The Effect of Levator Scapula Tightness on the Cervical Spine: Proposal of Another Length Test

Abstract

Levator scapulae is a “twisted” muscle with four separate origins from upper cervical vertebrae and two folds at its attachment on the scapula. It is active with every movement of the arm and is frequently in static contraction in order to stabilise the scapulae during precision use of the hand. Although its role in shoulder movement has been well researched, its effect on cervical function has seldom been investigated. Described tests for length and tone seem to test only the more vertical fibres or do not make use of enough cervical rotation to test the more horizontal fibres.The hypothesis is made that the more horizontal fibres have a stronger tendency to become tight. An alternative muscle length test, emphasising C2 contralateral rotation, is described and substantiated from anatomy and possible biomechanics.102 subjects were assessed to determine the most effective way to test the length of levator scapula. The tests described by Janda, Travell and Simons were compared with the suggested alternative test. It was found that more subjects tested positive for decreased length in levator scapula in the C2 rotation test than in any of the others. A combination of this test and Janda's length test is suggested as a true assessment of levator scapula dysfunction.