A 63-year-old rehabilitation patient has tenderness at the insertion of the levator scapulae on the superior medial border of the scapula. Which statement about this somatic dysfunction is true?

A 63-year-old rehabilitation patient has tenderness at the insertion of the levator scapulae on the superior medial border of the scapula. Which statement about this somatic dysfunction is true?

• A. A tonic muscle which is dysfunctional and contracted
• B. A phasic muscle that relaxes spontaneously
• C. An antagonist to the upper trapezius
• D. Indicative of a nerve lesion

Answer: (A)

In somatic dysfunction, muscles are described as tonic or phasic. Tonic muscles are postural and tend to stay in a state of higher tone; when dysfunctional, they are often hypertonic, shortened, and actively contracted. Phasic muscles, by contrast, are more dynamic and are prone to fatigue and relaxation rather than sustained contraction. The levator scapulae is a postural, or tonic, muscle that elevates the scapula and helps stabilize the shoulder girdle. When there is somatic dysfunction involving this muscle, it commonly presents with hypertonicity and tenderness at its insertion—the superior medial border of the scapula—reflecting a contracted, dysfunctional state. Therefore, the statement that this represents a tonic muscle that is dysfunctional and contracted best fits the scenario. It’s not typically an antagonist to the upper trapezius (they often work together to elevate the scapula), and tenderness at an insertion does not imply a nerve lesion.

In somatic dysfunction, muscles are described as tonic or phasic. Tonic muscles are postural and tend to stay in a state of higher tone; when dysfunctional, they are often hypertonic, shortened, and actively contracted. Phasic muscles, by contrast, are more dynamic and are prone to fatigue and relaxation rather than sustained contraction.

The levator scapulae is a postural, or tonic, muscle that elevates the scapula and helps stabilize the shoulder girdle. When there is somatic dysfunction involving this muscle, it commonly presents with hypertonicity and tenderness at its insertion—the superior medial border of the scapula—reflecting a contracted, dysfunctional state.

Therefore, the statement that this represents a tonic muscle that is dysfunctional and contracted best fits the scenario. It’s not typically an antagonist to the upper trapezius (they often work together to elevate the scapula), and tenderness at an insertion does not imply a nerve lesion.