Neck Pain and Upper Crossed Syndrome (UCS)

Article by Daniel Osborn, D.C.

Upper Crossed Syndrome (UCS) occurs when the muscles and overlying fascia of the upper back, neck, and shoulders become deformed as a result of poor posture. The posture correlated with UCS is described as when the head drifts forward to the point where it is no longer aligned vertically over the spine, hyper-kyphosis of the thoracic spine, and rounded forward shoulders. The muscles that are most affected are the upper trapezius fibers, levator scapulae, and pectoralis minor. These muscles are placed under extra stress due to the posture imbalances listed above, and as a result become tight, shortened, and over-active. When a muscle is over-active its antagonist, the muscles that performs the opposite movement, becomes relatively underactive. Therefore, the deep cervical flexors, rhomboids, and posterior deltoid muscles become loose, lengthened, and under-active. This is what we describe as the “cross” in Upper Crossed Syndrome. 

How does Upper Crossed Syndrome occur?

UCS develops following thupper crossed syndromee guidelines of the Specific Adaptations to Imposed Demands (SAID) principle. In our modern society we are constantly sitting in front of a computer, looking down at our phones, slouching in our car seats, etc. The positions we assume when we are performing all these activities align with the components of the posture imbalances listed above and associated with UCS. Head forward, rounded upper back and rounded shoulders. We stay in these positions for hours on end, overutilizing specific muscles in the process. Overtime, the SAID principal causes these muscles to become chronically tight, short, and over-active. Conversely, the opposing muscles that we severely underutilize in these positions become weak, lengthened, and under-active. On a physiological level, our body is doing exactly what it was made to do. Adapt. These specific adaptations occur to make these positions easier to maintain.  The problem is that these adaptations create excess strain on our neck, upper back, and shoulders, which inevitably leads to pain and dysfunction. 

What can I do about Upper Crossed Syndrome?

UCS is reversible. In the same way that we adapt into this postural deformity we can adapt out of it. We just need to change the demands that we place on our body. Remember the muscles listed above that were loose and underactive? Time to start strengthening them. Corrective exercises designed to target these underactive muscles can be done daily and even at your workstation. Remember the muscles that were tight and overactive? Time to start stretching them. Manual and manipulative therapies are exceptional treatments to address the tightness and associated pain in these muscles. Our muscles were made to move, and when we deny them their primary function, they inevitably become problematic. Get up and move around every thirty minutes, change your position from sitting to standing, go stretch out, or do one to two corrective exercises. These simple lifestyle changes will help to reverse and combat UCS as well as any associated pain and dysfunction. 

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