Upper Crossed Syndrome

Your posture plays an important role in your overall health.  Poor posture leads to chronic strain and discomfort. “Upper crossed syndrome” describes poor posture that results from excessive tightness in your shoulders and chest with weakness in your neck and mid-back.  This combination forces your shoulders to roll inward and your head to project forward.

Perhaps posture is a symptom of a pain problem, and not always the cause of a pain problem

To help understand how upper crossed syndrome causes trouble, think of your spine as a telephone pole and your head as a bowling ball that sits on top.  When the bowling ball is positioned directly over the top of the upright post, very little effort is required to keep it in place.  If you tip the post forward and the ball begins to roll over the edge of the post, significantly more effort would be required from the muscles trying to hold it there.  This effort results in chronic strain of the muscles of your neck and upper back.

The chronic strain is uncomfortable and may also lead to neck pain, upper back pain, headaches, TMJ pain, and ultimately- arthritis.  This postural problem is exceptionally common in computer workstation users and those working at countertops.  Your doctor of chiropractic can assist with this problem, likely through a course of chiropractic care and prescribed self-care.  Home care usually involves stretching the tight muscles, strengthening weak muscles, and modifying your workstation.

“Upper Crossed Syndrome” or “Cervical Crossed Syndrome” was first described by Vladimir Janda in 1979 as a predictable pattern of alternating tightness and weakness involving the neck and shoulders.  This posture occurs in very stereotypical ways.

A muscular imbalance like this does not occur randomly, but rather in a predictable way.  The body attempts to find a comfortable position and reach movement homeostasis.  The imbalance usually begins when one muscle is overused in a certain direction and becomes short and tight.  The opposite of this muscle is subject to a prolonged stretch and becomes long and weak.

An upper crossed pattern results in a specific pattern of muscular dysfunction. The upper trapezius, levator scapulae, SCM, and pectoralis major are predisposed to tightness.  On the other hand, the rhomboid, serratus anterior, scalenes, and middle and lower trapezius muscles become weaker.  The term “upper crossed syndrome.”  Was coined because a line drawn to connect the tight muscles forms a cross with a line drawn to connect the week muscles.

This postural syndrome is a direct result of a flexed forward posture.  Usually this process begins with a child in a classroom and then progresses throughout working years, particularly with those either seated or standing at a workstation.

Muscular balance is necessary for the normal function of a healthy human frame.  On the other hand, muscular imbalance results in poor movement pattern and stress on the muscle, spine, and joint system.  Specifically, a forward head posture increases the compressive force on the cervical spine joints and results in muscle tenderness at the base of the skull and across the shoulders.  This cycle of poor posture and pain is self-perpetuating.

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