If you slouch, chances are you have UPPER CROSSED SYNDROME. It’s the natural consequence for not obeying your mom when she used to tell you to “Sit up straight!!” and “Quit slouching!!”
Though this may not be considered a “serious” condition this bad posture can cause serious muscular imbalances that can result in chronic pain and disability.
Now, before you go thinking that this is a major condition like Fibromyalgia or Degenerative Joint Disease you should know that Upper Crossed Syndrome merely describes what happens when someone has forward head posture. In laymen’s terms it merely describes the consequences of what happens when your head is not in line with your shoulders; rather, you carry your head in front of your shoulders – what’s called a stooping posture – which creates a tremendous amount of muscular tension on top of the shoulders and between the shoulder blades.
Over the course of a day, this muscular tension from poor posture builds and builds and those overstretched, overstressed, and overstrained muscles create pain that you feel in the neck, at the base of the skull and in the shoulders. This muscular tension could be the cause of your headaches, neck pain and shoulder pain.
People with this forward head carriage typically work at the computer for long periods of time. It could also be someone who sews or does a lot of needlepoint work. Musicians could also be included in the list (I have to throw that in there; I was a drummer who spent years slouching in a drum chair) or even kids who spend their days in uncomfortable desks at school.
So, technically speaking, Upper Crossed Syndrome (UCS) is defined as shortening or weakness of the muscles on the front of the neck, shoulders and chest along with overstretching and tension of the muscles on top of and in-between the shoulder blades.
If you really want to get technical, the muscles that get weak and shortened are the upper trapezius (big shoulder) muscles, pectoralis major (chest) muscles, and the levator scapulae (right at the top of the shoulder blades) muscles. (Interestingly enough, those are muscles that I palpate on most people at every visit to assess shoulder/neck problems).
UCS also involves weakness of the rhomboids (the muscles in between your shoulder blades and your spine); serratus anterior (a muscle under the arm that attaches the ribs to the shoulder blade); middle and lower trapezius, and the deep neck flexors (muscles that allow you to bend your head forward), especially the scalene muscles.
The DREADED UPPER CROSSED SYNDROME (really, I just love saying that; it sounds so much better than “Hey!! You’re slouching!!”)
This syndrome was named “Upper Crossed” because when the weakened and shortened muscles are connected in the upper body, they form a cross.
There’s a neat website here where you can see the muscles.
People with the dreaded UPPER CROSSED SYNDROME (really, I just love saying that; it sounds so much better than “Hey!! You’re slouching!!) will typically have no weight-bearing curve in their neck.
But, wait a second, let me explain. When viewed from the side, the spine should have a gentle forward curve in both the neck and lower back called a “lordosis.” These curves exist to give the spine strength and flexibility.
The lower back needs strength because it’s the center of gravity. Every single movement that you perform will require stability from the lower back, so a good weight-bearing curve in your lower back is absolutely necessary.
The neck needs strength because these 7 two-ounce bones have to support the weight of the head, which is around 15 pounds on average. A good weight-bearing curve allows the weight of the head to stay where it’s supposed to stay, which is on the spinal joints. Loss of that curve means that the job of “stability” now becomes more of the responsibility of the aforementioned muscles on top of the shoulders and between the shoulder blades.
Look at the example of a normal cervical spine – well, “normal” is a relative term, so let’s say “ideal” instead -when viewed from the side.
The seven cervical vertebra form a gentle, forward curve. The backs of each vertebra are in line with the one above and the one below. The spaces in-between the vertebrae (where the intervertebral discs are positioned) all appear to be equally spaced.
Please note: intervertebral discs cannot be seen on X-rays. Instead, we can only see the disc spaces. But, the state of these disc spaces, along with correlation to a person’s symptoms and a thorough examination, can help us to make certain assumptions about the health of the disc. To absolutely confirm a disc bulge or disc herniations, one would need an MRI to visualize the disc in question.
Now, look at the two examples below.
The neck on the left has a reversed curve in it. It is the exact opposite of normal. The base of the neck, a vertebra that we number as C7, should be positioned directly under the top of the spine, the vertebrae known as C1-C2. Clearly, it’s not, meaning the job of supporting the weight of the head is now going to be transferred to the muscles.
The next picture of a neck also has a “reversed” curve. This type of curve will be incredibly weak and, without intervention, will develop arthritis more rapidly in the lower cervical vertebrae. And just like the first view, weight of the head will be supported more by the muscles instead of by the vertebrae of the cervical spine.
People with Upper Crossed Syndrome will have shoulders that are up around their ears and rounded forward. Their head will be carried in front of the shoulders. This type of posture produces overstress at the joints where the occiput (the base of the skull) meets the first cervical vertebra; at the C4-C5 area of the spine (mid-neck); the upper thoracic spine segments; and the shoulder where the arm sits in the shoulder socket. This person will also have reduced motion in the neck.
Upper Crossed Syndrome also causes changes in the shoulder blades; specifically the bottoms of the shoulder blades rotate out and the tops of the shoulder blades angle in toward the second and third ribs. This leads to even MORE stress on the levator scapulae and upper trapezius muscles; they now have to be even more active to provide stability to the humerus as it sits in the shoulder socket. This will be accompanied by increased and constant activity of the supraspinatus muscle – one of the rotator cuff muscles — causing early degeneration of the muscle.
In an ideal posture, the ear, the shoulder, the hip and the middle of the foot will all be in a straight line. However, from the side people with Upper Crossed Syndrome will appear as if the hips are forward of the shoulders creating too much curve at the bottom of the lumbar spine, a condition called “sway back”. Meanwhile, the neck is forward of the shoulders.
If you have this posture, don’t feel bad!! Even celebrities are not immune to bad posture (Think Sandra Bullock on the cover of Bazaar magazine or Mary Kate Olsen in the image below).
This type of posture over time creates muscular imbalances that will also cause stress to the discs, joints and ligaments that support and stabilize the spine. And this in turn, can cause arthritis to accelerate, showing up much earlier in life than it should.
So, what can be done about Upper Crossed Syndrome?
First, you should have your spine X-rayed and analyzed by a chiropractor. Chiropractors are the only type of healthcare professional trained to detect and correct misalignments of the spine. These misalignments represent weak points in the spine where the structure breaks down to such an extent that it affects the nervous system and the musculoskeletal system as well as possibly affecting other systems of the body.
Corrections to these misaligned areas of your spine – called subluxations – will improve the imbalance of the musculoskeletal systems and improve the weight-bearing curves of the spine.
However, spinal corrections alone may not be enough to correct Upper Crossed Syndrome. To combat the muscle memory from years of bad posture, you need to go through a series of strengthening and stretching exercises designed to improve the muscular imbalance component associated with UCS.
Specifically, you will want to stretch the chest muscles – pectoralis major and minor – that are likely contributing to pulling the shoulders forward. The neck flexors – the sternocleidomastoid (SCM’s) and scalene muscles – which are helping to pull the head forward, need to be stretched also. The muscles on the outer, lower edge of the shoulder blades – the subscapularis, serratus anterior, and latissimus dorsi – should be stretched as well.
In combination with these stretches, certain muscles need to be strengthened. The muscles between the shoulder blades – the rhomboids – need to be strengthened as do the muscles on top of the shoulder blades – the upper trapezius and the levator scapulae. One of the rotator cuff muscles, the supraspinatus, also needs to be strengthened. Finally, the muscles in the back of the neck, the neck extensors, need to be strengthened.
Correcting these muscle imbalances, along with specific chiropractic corrections to the spine, is the KEY to regaining proper spinal alignment and STAYING that way.
Or, I could just call your mother and make her tell you to sit up straight.
Dr. Steve Goninan
11582 Cumming Highway
Canton, GA 30115
Visit Dr. Steve’s website, Integrity Chiropractic to get more information about his clinic in Canton, GA.