Levator scapulae-Supraspinatus myofascial connection

More times that I would like I get patients coming into my office with chronic (and boring) levator scapulae hypertonicity and pain which with time leads to a very stubborn insertional tendonopathy on the superior angle of the scapulae.  Often these patients come in having already been for massage therapy, myofascial release, etc., that has focused solely on the levator scapulae itself which has resulted in temporary, and minimal improvement.  While this condition is almost inevitably associated with postural decompensation patterns which would have to be addressed in addition to the application of therapy in order to fully resolve the condition, treatment of the ipsilateral supraspinatus should always be considered due to the very strong myofascial connection between the two muscles.

Through cadaveric dissection I have noticed that as the levator scapulae makes its broad based insertion into the superior angle of the scapulae, the epimysium layer is largelycontinuous with the supraspinatus muscles fascial covering over the superior angle.  Thus, in order to fully release tension in this “myofascial sling,” treatment of both muscle groups, or more specifically release of the ‘epimysial continuation’ tends to produce far greater results vs. specifically focusing solely on the painful levator muscle.