Over the last few weeks, I have been treating people with tons of tension in the upper shoulders/neck. This area is a common location for us to hold all of our stress. To go a little further, many of these people are symptomatic on the side they do repetitive, low-stress daily activities, such as: hold a purse, drive their car, talk on the telephone, etc. There is a huge connection between very basic daily activities, which we don’t usually perceive as harmful, that could make all the difference in causing symptoms on top of the increased tension.
The levator scapulae muscle in particular often takes the brunt of our poor posture, shrugged shoulder positioning. This muscle connects the shoulder blade to the cervical spine and means it is involved in both neck and shoulder motions, and can be painful with both. It is common that without experiencing symptoms, the attachment on the superior angle of the scapula is already becoming a bit fibrotic. This is noticed while palpating and performing soft-tissue work that the muscle has a crunchy or sandpaper feeling and is also quite tender. Once we maintain tension in a muscle for long periods of time, we are not allowing blood flow to re-circulate to the area. This lack of blood flow and oxygen causes the tissue to become more rope-like and stiff, as it loses its elastic properties.
As opposed to the levator scapulae being in a constantly tensioned state while being contracted and shortened, this muscle is also at risk from tension while being lengthened. With the attachment at the cervical spine, anyone who sits at a desk and computer all day is at risk of becoming symptomatic. Forward head posture is very common and getting worse with the growing use of technology. When we are not using our computers, we are texting on our phones. When we aren’t texting on our phones, we are sitting poorly on the couch. As the head creeps forward in relation to the shoulders, it places the posterior neck and upper back muscles in a lengthened state. Once again, this constant tension and lack of blood flow can result in fibrosis within these muscles.
Notice much of what I described here was postural in nature. By holding excessive stress in the shoulders and/or being in a constantly shrugged state, we could be causing long-term problems. Then, by always staring at computer screens and cell phones, we are lengthening these upper back/neck muscles while shortening their reciprocal. The solution for preventing long term detriment is to maintain balance around the shoulder blade and to also prevent postural decline. The muscles around the scapula need to be balanced to allow for a natural resting position over the rib cage and proper movement. Balance between the anterior and posterior muscles are vital as well. Tight anterior structures in the chest, and neck will pull the head and shoulders forward into a problematic position if the upper body isn’t balanced with an adequate tension posteriorly. Next time you start to feel this tension in the upper shoulders creep up on you, look at the whole picture and decide how you are carrying yourself during basic daily activities and try to adjust accordingly. Occasional manual therapy and a sound exercise program will also be beneficial to improve the quality and balance of your soft-tissue.
By: Garrett McLaughlin, MS, ATC, CSCS, ART