I’m a massage therapist making sense of what I discover working on clients — the most common issues I encounter, why people have these problems, and what to do about them (massage-wise and making minor but meaningful lifestyle changes that result in more well-being).

Recently I posted about massaging the upper trapezius muscles. In that same shoulder/neck area, another muscle, levator scapula, gives some people a lot of problems.

As I mentioned in my earlier post, the upper trap issues seem to be from working with the hands out in front of the body, such as using a keyboard, cutting hair, chopping vegetables, operating a cash register, and so on.

If the bulk of your time is spent with  your arms just hanging down, surrendered to gravity, you wouldn’t have issues with your upper traps.

I don’t think there are many jobs like that! Irish dancer, perhaps?

Levator scapula (sometimes called just levator) attaches to the upper inner corner of the shoulder blade and to the transverse processes of the top four neck vertebrae (the bony parts that stick out on the sides of your neck under your ears). Levator lies underneath the upper trap and other muscles.

I notice that some folks just have upper trap issues, and some have both upper trap and levator scapula issues. Trap issues come from working with the hands out in front. Levator issues come from raising the shoulders up toward the ears. In fact, levator scapula means “elevating the shoulder blade”. This is often accompanied by the “head-forward” posture.

If you rub across the top of your shoulder between your neck and shoulder joint and feel your fingers crossing over a tight but tender lump of a muscle, it’s your levator.

People who have pain in levator are raising their shoulders toward their ears, and they are most likely unaware they are doing this. They just notice the pain.

Sometimes it’s one-sided pain. The cause is often cradling a telephone receiver between the ear and shoulder to have the hands free while talking on the phone. If you work in an office and talk on the phone for much of the day, you can avoid levator pain by using speakerphone or a device that sits on your shoulder and holds the phone receiver up to your ear….

When it’s two-sided pain, the cause is usually an unconscious, habitual tension, a response to stressors of raising the shoulders toward the ears (“turtling”).

As a stress response, this would protect the vulnerable neck area, but since our modern stressors are usually not predators out to have us for dinner, the solution is to start catching yourself doing it and consciously retrain yourself to lower your shoulders. Your body will eventually catch on, and lowered shoulders will become your new habitual posture! (Also practice moving your head slightly back, if you have the “forward head” posture.)

You can lengthen the levitator muscle by standing and letting your shoulders drop downward, surrendering to gravity. You can hold a light weight — 1 or 2 pounds, or a can of soup — to help pull your arms and shoulders down and let the levator lengthen.

It also feels good to make forward and backward circles with the shoulders. Spend more time where it does the most good.

You can also stand and lower your ear to your shoulder, alternating sides. I think slow is good.

Another good practice is letting the head float up, as if it were a helium balloon. You can release all kinds of neck tension this way.

For massaging the levator, it usually feels awesome to press on the end of the muscle that attaches to the top of the shoulder blade. This is a magical point on almost every body that feels terrific to have pressed!

If you have a hard time finding that corner of the shoulder blade, put the client’s hand behind their back to make the shoulder blade pop out. You will feel that upper corner more easily. Static pressure and rubbing the corner area both feel great.

Because levator is deep to the upper trap and neck muscles, it’s difficult to knead the way you can knead the upper trap. I like to work my fingers around the inner part and bottom corner of the shoulder blade. Then, standing at the head of the table, I pull on the edge of the triangle that’s opposite that upper inner corner, leaning back and pulling it toward me. (You can also push this edge toward the head when standing at the client’s side.)

This allows levator to go slack and shorten, taking the pressure off it. I usually hold this for about 15-30 seconds.

Then I do the opposite. Standing at the head, I place both thumbs on that upper inner corner of the shoulder blade and lean into it. This gives levator a nice stretch. I hold this for 15-30 seconds too. The entire shoulder blade will have more mobility.

And yes, I can shorten and lengthen levator scapula during Ashiatsu barefoot massage sessions, using my feet!