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Upper Cross Syndrome – A Pain in The Neck

Bad back…..tight neck……tight shoulders.  These are common issues we see in the clinic very often.  In fact, 9 times out 10 I treat someone with some form of upper back, neck and/or shoulder discomfort.

Why is that?  Why do so many people suffer with back, neck and shoulder issues.  Are they even the problem?  Unless there is some pathological issue or acute injury, most likely the answer may be no. So, what is the problem.  The chest – The Pectoralis Major & The Pectoralis Minor.

Life has a way of making the muscles in the chest short and tight. 

  • Working at a desk
  • Driving
  • Carrying children
  • Cooking
  • Use of technology, 
  • Biking

These are a few of the many causes of tightening up of the chest muscles and the pulling of your neck forward causing something called Upper Cross Syndrome

What is upper crossed syndrome?

It is a term developed by Vladimia Janda to explain the imbalance of muscles in the upper body, pulling on the skeleton, causing the pain and issues in the back, neck, & shoulders.

You can see in Img 1 below that the Pec minor muscle has its origin from ribs 3, 4, & 5 and inserts into the coracoid process of the scapula (shoulder blade).  As the muscle gets tight it pulls the shoulder blade up and over (the blue arrow)

Pec Minor
Img 1

As the shoulder blade is pulled forward by the over active chest muscles, it stretches the opposing muscles causing them to be pulled taught and become underused and weak. 

In the neck this is the cervical flexors, in the shoulders it is the rhomboids and lower trapezius muscles.

This area then has a X shape as in img 2 showing the areas of tightness and weakness.

Upper Cross Syndrome
 [1]Img 2: Janda’s Muscle Imbalance

You will also see in img 3 below that this causes the head to be pulled forward, and for every inch your head is forward, you add roughly 10lbs of pressure to your spine, adding to the discomfort being caused by the tightening of the chest.

[2]Img 3

So when you hear someone say “my back/neck/shoulders is/or tight”, they are most likely not.  They are taught.  Most likely the chest is tight, the chest is the cause, and the chest needs to be released.

So, to Summarise

The main cause of this is poor posture, specifically sitting or standing with the head forward for prolonged periods.

The Cause

Activities that promote this postural position, such as:

  • Computer and laptop use
  • Driving
  • Watching TV
  • Mobile phone browsing, texting, app, or game use
  • Reading
  • Biking
  • In some cases, injury or congenital disabilities may also contribute to the development or creation of the condition.

The Symptoms

Common characteristics of upper crossed syndrome include:

  • The head is consistently or often in a forward position
  • Inward curvature in the portion of the spine containing the neck (increased cervical lordosis)
  • Outward curvature in the part of the spine that includes the upper back, shoulders, and chest (increased thoracic kyphosis)
  • Elevated, protracted, or rounded shoulders, where the muscles are in a continuous state of being pulled or stretched forward
  • The visible portion of the shoulder blade sits out instead of laying flat (scapula winging)
  • The deformed muscles associated with upper cross syndrome put stress on the surrounding muscles, tendons, bones, and joints, causing most people develop symptoms that include:
  • Headache
  • Neck pain
  • Strain in the back of the neck and often a weakness in the front
  • Chest pain and tightness
  • Breathing resctrictions
  • Pain in the upper back, especially the shoulders
  • Sore shoulder blades
  • Pain in the jaws
  • Tiredness
  • Difficulty sitting, reading, and watching TV
  • Driving for more than a short period because of pain or muscle tightness or soreness
  • Restricted range of motion in the neck or shoulders
  • Numbness, tingling, and pain in the upper arms
  • Pain and reduced range of motion in the ribs
  • Lower back pain[3]

How we can help

Soft Tissue treatment is great and recommended option in resolving upper cross syndrome by releasing the chest. 

If you are struggling with any of these symptoms, get in touch with us.  We will do a postural assessment and take a look at treating the cause and offer rehab exercise to help improve the pain and posture long term.