Every now and then you run across something in clinic that surprises you. I was working on a young lady that has a history of headaches and had some levator scapula muscles that had a lot of tension in them. Most lay people would say her traps are tight.
I asked her to put her arms above her head. then touch the ceiling. Nothing happened. There was a complete inability to shrug upwards. The levator has a hard time in this position. Take away a muscle that does most of the work and we were left with an inability to upwardly shrug.
I had never seen this before.
I placed her on her back on the floor and we did the same thing. This time without fighting gravity, she was able to do the upward shrug.
When the upper trap isn't very strong, the levator scapula will do more work. It's a corkscrew muscle. This means that the fibers at the bottom twist and become the fibers at the top when they insert on the neck vertebrae. When they tighten they can really create some havoc in the neck.
It makes sense then, when the upper trap is so weak, the levator scapula does all the work. It will be an interesting case study to see as she regains strength in her traps if the neck becomes more stable with less pain and less headaches.
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