Most people know about lower cross syndrome, which results from a combination of weak and tight muscles in the lower body. But did you know this can occur in the upper body too?
Upper Cross Syndrome (UCS) results from similar circumstances. The weak lower trapezius, deep cervical (neck) muscles, rhomboid and serratus anterior muscles cross over the tight upper trapezius, levator scapulae and pectoralis major. This means there is a considerable imbalance of the muscles of the chest, neck and back which can lead to pain and dysfunction. Notably, joint dysfunction can occur in the upper cervical spine and mid-thoracic spine. Many people get a sharp burning pain along the shoulder blades.
Well, what does it look like?
This condition is often called “poor posture” – and while this is true, we need to consider that fixing this poor posture isn’t as simple as putting your shoulders back and sticking out your chest.
Specific postural changes are noticeable, including:
Forward head posture, referred to as “anterior head carriage”
Increased curvature of the cervical spine
Increased thoracic kyphosis – or forward curvature
Rounded shoulders
Winging of the shoulder blades
What causes UCS?
While there are many theories – there is one that best explains the condition. Repetitive tasks and immobility leads to muscle imbalances, such as some muscles getting stronger and tighter, while others shorten and become weaker. These changes lead to further inappropriate patterns of movement – thus becoming a positive feedback system for improper movements.
Other causes include:
Rounded shoulders, forward head posture and slouching
Trigger points in serratus anterior, rhomboids or pectoralis major muscles
Adhesions or scar tissue formation
Traumatic injury (whiplash or a direct blow)
Risk factors include:
Poor ergonomic set up (desk job/ student/ arms extended in front of body for long periods)
Overuse during sports (swimming/ gymnastics)
Prolonged poor posture
How can you define a normal muscle balance if all muscles are different?
While there isn’t an exact balance, there is a relative equality of muscle length and strength between opposing muscles. This balance is necessary to maintain normal movement and therefore, function.
How is this assessed?
Your practitioner will conduct a physical examination including posture analysis from the front, back and sides. Additionally, muscle function testing and evaluation of balance, both stationary and when walking will be examined.
How can chiropractic help with Upper Cross Syndrome?
Your chiropractor should be able to help with pain relief, maintenance, and rehabilitation of the affected muscles to improve your posture and prevent recurrence. Your treatment may include a variety of modalities such as massage, ischemic compression, dry needling, thermotherapy, mobilization, and chiropractic adjustments. Sometimes, your chiropractor will use kinesiotape to stimulate the affected areas and help reinforce the outcomes from your treatment.
Home exercises are also essential to help the progression of this condition. Stretches of the neck, upper back, chest, and shoulders are all necessary. Check out my upper body stretches below. You can also place a heat pack/ hot water bottle on the painful area for 20 minutes.
A strengthening exercise you can do is Brugger’s Exercise. Follow these easy steps:
1. Sit at the edge of your chair
2. Bend your elbows and bring them close to your sides with your palms facing up
3. Squeeze the bottom of your shoulder blades together by engaging your rhomboid muscles (below)
4. While maintaining the squeeze, rotate your hands outwards but keep your elbows tucked in
5. Finally, move your elbows outwards away from your body while still maintaining the squeeze
6. Release
7. Repeat 3 times
Does it ever go away?
With suitable treatments, strengthening and rehabilitation – it is possible to restore correct motion.
Want to sort out your posture? Get in Touch Today!
Be optimistic about your condition, stick to your rehabilitation program and keep active! Don’t let your pain get you down.
Vizniak, N., 2018. Orthopedic Conditions. 3rd ed. Canada: Professional Health Systems Inc.
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