견갑거근

[문형철]

수없이 많은 환자들이 잠을 자고 있어나서 경추를 움직이지 못하는 stiff neck으로 고생한다.

그 원인 근육은 바로 견갑거근이다.

많은 환자들은 이런 문제들이 우연하게 발생한다고 생각하지만, 정확한 진단을 해보면 거의 모든 환자들의 경추는 일자목, 거꾸로 목, 과신전목, 경추 디스크 등이 있다. 

왜 발생하고 어떻게 치료할까?

원인

1. 경추의 불안정성으로 발생하는 견갑거근의 반사성 근수축

2. 견갑거근의 비정상적인 장력부하

3. 견갑거근의 strain, Trp

panic bird..

1. 낙침의 원인근육

2. 반드시 정확한 스트레칭, Trp를 기억해야

3. C1-4 횡돌기 - 견갑골 상각

4.  척추를 고정하고, 견갑거근이 수축하면 견갑골이 들어올려지면서 견갑골 하각이 내측으로 움직임.  대개 능형근과 소흉근이 함께 작용

5. 어깨를 고정하고 견갑거근이 수축하면 경추를 회전과 굴곡시킴. 

6. 상부승모근을 피해서 촉진하는 법을 알아야

견갑거근 스트레칭 방법(클릭)

Stiff Neck Causes and Symptoms

Muscle Strain or Sprain
By far the most common cause of a stiff neck is a muscle sprain or muscle strain, particularly to the levator scapula muscle. Located at the back and side of the neck, the levator scapula muscle connects the cervical spine (the neck) with the shoulder. This muscle is controlled by the 4 and 5 cervical nerves (C4, C5).

낙침(stiff neck)은 견갑거근(levator scapular muscle)의 strain임.

견갑거근은 경추 1-4번 횡돌기의 dorsal tubercle에서 기시하여 견갑상극에 종지하고, 경추 4, 5번신경근의 지배를 받음.

Origin and insertion[edit]

Levator scapulae originates from the dorsal tubercles of the transverse processes of cervical vertebrae one to four. The muscle is inserted on the superior angle and adjacent medial border of the scapula. ^[1]

The levator scapulae may lie deep to the sternocleidomastoideus at its origin, deep or adjacent to the splenius capitis at its origin and mid-portion, and deep to thetrapezius in its lower portion.

견갑거근의 기능

When the spine is fixed, levator scapulae elevates the scapula and rotates its inferior angle medially.^[1] It often works in combination with other muscles like the rhomboids and pectoralis minor to rotate down. Elevating or rotating one shoulder at a time would require muscles to stabilize the cervical spine and keep it immobile so it does not flex or rotate. Elevating both at once with equal amounts of pull on both side of cervical spinal origins would counteract these forces. Downward rotation would be prevented by co-contraction of other muscles that elevate the spine, the upper fibers of the trapezius, which is an upward rotator. 

When the shoulder is fixed, levator scapula rotates and flexes the cervical spine laterally.^[2] When both shoulders are fixed, a simultaneous co-contraction of both levator scapulae muscles in equal amounts would not produce lateral flexion or rotation, and may produce straight flexion or extension of the cervical spine. Which would happen is unknown.

- 척추를 고정하고, 견갑거근이 수축하면 견갑골이 들어올려지면서 견갑골 하각이 내측으로 움직임.  대개 능형근과 소흉근이 함께 작용

- 어깨를 고정하고 견갑거근이 수축하면 경추를 회전과 굴곡시킴. 

Relations[edit]

One of the muscles within the floor of the posterior triangle of the neck, the superior part of levator scapula is covered by sternocleidomastoid and its inferior part by the trapezius. ^[3] It is bounded in front by the scalenus medius and behind by splenius cervicis. The spinal accessory nerve crosses laterally in the middle part of the muscle and the dorsal scapular nerve may lie deep to or pass through it. ^[4]

Variations[edit]

The number of vertebral attachments varies; a slip may extend to the occipital or mastoid, to the trapezius, scalene or serratus anterior, or to the first or second rib. The muscle may be subdivided into several distinct parts from origin to insertion. Levator claviculæ from the transverse processes of one or two upper cervical vertebræ to the outer end of the clavicle corresponds to a muscle of lower animals. More or less union with the serratus anterior. ^[5]

Innervation and blood supply[edit]

The levator scapulae is supplied by two or three branches of the fourth and fifth cervical nerves,^[1] and frequently by a branch from the dorsal scapular.^[5]

The levator scapulae is supplied by the dorsal scapular artery. Normally, this artery has a small branch which passes laterally to the supraspinatus fossa of the scapula, and in a third of cases, this branch supplies the muscle. If the dorsal scapular artery comes off the transverse cervical artery, the parent transverse cervical artery splits, the dorsal scapular artery passes medially, while the transverse cervical artery passes laterally. ^[4]

Evolutionary variation[edit]

The muscles of the shoulder can be categorized into three topographic units: the scapulohumeral, axiohumeral, and axioscapular groups. Levator scapulae forms part of the latter group together with rhomboid major, rhomboid minor, serratus anterior, and trapezius. The trapezius evolved separately, but the other three muscles in this group evolved from the first eight or ten ribs and the transverse processes of the cervical vertebrae (homologous to the ribs). The serratus anterior formed the basal unit for these three muscles. In higher primates it has evolved into two separate muscles — serratus anterior and levator scapulae — by concentration of the proximal and distal fibers and progressive reduction of the intermediate fibers. The fibers concerned with the cranial displacement of the scapula became the levator scapulae.^[6]

견갑거근 Trp

에반스의  견갑거근 isolated stretching

[홍석주]

위에 두 동영상은 어떤 프로그램을 사용하신건지 궁금합니다. 2번째것은 muscle in motion인가요?^^

[문형철]

첫번째 것은 위키디피아에서 끌어온거구요

두번째 것은 ... 저도 잘 모릅니다. ... 누군가 힘들게 만든 자료겠죠 ㅎㅎㅎ

[김종현]

감사합니다. 스트레칭 해보니 시원하고 좋네요^^

[강정호]

감사합니다^^