How good is your posture? If you have a desk job, go to school, or spend a lot of time in front of a computer/TV/phone, then the odds are not good. In today's society, it's not a surprise when people present with significant postural issues, such as a forward head posture, rounded and elevated shoulders, winged shoulder blades, and a hunched upper back. These are classic signs of something called "upper crossed syndrome."
Upper Crossed Syndrome
What is it?
Upper crossed syndrome is a set of muscle imbalances in the, you guessed it, upper body. There also exists something called lower crossed syndrome, which I'll talk about in another post. Upper crossed syndrome is characterized by a tightening and shortening of the muscles in the back of the neck (upper traps and lev scap) crossed with a tightening and shortening of the muscles in the chest (pecs). At the same time, a weakening and lengthening of the muscles in the front of the neck (deep neck flexors) is crossed with a weakening and lengthening of the muscles in the back (rhomboids and middle/lower traps). This pattern of imbalance causes stress on focal areas of the upper body, which translates to the abnormal postures that I mentioned earlier. In turn, this causes pain and dysfunction in the head, neck, shoulders, and upper back.
What causes it?
Although upper crossed syndrome is usually the result of a sedentary lifestyle and poor posture, it can also be caused by other activities, such as riding a bike in a hunched over position or imbalanced weight training with more focus on the chest and shoulders compared to the upper back. Upper crossed syndrome involves something called reciprocal inhibition, a process whereby muscles on one side relaxes (and weakens) in order to allow contraction (thus, tightening) of muscles on the other side.
What are the signs and symptoms?
- Forward head posture
- Hunchback caused by an increased curvature in the neck and upper back
- Elevated (shrugged) and rounded shoulders
- Winging shoulder blades
- Headaches
- Pain or dysfunction in the neck, shoulder, or upper back
What can be done?
Correcting posture
Postural correction is not an easy task, but it's the most effective approach in fixing and preventing upper crossed syndrome. Maintaining a good posture is an active or habitual process that requires constant contraction of specific muscles; therefore, they need to have good endurance capacity. If you normally live a sedentary lifestyle, or if you're used to sitting in a slouched position, you're probably not used to activating these muscles. You'll find that it is quite difficult for you to sit with a good posture. It's important not to overdo it at first, or else you'll hate it and never want to continue with it again. Start off slowly... maybe try to sit up straight for a couple of minutes at a time and build your tolerance. If it helps, you can place a dot somewhere on your monitor or desk, and every time you see this dot, remind yourself that you need to correct your posture.
Stretching tight muscles
When a muscle is tight or overactive, it will have a tendency to pull your body into a certain position. In upper crossed syndrome, tightness occurs in the front of the shoulders and chest (pecs), as well as in the back of the neck (upper traps and lev scap). Tightness in the chest causes your shoulders to round forward, and tightness in the back of the neck causes your shoulders to shrug. Increased tension in the back of the head and neck can result in tension headaches as well. Stretching these muscles will help to relieve tightness and tension in these areas of the body. If you're not sure how to stretch, be sure to visit my previous blog post on The Basics of Stretching.
Strengthening weak muscles
In contrast, when a muscle is weak or inhibited, it lacks the ability to pull your body into a certain position. In upper crossed syndrome, the muscles that are weak include the deep neck flexors, as well as the rhomboids and middle/lower traps of the upper back. The deep neck flexors are responsible for keeping your head in a neutral position (as opposed to a forward head posture), so you can imagine that weakness in these muscles will cause you to lack the ability to pull your neck back. The rhomboids and mid/lower traps are muscles in the upper back that pull your shoulder blades back and down. Inhibition of these muscles also cause rounded shoulders, winged shoulder blades, and a "hunchback." Strengthening weak muscles and increasing their endurance will help dramatically to maintain an upright posture.
If you have pain in the neck, shoulders, upper back, or headaches, these are typical signs of upper crossed syndrome. Over the last couple of weeks, I've been seeing a lot of kids and teenagers that exhibit these symptoms. They're in the middle of their growth spurt, so it's important that they don't develop bad habits this early in their lives. Don't hesitate to visit your physiotherapist today to have it looked at!
