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Upper Crossed Syndrome – Poor Posture Do you sit at a desk for more than 4 hours in a day? Are you experiencing neck pain, upper back discomfort, or shoulder irritation?

You may fall under the category “Upper Crossed Syndrome”, as described by Dr. Janda. This Syndrome includes shortening of muscles in the back of your neck (levator scapulae, upper trapezius, subocciptal) as well as muscles in front of your chest (pectoralis major/minor). The shortening of these muscles, reduce the strength of your shoulder blade stabilizers (middle/lower trapezius, rhomboids) and neck stabilizers (longus capitis, longus colli) , which help us maintain proper posture. In general, the shortening of muscles will weaken others resulting in “poor posture” in the upper body.

Upper Crossed Syndrome (UCS) can be characterized by:
• Rounding of the shoulder complex
• Shoulder blade misalignment
• Forward head posture
• Decreased stability or range of motion in the shoulder joint
• Increased neck or upper back pain


Causes

This occurs over a period of time resulting from inadequate positioning of the upper body. UCS alters the structural relationships of the neck and shoulder joints. The alteration affects the muscle length-tension relationship, the movement of the neck and shoulder complex. This altered structural relationship may result in nerve root irritation, cervical radiculopathy, headaches, and decreased ranges of motion through the neck or shoulder joint.


Treatment


There are many proven conservative treatments for UCS in the literature to decrease discomfort and increase overall function. Treatments are tailored to each individual needs.

Patients with UCS can expect:
• Joint mobilizations aimed to increase ranges of motion for the cervical spine, thoracic spine,
scapulothoracic joint, or glenohumeral joint
• Soft tissue mobilizations aimed to decrease muscular restrictions
• Stretches and Exercises targeting optimal positioning of the upper body
- Head nod exercise progressions
- Shoulder retraction exercise progressions
- Active joint range of motion movements
- Unilateral or bilateral pectoralis stretches
• Trans Cutaneous Electrical Stimulation (TENS) aimed to relax muscles and decrease pain
• Ergonomic Assessment

 


ProSport Physical Therapy, 1000 N. Bristol Street, Ste #25, Newport Beach, CA 92666. Phone 949-250-1112

References:
-Dutton M. Dutton's Orthopaedic Examination Evaluation and Intervention, Third Edition. McGraw-Hill Medical; 2012.
-Verhagen AP, Bierma-zeinstra SM, Burdorf A, Stynes SM, De vet HC, Koes BW. Conservative interventions for treating work-related complaints of the arm, neck or shoulder in adults. Cochrane Database Syst Rev. 2013;12:CD008742.
Article produced by: Kevin Aguinaldo, Student Physical Therapist