Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

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Helping Your Levator Scapulae

On Wednesday, we looked at what exactly the Levator Scapulae are.  When do you use them?  When you lift your shoulders, flex your head to one side, rotate your head...all things that many musicians do frequently, often without awareness.  You will also elevate your levator scapulae when you carry bags, either on one side or both sides, which many of us do to carry our instruments everywhere.  If your levator scapulae cause you some discomfort, here are some suggestions:

The levator scapulae are just two of many, many different deep muscles of the upper back and neck, which all work together to create movement in the neck and upper back.  To find them on your own body, palpate the superior angle of your scapula (the innermost corner of your shoulder blade) and look for a muscle that runs diagonally to the lateral sides of the neck.  Try lifting and lowering your shoulder blades and see if a muscle jumps underneath your fingers.  You will definitely feel the middle fibers of the trapezius, which are superficial to the LS, but feel around with more pressure and see what you notice.  What is the quality of the tissue?  How does it feel underneath your fingers?  Do you have pain or lack of sensation?  Are there adhesions?    

The levator scapulae are just two of many, many different deep muscles of the upper back and neck, which all work together to create movement in the neck and upper back.  To find them on your own body, palpate the superior angle of your scapula (the innermost corner of your shoulder blade) and look for a muscle that runs diagonally to the lateral sides of the neck.  Try lifting and lowering your shoulder blades and see if a muscle jumps underneath your fingers.  You will definitely feel the middle fibers of the trapezius, which are superficial to the LS, but feel around with more pressure and see what you notice.  What is the quality of the tissue?  How does it feel underneath your fingers?  Do you have pain or lack of sensation?  Are there adhesions?    

1.  Manual Therapy: Massage is a critical part of self care and soft tissue health, yet few musicians can afford to get massage as regularly as they might need it.  As a teacher of self massage techniques and Yoga Tune Up, I think self-massage can enhance proprioception and overall awareness of the body, while also supporting  regular (or less frequent) bodywork.  It's not meant to replace manual therapy, but merely give the practitioner an opportunity to continue the self-treatment beyond a session. I prefer soft, pliable stress transfer mediums (squishy balls over lacrosse balls or wooden or plastic implements) and for more information on self-massage, read here.  My favorite sequences target the upper back musculature, the latissimus attachment sites, and the tempermental trapezius.    Here’s a great video of YTU teacher Holli Rabishaw demonstrating “zombie with a twist" which is one of my favorite moves to do on the wall.

2.  Observation and retraining: For upper string players, working with an Alexander Technique teacher, Feldenkrais teacher, body mapping instructor, or other somatic practitioner can not only help one find more freedom without one’s instrument, but also tweak mechanical instrumental setup to better suit one’s individual body.  There are a myriad of different ergonomic products being developed to improve instrumental setup and alignment for all musicians, and more than ever, there are options for every body.  (Gone are the days of one chin rest and one shoulder rest fits all).    For upper string players, lessons can enhance overall awareness of the upper body and neck, find freedom throughout the neck, upper back, and shoulders, and an observation of less than optimal habits.  Having another set of trained eyes can help a student find a more optimal setup, regardless of instrument, but also more carefully examine the movement choices that may be hindering freedom.  There isn't a fixed position that will solve all issues, but looking at mechanical gear with the help of another can greatly aid students or professionals working to find more freedom.  *Side note-I personally have found that the teacher matters more than the particular methodology being taught, in regards to movement teachers, exercise instruction, Alexander Technique, Feldenkrais, etc.  A method that is taught safely, conscientiously, and with sensitivity towards the student, has the potential to be beneficial.*

 

When working with the neck, gentle movements are paramount!  This illustration shows a simple lateral flexion exercise, though adding the weight of the arm can be too intense, and please don't PULL on your neck!  The weight of the arm here is passive and ultimately optional

When working with the neck, gentle movements are paramount!  This illustration shows a simple lateral flexion exercise, though adding the weight of the arm can be too intense, and please don't PULL on your neck!  The weight of the arm here is passive and ultimately optional

3. Neck mobility: Make sure that you’re bringing your neck through a wide range of motions, especially if you play an asymmetrical instrument.  With the advent of technology, cell phones, driving...etc, most of us keep our head and neck in a very static position for hours a day.  With all neck movement, slow gentle movement is critical, as opposed to violent cracking and popping.  Neck circles can help, as well as lateral neck flexion coupled with rotation at different angles.  If there is repetitive clicking or popping in the cervical vertebrae, stop  the motion.  Many physical therapists and movement teachers will instruct a neck mobility sequence- I don't have a video that I particularly love, but there are tons of resources available in books, in person, and on the web.

4. Dynamic shoulder movements: Along with daily mobilization of the neck, dynamic shoulder warmups can help increase bloodflow, maintain healthy ranges of motion, and warmup the upper body before or after playing.  There is an infinite amount of movement possible at the shoulder, yet most of us only explore a fraction of what's possible in our day to day lives.  Shoulder shrugs, shoulder circles, overhead motions, circumduction...anything that helps to move your humerus, clavicle, and scapula will help bring some movement to this area.  Make shoulder movement a part of daily maintenance, not just something you do in your yoga class or lap swim.  Here's one of my teachers, Jill Miller, demonstrating a brief warmup.

5. Self-examination: What are your habits?  Do you carry a one sided purse or case and do you always use one shoulder in particular?  Are you satisfied with your overall instrument setup?   Can you carry less music in your case or bring a lighter bag with you ?  Do you hold your cellphone with your shoulder?  Do you always sleep on one side of the body or flex the head and neck while sleeping?  Are the movements you've adopted while playing serving the technical and musical goals?  Or are they hindering you?  Consider video taping yourself playing or performing  to observe what your tendencies are.  When you are inquisitive  with your assumed habits, both in playing and in the life, you can often find solutions to musical issues within your own body, as well as a new embodied awareness of what may (or may not) be serving you.

Remember that when changing movement habits, your soft tissues need time to adapt to a new setup, case strap situation, exercise, or chin rest!  Gradual change trumps extreme changes every time, especially when a pattern has been sustained for years at a time. 

 

This guy is using his LS to carry his cello, although he has a waist strap to try to distribute the weight better throughout the upper body.  Although carrying a backpack will even out out the load between the shoulders (assuming the straps are the same length), both Levator Scapulae are working to hold the object in a fixed position.

This guy is using his LS to carry his cello, although he has a waist strap to try to distribute the weight better throughout the upper body.  Although carrying a backpack will even out out the load between the shoulders (assuming the straps are the same length), both Levator Scapulae are working to hold the object in a fixed position.


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The Levator Scapulae: Musicians' Frenemies

If you take a look at most musicians in the heat of performance, you’ll probably notice elevated shoulders, either asymmetrically or simultaneously.  Sometimes it appears in an expressive moment of passion, especially with pianists, guitarists, and wind players, or other times it’s the result of setup or a one-sided instrument.  In isolation, such a movement will have minor repercussions, but when coupled with shoulder and neck overuse and abuse from other movement choices, can spell disaster for two muscles known as the levator scapulae.  As the name suggests, it elevates the scapula (on each side), but it also plays a significant role in neck movement, attaching at the transverse processes of C1-C4. 

The levator scapulae also co-create lateral neck/head flexion (along with many other small neck muscles), and rotation, which is why it is often a huge trouble maker for violinists and violists!  Here are some of the culprits for pain and misalignment:

Many violinists and violists turn the head out to look at the fingers, but over time, this can create stress and strain on the Left levator scapula!

Many violinists and violists turn the head out to look at the fingers, but over time, this can create stress and strain on the Left levator scapula!

1. Neck Position: Ideally, the head is not constantly turned to look at the fingers or fingerboard while playing the violin or viola, nor jutting forward towards the music stand.  A head looking forward allows more freedom in the neck long term, as well as a reduction in tension along the left Levator scapula.  Many images of violinists and violists feature an extreme rotation in the neck, often coupled with neck flexion!  For more on chin rest alignment, read here.

Although this image shows an elevated scapula to hold a phone, many violinists and violists elevate their shoulders to support their instrument!  Other times, the right shoulder elevates in an attempt to enhance sound or emotion.

Although this image shows an elevated scapula to hold a phone, many violinists and violists elevate their shoulders to support their instrument!  Other times, the right shoulder elevates in an attempt to enhance sound or emotion.

2. Shoulder elevation: Many violinists and violists find that they want to (or need to!) elevate their shoulders in order to grip the instrument.  Over time, this can create restriction in the upper back and neck, as well as tension patterning that is difficult to relearn.  It's always good to try different shoulder rest/chin rest setups to find one with the most ease and spaciousness in the neck and shoulders!  The same can be true for brass and woodwind players as well-especially if the instrument is asymmetrical like the flute or trombone.  Other instrumentalists may need to relearn their habits of expressive shoulders, and see if there’s a way to create a musical response without constantly elevating the shoulders or distorting the spine and head.

3.  Carrying things: Most musicians have the carry their instrument on their back, either as a one sided carrying case or backpack.  In order to prevent the object from falling, the levator scapulae have to lift the scapula up!  Carrying large backpacks, heavy instruments cases, or purses on one shoulder can lead to asymmetrical issues, including impingement and compression.  


In part 2, we’ll look at how to address this muscle in movement and setup!

The great thing about stock photos is that they're ridiculous.  Who walks down the street in heels carrying their case on one shoulder and violin in the other arm?  No one.  But her left levator scap is working to keep that case up there!

The great thing about stock photos is that they're ridiculous.  Who walks down the street in heels carrying their case on one shoulder and violin in the other arm?  No one.  But her left levator scap is working to keep that case up there!

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