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Upper Cross Syndrome

Upper Cross Syndrome | Orchard Health Clinic

Did you know that Upper Cross Syndrome is extremely common in office workers and even athletes?

Upper Cross Syndrome occurs when the muscles in the neck, shoulders, and chest become deformed. Specifically, the back muscles of the neck and shoulders (upper trapezius, and levator scapula) become extremely overactive and strained. The muscles in the front of the chest (the major and minor pectoralis muscles) then become shortened and tight. As a result of these overactive muscles, the surrounding counter muscles become underused and weakened. This causes weak muscles in the front of the neck (cervical flexor muscles) and in the lower shoulders (rhomboid and lower trapezius muscles). The overactive muscles and underactive muscles can then overlap, causing an “X” shape to develop.

Individuals with a sedentary lifestyle are at risk for developing Upper Cross Syndrome. Long hours of sitting at a computer, watching television, or playing on a smartphone can contribute to bad posture. This prolonged poor posture can weaken the rhomboid and neck flexor muscles, while tightening and shortening the pectoral and upper trapezius muscles. This imbalance causes the spine to pull forward, significantly increasing the amount of stress on the supporting muscles. While poor posture and too much sitting is a leading cause of Upper Cross Syndrome, it is not uncommon to find this condition in athletes especially swimmers and weightlifters. This is often due to overuse of the muscles in the neck, shoulders, and upper back region.

Common characteristics of Upper Cross Syndrome include:

  • The head is consistently or often in a forward position
  • Inward curvature in the portion of the spine containing the neck (increased Cervical Lordosis)
  • Outward curvature in the part of the spine that includes the upper back, shoulders, and chest (increased Thoracic Kyphosis)
  • Elevated, protracted, or rounded shoulders, where the muscles are in a continuous state of being pulled or stretched forward
  • The visible portion of the shoulder blade sits out instead of laying flat (scapula winging)

The imbalanced muscles associated with Upper Cross Syndrome put stress on the surrounding muscles, tendons, bones, and joints, causing symptoms such as headaches, neck pain, chest pain, upper back pain, or shoulder pain.

Physical therapy is recommended for Upper Cross Syndrome. Your therapist will customise a treatment program according to your condition. Treatment program will include manual therapy as well as modalities such as electro-therapy stimulation, heat therapy, and Cryotherapy to relieve pain, stiffness, and encourage better movement of the body. Apart from manual therapy, strengthening exercises for weak muscles and stretches to relieve tightness will be prescribed. Postural changes and functional training will also be taught by your therapist to correct Upper Cross Syndrome. If in doubt, seek professional advice.

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