Clinic Wellness Team. A key factor to spine or back pain conditions is staying healthy. Overall wellness involves a balanced diet, appropriate exercise, physical activity, restful sleep, and a healthy lifestyle. The term has been applied in many ways. But overall, the definition is as follows.
It is a conscious, self-directed, and evolving process of achieving full potential. It is multidimensional, bringing together lifestyles both mental/spiritual and the environment in which one lives. It is positive and affirms that what we do is, in fact, correct.
It is an active process where people become aware and make choices towards a more successful lifestyle. This includes how a person contributes to their environment/community. They aim to build healthier living spaces and social networks. It helps in creating a person’s belief systems, values, and a positive world perspective.
Along with this comes the benefits of regular exercise, a healthy diet, personal self-care, and knowing when to seek medical attention. Dr. Jimenez’s message is to work towards being fit, being healthy, and staying aware of our collection of articles, blogs, and videos.
As the body’s most mobile joints, the shoulders are surrounded by muscles, tissues, and ligaments that help support the shoulders and the rotator cuff in mobility function, thus ensuring the shoulders remain in a stable, normal position. As a complex structure that is made up of three bones: the humerus (upper arm bone), the scapula (shoulder blades), and the clavicle (collarbone), the shoulders provide a wide range of motion without feeling pain. When injuries affect the muscles, tissues, and joints of the shoulders, they can potentially develop tiny knots along the muscle fibers and invoke pain-like symptoms on the upper extremities of the body. To that point, it affects not only the shoulders but also the arms and the hands. Today’s article looks at the infraspinatus muscle, how shoulder joint pain is associated with trigger points, and various treatments to manage trigger points related to the shoulder joint. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulder joints and the infraspinatus muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Infraspinatus Muscle?
Do you feel stiffness along your shoulders or upper arms? Does it hurt when you rotate your shoulders? Or have you been experiencing a tingling or numbing sensation traveling down your arms? Many people who experience shoulder pain might be due to trigger points affecting their infraspinatus muscles. The infraspinatus muscle is a muscle that looks like a thick triangle that covers the front of the scapula. The infraspinatus is a part of the rotator cuff muscles or commonly referred to as SITS:
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
These four muscles provide the functionality to the rotator cuffs in the shoulders to allow the arms full range of motion. Studies reveal that rotator cuff activity from these muscles is crucial for normal shoulder motion. To that point, the infraspinatus plays a vital role by providing dynamic stability while producing external rotation at the shoulder. However, traumatic forces can affect the infraspinatus muscles causing lesions and other conditions to affect the shoulders and rotator cuffs, causing pain-like symptoms to the upper half of the body.
Shoulder Joint Pain Associated With Trigger Points
Since shoulder pain is the third most common musculoskeletal disorder, the underlying causes are rotator cuff disorders and referred pain in the neck. When traumatic factors begin to affect the shoulder muscles and the rotator cuff muscles, it can potentially lead to the development of myofascial pain syndrome or trigger points along the muscle fibers of the shoulders. Referred pain causes pain in one area of the body when in actuality is affecting the other side of the body. For trigger points associated with shoulder joint pain, studies reveal that myofascial pain from trigger points in the infraspinatus may give rise to referred pain in the arms, shoulders, or even the cervical spine in some patients. To that point, trigger point pain associated with the shoulder joint may mimic carpal tunnel symptoms around the wrist. When trigger points mimic other chronic conditions, it often makes it a bit harder to diagnose the symptoms.
Treating Trigger Point Release On The Infraspinatus Muscle-Video
Have you been dealing with pain-like symptoms in your wrist? Do you feel muscle stiffness when rotating your shoulders? Or have you been experiencing numbness or tingling sensations from the shoulders to the fingertips? If you have been experiencing any of these symptoms, it could be referred to pain from trigger point pain associated with the infraspinatus muscle on the shoulder joint. Trigger points form tiny nodules along the taut muscle fibers of the affected muscle area. The video above explains where the trigger points are located on the infraspinatus muscle on the scapula (shoulder blades) and how to release the trigger points. All is not lost, as various treatments can help manage trigger points associated with the shoulder joint. Studies reveal that chronic musculoskeletal disorders in the shoulder joint are often associated with myofascial trigger points, causing referred pain along the arm down to the fingertips. To that point, pain specialists incorporate and apply acupuncture or dry needling on the trigger point can help improve pain and disability for many individuals with shoulder pain.
Treatments Managing Trigger Points Associated With The Shoulder Joint
When many individuals are dealing with trigger point pain associated with the shoulder joint, they sometimes believe that it could be something that is affecting their heart. Now, why would the heart be associated with the shoulder joint? This is due to somato-visceral pain (the affected muscle is causing issues to the corresponding organ) that is causing referred pain to affect the heart. When patients go to their primary doctors, they go through an examination to see what the issue is, and this allows the doctor to go through a clinical process to come up with a diagnosis of what is going on, which in this case is trigger points associated with the shoulder joint. Once the doctor diagnoses the issue, they can refer their patients to a pain specialist like a chiropractor, massage therapist, or a physiotherapist to manage the trigger points in the affected muscle area. Chiropractors, massage therapists, and physiotherapists utilize various techniques to relieve trigger points from the infraspinatus muscle in the shoulder joints. Some of the available treatments that are used to manage trigger points associated with the shoulder joint include:
Stretching
Ice/Heat Compress
Spinal Adjustments
Acupuncture
Trigger Point Injection
Conclusion
The muscle known as the infraspinatus is part of the rotator cuff that works along the shoulder and looks like a thick triangle on the scapula or shoulder. This muscle helps the rotator cuff activity for normal shoulder motion by providing dynamic stability while performing external rotation on the shoulder. When traumatic factors affect the infraspinatus muscle, it can develop trigger points along the muscle fibers of the infraspinatus muscle and cause referred pain along the shoulders and down to the arms. Fortunately, various treatments available can manage trigger points and relieve the pain from producing more issues along the shoulder. To that point, many individuals can have normal shoulder function without pain.
References
Ha, Sung-Min, et al. “Selective Activation of the Infraspinatus Muscle.” Journal of Athletic Training, National Athletic Trainers Association, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3655748/.
Kamali, Fahimeh, et al. “Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes with Unilateral Shoulder Impingement Syndrome.” Journal of Sport Rehabilitation, U.S. National Library of Medicine, 30 Nov. 2018, pubmed.ncbi.nlm.nih.gov/29364040/.
Meder, Marek A, et al. “Reliability of the Infraspinatus Test in Carpal Tunnel Syndrome: A Clinical Study.” Journal of Clinical and Diagnostic Research : JCDR, JCDR Research and Publications (P) Limited, May 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5483796/.
Williams, Jeslin M, et al. “Anatomy, Shoulder and Upper Limb, Infraspinatus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK513255/.
Chiropractic treatment focuses on the musculoskeletal and nervous systems. As with all body systems, specific nutrients protect and increase their functional strength. Various chiropractic-recommended supplements can help in the treatment of musculoskeletal issues and help transform an individual’s health.
Chiropractic Education
Chiropractors study food-based supplements that are bio-available to cells and are easily absorbed by the body. These food-based supplements and vitamins are seen as food by the body. Supplements are used in detoxification to overcome nutritional deficiencies and enhance an individual’s diet by taking nutrients to optimum levels. Immune system health can also be strengthened by keeping the body resistant to diseases.
Functional Nutrition
Chiropractic medicine study’s all the building blocks of the body that, include:
Holistic nutrition teaches that the body heals from within, which is why healing the gut first, is essential to healing the rest of the body and maintaining health.
Recommended Chiropractic Supplements
Dietary supplements that directly impact the health of the musculoskeletal and the nervous system.
Potassium
Potassium is an important regulator of nerve impulses.
Electrochemical signals or action potentials use potassium and sodium to generate responses from cells in the nervous system.
Potassium is necessary for turning off nerve impulses and preventing the uncontrolled signaling of nerves.
Uncontrolled signaling can lead to movement disorders.
Calcium
Calcium is necessary for the regulation of the action potentials throughout the body.
Calcium helps initiate action potentials and helps the cells return to a normal state afterward.
Calcium contributes to the development of the nervous system helping guide the nerve cells.
Calcium is a major element of bone health to repair bones’ and facilitate regrowth.
The body will take the calcium from the bones if there is a calcium deficiency.
Vitamin D
One of the most important nutrients for bone health.
Vitamin D helps promote bone development and growth.
Facilitates calcium absorption helping the body process and absorb the calcium.
B12 is essential to the function of the nervous system and the body’s metabolism.
B12 breaks complex carbohydrates into more simplistic glucose for basic functions.
B12 helps maintain the nerve insulator myelin, which is necessary for nerve transmission.
B12 deficiency has been linked to the loss of myelin and can lead to serious conditions like Alzheimer’s.
B12 shots deliver the nutrient directly to the bloodstream bypassing the absorption process necessary for oral supplements.
Vitamin K
Vitamin K helps balance and facilitate calcium absorption.
Vitamin K helps strengthen bones and increase bone density.
Often recommended for individuals with osteopenia and osteoporosis to help prevent fractures.
How To Choose Supplements
References
Lee, Mi Kyung, et al. “The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.” Chiropractic & manual therapies vol. 26 7. 20 Feb. 2018, doi:10.1186/s12998-018-0175-1
Nguyen, Douglas L. “Guidance for supplemental enteral nutrition across patient populations.” The American journal of managed care vol. 23,12 Suppl (2017): S210-S219.
Pludowski, Pawel, et al. “Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence.” Autoimmunity reviews vol. 12,10 (2013): 976-89. doi:10.1016/j.autrev.2013.02.004
Song, Yong-Ak, et al. “Electrochemical activation and inhibition of neuromuscular systems through modulation of ion concentrations with ion-selective membranes.” Nature materials vol. 10,12 980-6. 23 Oct. 2011, doi:10.1038/nmat3146
The shoulder muscle functionality allows support and stability to the flexible joints in the body. The shoulders allow a full range of motion without feeling pain or discomfort, like throwing a ball or reaching an item on the shelf. The shoulders are also supported by many muscles, tendons, and ligaments surrounding the rotator cuffs that allow the shoulders to remain stable. The rotator cuffs consist of four muscle groups that allow the arms to be mobile. However, the range of motion from the shoulders and the rotator cuff can be prone to injuries and become unstable. To that point, the shoulders and their associated muscles are often the sites for many issues to develop. Today’s article looks at the supraspinatus muscles in the rotator cuffs, how trigger points affect the rotator cuffs and various therapies for rotator cuff injuries. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulders affecting the rotator cuffs and the supraspinatus muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
The Supraspinatus Muscles In The Rotator Cuffs
Do you feel stiffness along your shoulders? Does it hurt when you rotate them? Or have you been experiencing numbness and tenderness traveling your upper arm? Individuals experiencing these symptoms in their shoulders could be dealing with trigger points along the supraspinatus muscles. The supraspinatus muscle resides in the supraspinous fossa of the scapular spine and is superiorly located in the rotator cuff muscles. The supraspinatus muscle is associated with the other muscles that surround and support the rotator cuffs in the shoulder, which include:
Infraspinatus
Teres Minor
Subscapularis
These four muscles closely relate to the deltoid muscles to provide stability, movement, and rotation to the upper arm joint. When issues affect the shoulders or the rotator cuffs, it can cause the rotator cuff muscles to develop trigger points and other associated symptoms along the upper arm.
How Trigger Points Affect The Rotator Cuffs
When the muscles of the rotator cuffs become injured, many issues may cause musculoskeletal complaints. Studies reveal that tendinopathy or tendon injuries are often characterized by pain in and around the tendons in the rotator cuffs and are associated with repetitive actions. When the supraspinatus muscle becomes overused due to repetitive motions, it can develop trigger points to affect the rotator cuffs. Studies reveal that local and referred pain symptoms reproduce active trigger points in the muscles surrounding the shoulders and rotator cuff that many individuals recognize as familiar pain. According to Dr. Janet G. Travell, M.D., the activation of trigger points associated with the supraspinatus muscles are activated from strenuous activities like carrying heavy objects, walking a large dog that is pulling the leash, or lifting an object above shoulder height with the arms outstretched. These strenuous activities allow the trigger points to form along the supraspinatus muscles and cause referred pain symptoms on the shoulders.
Stretching The Supraspinatus Muscles- Video
Have you been feeling stiffness along your shoulders? Do you feel tenderness in certain areas of your shoulders or arms? Or do you experience a numbing sensation running down your arms? If you have been experiencing these issues along your shoulders and upper arms, it could be due to trigger points associated with the supraspinatus muscles. Trigger points are small knots along the taut muscle band of any muscle group that can mimic any overlapping condition that can cause issues to the body. For example, shoulder pain is associated with trigger points along the supraspinatus muscle. The video above shows how to stretch the supraspinatus muscles to reduce future trigger points from forming along the rotator cuff muscles. Individuals who incorporate stretching exercises for shoulder pain associated with the supraspinatus can feel relief in their shoulders as the overall function is restored and the pain is reduced.
Various Therapies For Trigger Points Associated With The Rotator Cuffs
The various therapies for trigger points associated with the rotator cuffs can help reduce the pain-like symptoms along the supraspinatus muscles. Studies reveal that exercises and manual therapy can help decrease pain along the supraspinatus muscles and increase shoulder muscle strength and function. Other treatments like chiropractic care can benefit many patients with shoulder pain or injuries that can help reduce pain, improve ROM (range of motion), increase flexibility, and even restore function to the joint. Depending on how severe the muscle injury is on the shoulders, chiropractors utilize various techniques to assess the pain and help address all the areas of the body to relieve the issue without using drugs.
Conclusion
The supraspinatus muscles are part of the rotator cuff muscle group and work alongside the shoulder muscles to provide mobility and a full range of motion to the upper arm without feeling pain. When strenuous activities or injuries occur to the shoulders or the rotator cuffs, it can cause myofascial pain syndrome or trigger points to develop along the overused muscles in the shoulders and cause pain-associated symptoms. This can affect the mobility of the shoulders and arms from going through a full range of motion. Various therapies are available to help reduce pain, restore functionality to the shoulders and surrounding muscles associated with trigger points, and can help improve motor function. Treatments for shoulder pain associated with trigger points can help prevent future issues from forming and improve shoulder functionality.
References
Hidalgo-Lozano, Amparo, et al. “Muscle Trigger Points and Pressure Pain Hyperalgesia in the Shoulder Muscles in Patients with Unilateral Shoulder Impingement: A Blinded, Controlled Study.” Experimental Brain Research, U.S. National Library of Medicine, May 2010, pubmed.ncbi.nlm.nih.gov/20186400/.
Jeno, Susan H, et al. “Anatomy, Shoulder and Upper Limb, Arm Supraspinatus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 7 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK537202/.
Spargoli, Guido. “Supraspinatus Tendon PATHOMECHANICS: A Current Concepts Review.” International Journal of Sports Physical Therapy, Sports Physical Therapy Section, Dec. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6253746/.
Şenbursa, Gamze, et al. “The Effectiveness of Manual Therapy in Supraspinatus Tendinopathy.” Acta Orthopaedica Et Traumatologica Turcica, U.S. National Library of Medicine, 2011, pubmed.ncbi.nlm.nih.gov/21765229/.
Chiropractic care focuses on whole-body health, restoring optimal body function, helping injuries heal/rehabilitate, and maintaining musculoskeletal health. Yoga is one of the most popular forms of fitness because it is not overly physically demanding but still increases flexibility and muscle tone, helps with weight loss, improves cardiovascular and circulatory health, and enhances breathing and energy levels. Yoga provides benefits that directly relate to chiropractic, making the treatment more effective.
Yoga and Chiropractic
Yoga is an exercise focusing on mindfulness combined with deep stretches and focused breathing. Yoga focuses on balance, flexibility, and strength.
It helps to lower blood pressure and stress levels by releasing built-up tension.
Helps to activate the body’s natural healing process.
It stretches the muscles, ligaments, and tendons, keeping them loose and flexible, enhancing chiropractic adjustments.
Chiropractic
Chiropractic is multi-faceted,restoring the wellness of the neuromusculoskeletal system that involves the nerves, muscles, and bones. It works holistically with the body’s natural processes to restore balance and overall health.
Realigns the spine.
Returns the natural shape of the body’s structure.
Clears interference from the nervous system.
Rejuvenates the body.
Customized chiropractic adjustments, spinal decompression, and traction treatment plans help shift spinal deformities back toward proper balance.
Strengthen Soft Tissues
Yoga and chiropractic work and strengthen all the:
Connective tissues
Muscles
Ligaments
Tendons
Increasing the strength of the joints throughout the body reduces stress and the risk of injury.
Promote Healing
Yoga and chiropractic:
Prepare the body for healing.
Stretch and elongate the body.
Release built-up tension and stress.
Activate the body for healing.
Prevent Injury
Yoga and chiropractic:
Maintain body alignment.
Increase balance.
Stretch and relieve tense muscles.
Ensure proper joint operation.
Make the body less susceptible to injury.
Educate Individuals About The Body
Chiropractors and yoga teachers can educate individuals on how the body works, maintaining muscle strength, teaching posture awareness, and nervous system function for a healthier life.
Yoga Body Flow
References
Biman, Saranga, et al. “Effects of yoga on stress, fatigue, musculoskeletal pain, and the quality of life among employees of the diamond industry: A new approach in employee wellness.” Work (Reading, Mass.) vol. 70,2 (2021): 521-529. doi:10.3233/WOR-213589
da Costa, Fernanda Mazzoni, et al.”“Effects of an intervention program with health education and hatha yoga on the health of professionals with musculoskeletal symptoms”” Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT vol. 18,2 114-124. 11 Dec. 2020, doi:10.47626/1679-4435-2020-492
Hawk, Cheryl, et al.” Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline” Journal of alternative and complementary medicine (New York, N.Y.) vol. 26,10 (2020): 884-901. doi:10.1089/acm.2020.0181
Kolasinski, Sharon L et al.” 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee” Arthritis care & research vol. 72,2 (2020): 149-162. doi:10.1002/acr.24131
Urits, Ivan et al.” A Comprehensive Review of Alternative Therapies for the Management of Chronic Pain Patients: Acupuncture, Tai Chi, Osteopathic Manipulative Medicine, and Chiropractic Care” Advances in therapy vol. 38,1 (2021): 76-89. doi:10.1007/s12325-020-01554-0
The body is a functional machine that requires many muscles, organs, ligaments, joints, and tissues that provide everyday movements. In the upper extremities, the head, neck, and shoulders have many muscles, ligaments, and tissues that work together with the nerve roots from the nervous system that provides sensory-motor function to make the fingers move, the shoulders rotate, and the head turns from side to side. When injuries or common issues affect the muscles in the head, neck, or shoulders, it can cause small nodules to form along the muscle fibers of the affected muscle area and cause referred pain in different locations of the body. Today’s article looks at the scalene muscles, how trigger points affect the scalene muscles while mimicking shoulder pain, and how to manage chronic pain associated with trigger points. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points related to the shoulders affecting the scalene muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Are The Scalene Muscles?
Have you been experiencing tingling sensations running down your fingertips? Do you feel stiffness when rotating your neck or shoulders? Or do you feel muscle soreness in your shoulders? Many individuals who are feeling any of these symptoms affecting their neck or shoulders could be dealing with trigger point pain along the scalene muscles. The scalene muscles play a crucial part in the head and neck as they are deep muscles positioned laterally on the cervical tract of the spine. These muscles have three different branches: the anterior, medius, and posterior, which play the role of being accessory breathing muscles while being an important contributor to head and neck movement. To that point, it allows stability to the cervical spine. The scalene muscles even help support and elevate the upper rib cage when a person is lifting, pulling, or carrying heavy objects. However, like most muscles in the body, the scalene muscles can be prone to injury and can develop issues that can affect the upper extremities of the body.
Trigger Points Affects The Scalene Muscles Mimicking Shoulder Pain
When common injuries like pulling a muscle when carrying a heavy object or even a traumatic injury like being involved in an auto accident can cause pain in the affected area, over time, if not treated, can cause various symptoms to overlap and affect the muscles. When the scalene muscles are affected by injuries, they can develop tiny nodules along the taut muscle fibers and become hyperirritable to the surrounding areas of the upper half of the body. This is known as trigger point pain and can mimic other chronic issues that affect different body areas. To that point, trigger points affecting the scalene muscles may mimic shoulder pain in the upper half of the body. Studies reveal that scalene myofascial pain is a regional pain syndrome that originates pain in the neck area and radiates pain down to the arm. Since trigger points mimic other chronic issues, it is often misdiagnosed as another neck pain associated with radiculopathy when the scalene muscles are affected. When this happens, the muscles become stiff and weak, causing a reduction in the range of movement.
Studies reveal that when individuals suffer from acute whiplash-associated disorders, the local and referred pain can be elicited from active trigger points to reproduce neck and shoulder pain. This causes a higher disability that exhibits widespread pressure causing the muscles to be hypersensitive and reducing the cervical range of motion. Many individuals often complain about shoulder pain while rubbing the upper parts of their arms. The scalene muscle is affected by active trigger points, thus mimicking shoulder pain.
Scalenes Trigger Points-Video
Have you been feeling muscle stiffness in your neck or shoulders? Have you been experiencing a numbing sensation along your arms? Have you felt tenderness along your shoulders when you touch them? Many of these pain symptoms are associated with trigger points along the scalene muscles. The video above explains where the trigger points are located along the scalene muscles and how they are causing referred pain in the neck and shoulder areas. Many factors can lead to the causation of trigger point pain and overlap with other chronic issues that can affect the upper extremities of the body, using sleep as an example. Studies reveal that poor sleeping posture can affect the neck and shoulders, leading to muscle stiffness along the scalene muscles and developing trigger points over time. Fortunately, various ways to manage referred shoulder pain are associated with trigger points.
Management Of Chronic Shoulder Pain Associated With Trigger Points
Many individuals are referred to pain specialists that can alleviate trigger points along the scalene muscle to reduce the effects of shoulder and neck pain. When referred pain along the scalene muscles causes chronic shoulder pain associated with trigger points, many people often do various movements to alleviate the pain. However, it can cause more pain in the affected area and prevent relief from the neck and shoulders. Studies reveal that various treatments like physiotherapy, trigger point injections, manipulation of the cervical spine, or acupuncture can help relax and lengthen the muscle fibers associated with the scalene muscle. To that point, this allows the neck to extend further without pain and reduces the overlapping symptoms that affect the upper extremities of the body.
Conclusion
The scalene muscles play a crucial part in the head and neck area as deep muscles are positioned laterally on the cervical tract of the spine. These muscles help elevate the upper chest and laterally bend the neck from side to side. When injuries affect the scalene muscles and form tiny nodules known as trigger points, it can cause referred pain to the shoulders and the neck. To that point, symptoms like numbing or tingling sensations can travel down the arms and fingers. Fortunately, available treatments can reduce the symptoms and manage myofascial trigger pain along the shoulders and neck associated with the scalene muscles. This allows a better range of motion to the neck and shoulder and prevents future trigger points from forming in the scalene muscles.
References
Abd Jalil, Nizar, et al. “Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases.” The Malaysian Journal of Medical Sciences : MJMS, Penerbit Universiti Sains Malaysia, Jan. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC3216145/.
Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Head and Neck, Scalenus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 16 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK519058/.
Fernández-Pérez, Antonio Manuel, et al. “Muscle Trigger Points, Pressure Pain Threshold, and Cervical Range of Motion in Patients with High Level of Disability Related to Acute Whiplash Injury.” The Journal of Orthopaedic and Sports Physical Therapy, U.S. National Library of Medicine, July 2012, pubmed.ncbi.nlm.nih.gov/22677576/.
Lee, Won-Hwee, and Min-Seok Ko. “Effect of Sleep Posture on Neck Muscle Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5468189/.
Thapa, Deepak, et al. “Management of Chronic Shoulder Pain with Restricted Mobility – a Case Series.” Indian Journal of Anaesthesia, Medknow Publications & Media Pvt Ltd, Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5125193/.
The muscles in the body help provide motion and protect the skeletal joints from harm. Each muscle group has ligaments, tissues, and muscle fibers that retract, stretch, and contract the body while helping the host to do everyday movements, breath, digest food, stabilize, and even rest. When a person is dealing with pain from a traumatic event or making repetitive motions, it can affect the muscles over time. Factors like not drinking enough water, constantly looking down on the phones, and being hunched over can cause strain on the muscles, causing overlapping pain on top of other chronic issues that may develop. When the muscles begin to cause pain along the shoulders and neck, it can become a risk of developing trigger points in the levator scapulae muscles. Today’s article examines the levator scapulae muscles, how trigger points affect these muscles, and how treatments can help manage the trigger points on the levator scapulae muscles. We refer patients to certified providers who specialize in musculoskeletal treatments to aid individuals suffering from trigger points associated with the neck and shoulders affecting the levator scapulae muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure to find that education is the solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer
What Is The Levator Scapulae?
Have you been dealing with pain along the neck or shoulders? Do you feel stiffness when turning your head from side to side? Or do you feel tenderness in the base of your neck and shoulders? Many individuals with shoulder and neck pain risk developing trigger points along the levator scapulae. The levator scapulae muscles originate from the posterior tubercles of the C1 through C4 vertebrae in the neck that is between the superior angle and the root of the scapulae spine. This superficial muscle’s primary function is to elevate the scapulae or the shoulder blades while working together with the trapezius and rhomboid muscles to assist the movement. The levator scapulae muscles also assist in providing neck extension, ipsilateral rotation, and lateral flexion. When pathologies like fibromyalgia, levator scapulae syndrome, or cervical myofascial pain begin to affect the levator scapulae muscles, the symptoms can potentially involve the shoulders and neck to cause referred pain to the upper extremities.
How Trigger Points Affect The Levator Scapulae?
Many individuals with shoulder and neck pain have described radiating pain from their neck to their shoulders. Known as referred pain, the pain is located in one area of the body but in a different location. Studies reveal that when pain radiates from the neck and shoulders, any movements that are overstretching the levator scapulae can aggravate overlapping symptoms on the affected side. This allows small nodules to form along the levator scapulae muscle fibers, causing trigger points to affect the shoulder and neck muscles.
Trigger point associated with the levator scapulae muscles causes the individual to have pain-like symptoms in the neck that causes muscle stiffness. This causes an emphasis on referred pain symptoms from the levator scapulae, like neck tension and restriction of range of motion on the neck. Studies reveal that pain over the superior angle of the levator scapulae is a common musculoskeletal disorder that is often accompanied by radiating pain on the neck, head, and shoulders. Some of the ways that trigger points form along the levator scapulae muscle can be due to ordinary factors like:
Stress
Posture
Over-exercising
Upper respiratory infections
Some of these factors above can shorten the levator scapulae muscle and restrict muscle movement to provide a full range of motion for the head and neck to turn. To that point, treatments are available to help loosen up and stretch the levator scapulae muscles to allow rotation and flexion on the neck and shoulders.
Trigger Points Anatomy On The Levator Scapulae- Video
Have you been dealing with stress that is affecting your neck and shoulders? Have you been dealing with neck stiffness when turning your head? Or have you been feeling muscle tenderness between the neck and shoulders? Some of these symptoms are associated with trigger points affecting the levator scapulae muscles between the neck and shoulder. The video above overviews common trigger points and how they affect the levator scapulae, causing shoulder and neck pain. Since the levator scapulae muscles lay behind the trapezius muscle, studies reveal that trigger points or myofascial pain syndrome can cause hyperirritability in the muscle tissues and affect mobility functions in the nerve ends. Even though referred pain affects the neck and shoulder of the body, treatments are available to manage trigger points on the levator scapulae and relieve neck and shoulder pain.
Treatments To Manage Trigger Points On The Levator Scapulae
When there is trigger point pain affecting the levator scapulae, some common complaints that many individuals often complain about are neck and shoulder pain. However, various ways can alleviate the pain symptoms from the neck and shoulders while managing trigger points associated with the levator scapulae. Studies reveal that stretching the levator scapulae muscle in a seated position can improve muscle length along the levator scapulae and the cervical range of motion. Stretching the levator scapulae muscle can help reduce the pain along the levator muscle. To that point, it even helps reduce muscle imbalances and movement dysfunction along the cervical joints. Many individuals are referred to pain specialists like chiropractors by their doctors to reduce pain and functionality disability in the neck and realign the spine to loosen up the stiff muscles caused by subluxation. Realigning the cervical spine and stretching can reduce future trigger points and reduce pain symptoms from affecting the muscle.
Conclusion
The levator scapulae muscles in the body provide movement functionality to the neck and shoulders. The levator scapulae work together with the trapezius and rhomboid muscles to elevate the shoulder blades and assist with neck extension, ipsilateral rotation, and lateral flexion. When pathologies affect the levator scapulae muscles, they can develop trigger point pain along the muscle and cause neck and shoulder pain. The factors that cause trigger point pain can either be ordinary or traumatic and cause referred pain to the neck and shoulders. Fortunately, treatments like stretching and adjustments can help reduce the pain and loosen up stiff muscles along the levator scapulae. This will allow a cervical range of motion back to the neck and shoulder and elongate the levator scapulae.
References
Akamatsu, Flávia Emi, et al. “Trigger Points: An Anatomical Substratum.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4355109/.
Henry, James P, and Sunil Munakomi. “Anatomy, Head and Neck, Levator Scapulae Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 13 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK553120/.
Jeong , Hyo-Jung, et al. “Stretching Position Can Affect Levator Scapular Muscle Activity, Length, and Cervical Range of Motion in People with a Shortened Levator Scapulae.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, 4 Apr. 2017, pubmed.ncbi.nlm.nih.gov/28578252/.
Kulow, Charlotte, et al. “Levator Scapulae and Rhomboid Minor Are United.” Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft, U.S. National Library of Medicine, Aug. 2022, pubmed.ncbi.nlm.nih.gov/35367623/.
Menachen, A, et al. “Levator Scapulae Syndrome: An Anatomic-Clinical Study.” Bulletin (Hospital for Joint Diseases (New York, N.Y.)), U.S. National Library of Medicine, 1993, pubmed.ncbi.nlm.nih.gov/8374486/.
Yogurt is a dairy product made by the bacterial fermentation of milk. The bacteria used are called yogurt cultures, which ferment lactose, which is the natural sugar found in milk. This process produces lactic acid that causes milk proteins to curdle, giving yogurt its flavor and texture. It can be made from all types of milk. Although research is ongoing, the benefits of adding yogurt to one’s nutrition plan can improve overall health, including improved bone health, circulation, immune system function, and probiotics/healthy bacteria that improve digestion and gut health.
Health Benefits
Yogurt comes from milk that varies; some are made from skim and fat-free, whereas whole milk is full-fat. Other nutrients include calcium, vitamin B-2, vitamin B-12, potassium, and magnesium. More research is needed, but there is some evidence that active cultures can help certain gastrointestinal conditions, including:
The faster time food takes to circulate through the bowels.
Immune system improvement.
Feel Fuller
Yogurt is rich in protein and healthy fats, which makes it very filling. Both of these nutrients are key to feeling full for longer. A study found consuming high-protein Greek yogurt in the afternoon resulted in less hunger, increased fullness and delayed the need to eat before dinner.
It can replace the fat, oil, and/or butter in muffin, brownie, or cake recipes.
Speak with a nutritionist and health coach to find out if yogurt would be beneficial. Nutritionists work with individuals to find the best foods for their body type, age, and health condition, explain how different foods impact the body, and what foods to avoid.
Functional Nutrition
References
Andoh, Akira. “Physiological Role of Gut Microbiota for Maintaining Human Health.” Digestion vol. 93,3 (2016): 176-81. doi:10.1159/000444066
Bull, Matthew J, and Nigel T Plummer. “Part 1: The Human Gut Microbiome in Health and Disease.” Integrative medicine (Encinitas, Calif.) vol. 13,6 (2014): 17-22.
Cleveland Clinic: “Which Yogurt is Right For You?” “Why — and When — You Should Include Probiotics in Your Diet.”
Jandhyala, Sai Manasa, et al. “Role of the normal gut microbiota.” World journal of gastroenterology vol. 21,29 (2015): 8787-803. doi:10.3748/wjg.v21.i29.8787
Le Roy, C.I., Kurilshikov, A., Leeming, E.R. et al. Yoghurt consumption is associated with changes in the composition of the human gut microbiome and metabolome. BMC Microbiol 22, 39 (2022). doi.org/10.1186/s12866-021-02364-2
Wu, Hsin-Jung, and Eric Wu. “The role of gut microbiota in immune homeostasis and autoimmunity.” Gut microbes vol. 3,1 (2012): 4-14. doi:10.4161/gmic.19320
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