Blog Post

30 July 2013

Upper Crossed Syndrome (Part I)

Upper Crossed Syndrome

Each year, millions of people suffer from a condition known as Upper Crossed Syndrome (UCS). Sedentary lifestyles, excessive hours working at a desk or computer, texting, postural changes and even improper weightlifting can lead to UCS. Upper Crossed Syndrome occurs when there is muscular imbalance in the neck, shoulder region and upper to mid thoracic spine. It can lead to more serious problems such as early degenerative (arthritic) changes.

UCSHow Upper Crossed Occurs

Upper Crossed Syndrome occurs when the deep neck flexors, lower trapezius, serratus anterior and rhomboid muscles become weak or inhibited and the pectorals, sternocleidomastoid (SCM), upper trapezius and levator scapulae muscles become tight or facilitated. Forward head posture, rounded shoulders and a hunched upper back are also characteristics of UCS.

Reciprocal Inhibition

Reciprocal inhibition occurs when the agonist (muscle causing movement) contracts, and the antagonist (muscle opposing movement) relaxes. In order for movement to occur, a muscle on one side of a joint contracts and the opposing muscle on the other side relaxes.

Prolonged contraction in muscles causes prolonged relaxation in opposing muscles. When we look at Upper Crossed Syndrome, muscular imbalance is caused by chronic facilitation and inhibition of muscles. Muscles that are in a constant state of contraction are weak and opposing muscles in a constant state of relaxation are weak as well.

Anatomical Characteristics of Upper Crossed Syndrome

Tight pectorals and weak rhomboids will result in protraction of the shoulder blades causing the shoulders to appear rounded. Tight upper trapezius and levator scapulae and weak deep neck flexors and lower trapezius will result in hunching of the upper back and forward head posture.

Symptoms of Upper Crossed Syndrome

Headaches, pain in the upper back, neck, shoulders, chest, head and arms are common symptoms experienced when dealing with UCS. Trigger points in the upper trapezius, neck extensors, SCM, pectorals and rhomboids are common objective findings that are located by palpation of these muscles. Pain and discomfort at the atlanto-occipital region, C4/C5 and the upper thoracic spine are common areas to find joint restrictions.

In part II we will discuss treatment options for Upper Crossed Syndrome.