Upper Crossed Syndrome – A foundation for failure

Posture follows movement like a shadow

Are you being double crossed by your posture? There is a chronic condition called Upper Crossed Syndrome (USC) which is expressed by the rounding of shoulders, forward chin poke of the head.  Mostly seen with elderly, but with an accelerated escalation of sedentary lifestyles and work environments, it has become a common sight for all ages.

Upper Crossed Syndrome Anatomy

The position of your head and shoulder is orchestrated by various opposing forces. These muscle balance forces vary depending on the positions we regularly find ourselves in. With UCS there is usually a weakness of the deep neck flexors and overactive/tightness of the upper traps and levator scapulae. This causes a forward head position with a hinge point at the lower cervical spine.

Lower down with weakness of rhomboids and lower traps, matched with overactive/tight pectoralis major and minor causes a rounding of the shoulders.Posture

The muscle imbalance can affect multiple joint levels of the spine, the glenohumeral joint, the acromioclavicular joint and scapulothoracic joint. These might all lead to dysfunctions and result in injury.

How does this impact me?

Well that depends on how you live your life. This is a chronic condition that affects multiple joints and progressively over years they become stiff or weak. This closes the window on living an active lifestyle and increases risk of injury.

With less mobility and stability, comes greater risk to injury. 

This is typical with most office workers, students or driver’s. Their neuromuscular system has adapted to the UCS shape for years. But the injury risk increases when activity and movement levels are pushed higher than normal, for example overhead lifting, throwing sports or freestyle swimming that requires a wider overhead range of movement and ends up putting undue stress on the upper body.

Have you got the following?

  • Chin Poke: Is your head sticking so far out it’s at risk of falling off! Next time you stop at traffic lights take a look at the other drivers posture, it’s common to see the drivers head stuck at least 12 inches from the head rest.
  • Rounding of the Shoulders: Due to a weakness of scapula retractors, the lower traps and rhomboids, the super tight Pec muscles draw the shoulders forwards. Look at overly developed bodybuilders for a great example of rounded shoulders.
  • Winging scapula: When the scapula lifts away from the wall of the rib cage, it’s usually the result of a muscle imbalance. This might take a friend to spot this one for you.
  • Creasing in the neck: It’s the last places you want to see a crease. At the base of the neck and accompanied by the start of a hump in the thoracic spine.

Change starts now – How do I get there?

Expecting to do an overhead squat or chest to bar pull up straight away might be unrealistic if you’ve spent years holding a UCS posture. But there are ways of getting there…

  • Scaling the new movement that your practicing and working within the ranges that your body allows. Giving the joints time to adapt, without risking injury.
  • Working on individual muscles that developed the weakness and tightness over the years. This requires specific strengthening and stretching exercises.
  • Muscle tightness in your neck and chest may benefit from soft tissue work to release the muscle, like massage or dry needling.
  • Correcting form, sometimes we don’t have the body awareness to identify poor technique. Having the coach or physio look at your movement to correct where it’s needed.
  • Change can only be enforced through repetition and habit. The positions you’re in most of the day dictate your posture. At work, in the car, or at home, try to change your posture regularly.

Below are some basic examples of exercises to get you started with organising the shoulder and head. Try following them regularly to give your body the opportunity to change.

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Study: When is bending too much?

Alessa 2017

How long is too long, to be in a forward, bent posture? Many of us spend hours doing house chores; weeding, DIY, working on the car etc. Not to mention the time spent leaning over a computer desk or looking down at your phone.

Back pain

Your muscles play an amazing role of suspending us in these positions, but just like with exercise our muscles will reach a point of fatigue. When the postural muscles aren’t able to provide the support we then rely on “passive” structures like ligaments and fascia, which is not their primary role, eventually leading stress and increased risk of injury.

This study looked at 2 angles of the spine leaning forwards and found that within 40 seconds the participants transitioned from the support of postural muscles to the passive structures. While this was found to be a natural transition the prolonged strain on the passive structures has been shown to increase the risk of lower back pain as suggested in another study.

As mentioned in a previous blog, these positions are not “wrong” but it’s better for the overall health of the spine to regularly change position and break from sustained load on an individual structure to provide balance.

Abstract

Static trunk bending is an occupational risk factor for lower back pain (LBP). When assessing relative short duration trunk bending tasks, existing studies mostly assumed unchanged spine biomechanical responses during task performance. The purpose of the current study was to assess the biomechanical changes of lumbar spine during the performance of relatively short duration, sustained trunk bending tasks. Fifteen participants performed 40-s static trunk bending tasks in two different trunk angles (30° or 60°) with two different hand load levels (0 or 6.8 kg). Results of the current study revealed significantly increased lumbar flexion and lumbar passive moment during the 40 s of trunk bending. Significantly reduced lumbar and abdominal muscle activities were also observed in most conditions. These findings suggest that, during the performance of short duration, static trunk bending tasks, a shift of loading from lumbar active tissues to passive tissues occurs naturally. This mechanism is beneficial in reducing the accumulation of lumbar muscle fatigue; however, lumbar passive tissue creep could be introduced due to prolonged or repetitive exposure.

 

Alessaa F. et al (2017) Changes of lumbar posture and tissue loading during static trunk bending. Human Movement Science

Read moreStudy: When is bending too much?

Neck Pain

In New Zealand neck pain is a growing problem due to a more sedentary lifestyle. They can be tricky injuries to recover from. Take a look at how physio can help.

The Office WOD

The office WOD

Do your best when no one is looking. If you do that, then you can be successful at anything that you put your mind to. Following up from last weeks piece about SITTING POSTURE. It’s not about holding the perfect posture. Whats more important is changing position regularly, adding variation. Holding postures long enough results in …

Read moreThe Office WOD