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. Other times, it’s the inescapable 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, can spell disaster for 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 to the tranverse processes of C1-C4. The levator scapula also initiates lateral neck/head flexion, 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:
1. Neck position: Ideally, the head is not turning to look at the fingers or fingerboard while playing the violin or viola, nor turning to the music stand with other instruments. A head looking forward allows more freedom in the neck, 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!
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. The same can be true for brass and woodwind players, especially if the instrument is asymmetrical like the flute or trombone. Other instrumentalists may need to unlearn 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 carry their instrument on their back, either as a one sided carrying case or backpack. In this scenario, the levator scapulae remains constantly contracted to prevent the object from falling. Carrying large backpacks, heavy instruments cases, or purses on one shoulder can lead to asymmetrical issues, including impingement and compression. This is not only an issue for musicians, as many people carry heavy bags or purses on the same shoulder day in and day out.
In part 2 on Friday, we’ll look at how to address tension and asymmetry in this muscle and a targeted therapy ball sequence to help release it.