapulae
STEP 10: Address Posture

STEP 1: Stop Aggravating Activities

In the initial stages of addressing the pain in the Levator Scapulae, it is important to reduce exposure to any activity that is making the symptoms significantly worse.

Failure to comply with this step will likely make performing the suggested exercises on this blog post more challenging than it should be.

Examples of Aggravating Activities:

STEP 2: Symptomatic Relief

The next step is to get some immediate pain relief.

Here are some simple ways to do so:

Apply Heat

Heat can help reduce pain, promote blood flow and encourage relaxation in the Levator Scapulae muscle.

Apply a heat pack to the painful area for 10-20 minutes throughout the day.

You may also get a similar effect by taking a warm/hot shower.

(Note: Make sure that you do not apply an excessive amount of heat to your skin as you may burn your skin.)

Deep Heat Cream

Apply a deep heat cream in the region between the neck and shoulder blade.

Do this 3 times per day or as directed by the instructions of the specific product.

Pain Medication

If you are having difficulty tolerating the high levels of pain, you may need to consider taking the appropriate pain medication.

(Note: Please consult your Primary Care Provider before taking any medication.)

STEP 3: Releases

Performing the following releases can help reduce the amount of tension in the Levator Scapulae.

Shoulder Blade Release

Instructions:

• Lie down on the floor with your knees in a bent position.
• Place a massage ball underneath the upper/inner region of your shoulder blade.
• Slightly lift your hips off the floor to ensure that the massage ball is positioned directly underneath the painful area.
• Apply an appropriate amount of body weight into the massage ball.
• Roll the painful area on top of the massage ball.
• Continues for 1-2 minutes.

Levator Scapulae Self Massage

Instructions:

• Place your finger tips directly on the back/side of the neck.
• Apply a gentle pressure along the side length of the neck.
• Continue for 1 minute.

(Note: There are sensitive structures (such as nerves and blood vessels) in the neck region. If you are not comfortable with performing this release by yourself, please get assessed by a healthcare professional.)

STEP 4: Gentle Movements

The next step is to perform the following gentle movements of the neck and shoulder blade.

This will help to warm up the Levator Scapulae.

a) Shoulder Blade Rolls

Instructions:

• Keep your neck completely relaxed throughout this exercise.
• Shrug your shoulders upwards.
• Pull them backwards.
• Relax.
• Perform 20 repetitions.
• Repeat in the opposite direction.

b) Neck Rotation

Instructions:

• Aim to keep your neck and shoulders relaxed throughout this exercise.
• Turn your head slowly towards the left and right.
• Perform 20 repetitions.

STEP 5: Stretches

If the pain is associated with over activity of the Levator Scapulae in a shortened position, performing stretches to the tight muscle can be very useful.

(If you have drooped shoulders, you will likely benefit more from the strengthening exercises instead of stretches.)

Levator Scapulae Stretch

Instructions:

• Using the hand on the same side that you would like to stretch, hold onto the underside of a chair.
• Lean your body weight towards the opposite side.
• Gently tuck in your chin.
• Look down towards the arm pit on the opposite side of the hand holding onto the chair.
• Place your hand on the top of your head.
• Pull your head towards the arm pit.
• Aim to feel a stretch on the side of the neck.
• Hold for 30 seconds.

If you would like to see other ways to stretch this muscle, please feel free to check out this blog post:

See Post: Levator Scapulae Stretches

STEP 6: Strengthening Exercises

In my opinion – It is common to having a relatively weak Levator Scapulae muscle that is over-working.

This can eventually lead to pain in the Levator Scapulae.

By strengthening the Levator Scapulae, this can help encourage the muscle to comfortably tolerate more load.

a) Shrugs

Instructions:

• Keep your neck completely relaxed throughout this exercise.
• Shrug your shoulder upwards.
• Aim to feel a contraction in the area between the neck and shoulder.
• Hold for 3-5 seconds.
• Slowly lower your shoulders back to the starting position.
• Repeat 20 times.
• Progression:
  • Hold onto an appropriate amount of weight in your hand

b) Resisted Rotation

Instructions:

• Lie down on your side.
  • (The target side will be on the upper side.)
• Slowly turn your head up and down.
• Aim to feel a muscular contraction on the upper side of the neck.
• Repeat 5-10 times.
• Regression:
  • Perform this exercise in an upright position

c) Resisted Lateral Flexion

Instructions:

• Lie down on your side.
  • (The target side will be on the upper side.)
• Slowly tilt your head up and down.
• Aim to feel a muscular contraction on the upper side of the neck.
• Repeat 5-10 times.
• Regression:
  • Perform this exercise in an upright position

STEP 7: Shoulder position

In my opinion – It is important that you aim to have the most ideal position for your shoulder blades.

This will help encourage the weight of your arm to be distributed more evenly among all of the shoulder blade muscles. (… and not just predominantly on the Levator Scapulae.)

Here are 2 common shoulder positions that tends to place additional pressure on the Levator Scapulae:

1. Droopy Shoulders (Scapular Depression)

2. Shrugged Shoulders (Scapular Elevation)

How To Position The Shoulders

If you suspect that your shoulder blade position is contributing to the pain in your Levator Scapulae, follow the steps below:

1. Upward Rotation of Scapula

Instructions:

• Reach and stretch out your hands as far to opposite sides as possible. (See above)
• Keep your shoulders wide and long.

2. Retraction of Scapula

Instructions:

• Bring your arms slightly backwards.
• Aim to feel a gentle contraction between your shoulder blades.
• (Do NOT over squeeze your shoulder blades back together.)

3. Posterior Tilt

Instructions:

• Rotate your arms backwards as far as you can so that your thumbs are almost pointing towards the floor behind you.
• This is to help tilt/rotate the shoulder blade backwards.

4. Final Step

• Take note of your shoulder blade position.
• Keep this position!
• … And gently lower your arms by your side.

STEP 8: Scapula Stability

The Levator Scapulae (in conjunction with the Serratus Anterior, Trapezius and Rhomboid Major/Minor) is involved with the movement and stabilization of the shoulder blade.

If there is weakness in any of the other muscles that control the shoulder blade, this can lead to over-activity and reliance of the Levator Scapulae.

Here are some exercises to improve scapula stability:

a) Wall Plank on Foam Roller

Instructions:

• Stand in front of a wall.
• Place a foam roller between the wall and your forearms.
• Tilt the shoulder blades BACKWARDS.
• Pull your shoulder blades DOWN and AROUND the ribs.
• Keep your shoulders long and wide.
• Keep your neck completely relaxed.
• Do not shrug your shoulders.
• Gently push your forearms into the wall.
• Slowly roll the foam roller up and down the wall.
• Aim to feel the contraction in the muscle around the shoulder blade.
• Perform 20 repetitions.

b) Floor Plank

Instructions:

• Assume the plank position on the floor.
• Tilt the shoulder blades BACKWARDS.
• Pull your shoulder blades DOWN and AROUND the ribs.
• Keep your shoulders long and wide.
• Keep your neck completely relaxed.
• Do not shrug your shoulders.
• Push the forearms into the floor.
• Hold this position for 30 seconds.
• Do NOT let your shoulder blades cave in.

Note: If you are unable to maintain a good position of your shoulder blade, you can do this exercise on your knees instead.

c) Retraction

Instructions:

• Place both hands (with elbows forward) on the sides of your head. (see Start position)
• Bring your elbows all the back. (see End position)
• Feel the contraction in the muscles between the shoulder blades.
• Do not shrug your shoulders.
• Hold for 10 seconds.
• Repeat 5 times.

d) Lower Trapezius

Instructions:

• Lean your torso at approximately a 45 degrees angle.
• Place one hand on something for balance.
• Lift your other arm up with the thumb pointing upwards.
• Aim to feel a contraction in the lower trapezius muscle.
• Do not shrug your shoulders.
• Hold for 5-10 seconds.
• Perform 5 repetitions.
• Progression:
  • Hold onto a light weight in your hand

(For more exercises for this muscle, see post: Lower Trap Exercises)

STEP 9: Over-Reliance on Levator Scapulae

The next step is to make sure that you do not solely rely on your Levator Scapulae to stabilize your shoulder blade as you move your arm.

Do not allow your shoulders to shrug upwards as you perform the following exercises.

a) Shoulder Flexion (Supine)

Instructions:

• Lie down on your back.
• Hold onto your wrist with your other hand.
• Lift your arm over head as far as possible without excessively shrugging your shoulders.
• Provide a small amount of assistance using the other arm as required.
• Perform 30 repetitions.
• Progression:
  • Repeat exercise without hand support

b) Shoulder Flexion (Upright)

Instructions:

• Stand up right.
• Hold onto your wrist with your other hand.
• Lift your arm over head as far as possible without excessively shrugging your shoulders.
• Provide a small amount of assistance using the other arm as required.
• Perform 30 repetitions.
• Progression:
  • Repeat exercise without hand support

c) Arm Raise with Resistance Band

Instructions:

• Stand on the end of a resistance band.
• Pull the resistance band as high as you can comfortable go without excessively shrugging your shoulders.
• Hold for 3-5 seconds at the end range of movement.
• Slowly return the hand back to the body.
• Repeat 10-30 times.
• Progression:
  • Increase the tension on the resistance band

STEP 10: Address Posture

There are certain postures that may predispose to you developing pain in the Levator Scapulae.

Addressing these postures may take excess load off the Levator Scapulae and reduce the pain being experienced.

Forward Head Posture

Forward Head Posture is where the head is positioned in front of the midline of the torso.

This head position tends to place constant tension on the Levator Scapulae as it attempts to keep the head up right.

To see my complete guide to fix this issue, check out this blog post:

See Post: Forward Head Posture

Twisted Torso

This involves the torso being rotated towards one side.

This may lead to constant pressure on the Levator Scapulae as it is recruited to counter-rotate the head in attempt to keep the head in a more centered position.

To see my complete guide to fix this issue, check out this blog post:

See Post: Twisted Torso

Tilted Torso

This involves the side bending of the spine.

This may lead to constant pressure on the Levator Scapulae as it is recruited to counter-tilt the head in attempt to keep the head in a more levelled position.

To see my complete guide to fix this issue, check out this blog post:

See Post: Tilted Torso

Winged Scapula

This involves the protrusion of the medial border of the shoulder blade.

Winging of the Scapula may lead to over-reliance of the Levator Scapulae muscle to stabilize the shoulder blade.

To see my complete guide to fix this issue, check out this blog post:

See Post: Winged Scapula

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Conclusion

Levator Scapulae pain is a fairly common issue that is experienced by many people.

The pain is usually experience between the upper/inner part of the shoulder blade and/or side of the neck.

Follow the 10 steps recommended in this blog post to fix your pain.

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before attempting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.