Upper crossed syndrome

Upper Cross Syndrome.

Although you may not be familiar with the term upper Cross syndrome (UCS), you have more than likely seen people with this type of postural imbalance. UCS is characterised by rounded and elevated shoulders, forward positioning of the head and a rounding of the upper spine and neck or an increased thoracic kyphosis and a cervical lordosis.

Although this is a posture we often see in the elderly. It is becoming increasingly common earlier in life, especially in those who work at desks, hunched over a computer, those who drive vehicles for long periods and those who slouch in sofas and are relatively inactive. Over an extended period of time, the muscles at the front of the chest and rear of the neck become shortened and tight whist the flexors of the neck and the muscles stabilising the scapula, become weakened and lengthened.

This creates and maintains the muscular imbalances we see in UCS. The term UCS refers to the positioning of the weak and tight muscle groups. As viewed from the side, the muscles in the mid back and the upper neck create a line of weakness that is intersected by a line of tension travelling from the posterior neck to the upper chest wall. This creates a cross shape as seen in the diagram below.

Often associated with this type of posture is pain surrounding the base of the skull, at the midpoint in the neck and/or at the spinal levels between the shoulder blades. It is common for those with UCS to complain of headaches associated with the muscular tensions and restrictions of the cervical spine. Due to the altered positioning of the scapula, shoulder problems can develop along with radiation of pain into the arms.

As the sternum becomes depressed, breathing becomes more difficult and maximum lung

capacity is reduced which is of particular interest to athletes and those suffering pre-existing respiratory conditions.

So, is UCS treatable and how do we prevent it?

The treatment for UCS starts with the lengthening of the tissues that have become shortened

and tight. This means stretching out and increasing the length of the muscles in the front of the chest and the back of the neck. The spine and peripheral joints are assessed for restrictions and treated accordingly with gentle mobilisations, articulations and adjustments if needed. Finally, exercises are given to target and strengthen the specific muscles that are weak. This provides the basis for long term management as the combination of osteopathic treatment plus targeted exercise can successfully be used to treat not only the symptoms but the cause of this condition.

Once a correct posture has been achieved, maintaining this now becomes important. As working, driving and sitting postures play a major role in the the development of this condition, they should be assessed to minimise impact. In the office, the workstation should be set up so as to prevent hunching over the desk with regular rest periods. Driving and sitting positions can use supports for the lumbar spine as well as focusing on upper body position with shoulders down and back.

Increasing flexibility with a regular yoga practice and improving core strength with Pilates

have also been shown to be highly beneficial in the treatment of UCS and the maintenance of

a good body posture. Finally, regular remedial massage can help address tensions within the

musculoskeletal system whilst regular Osteopathic check ups ensure restrictions to movement are removed and optimal functioning of the spine and joints maintained.

If you experience any of these symptoms or recognise similar poor posture in yourself, why

not book an appointment with one of our qualified osteopaths today, to work out a treatment

plan tailored to you.

Christian Paesano
Osteopathic Physician
B Sc(Hons) Ost. Med., D.O., D.N.

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