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.

Read moreUpper Crossed Syndrome – A foundation for failure

Understanding your Nervous System

You can’t control the wind, but you can adjust your sails

Our nervous system has a connection to all structures in the body. Without a healthy working nervous system most bodily functions suffer, our performance in life situations and sport are hindered and recovery from injury is impacted.

The Nervous system

Part of our central nervous system, within our subconscious is a mechanism for handling stressful situations. This is called the Autonomic Nervous system. It branches into two parts; the Sympathetic NS (SNS) and Parasympathetic NS (PNS). The SNS stimulates the bodily functions preparing us for the “fight, flight or freeze” in life threatening situations. The PNS is the other branch that prepares us for “rest, digest and heal”. It’s the PNS that should be the primary driver of our physiology.

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Using the mailman and dog as an example. Most canines are territorial and when unknown visitors arrive they become defensive, will bark and jump at the door. It’s ready to fight. When the postman leaves, the dog quickly forgets what happened and is able to fall asleep within minutes. It recognises the threat has gone and can immediately relax.

Consider yourself in the same situation, feeling threatened of an intruder. You might shout at them to leave or prepare to engage with them. When the person retreats could you relax straight away or will you be on edge for hours or even days?

The SNS is important but only has a purpose for the short term, to allow us to deal with threatening situations. Unfortunately with hectic lives, our brain interprets these physical and mental stresses as life threatening, which frequently triggers the SNS on a daily basis. Constantly stimulating SNS can lead to chronic issues…

  • Anxiety
  • Fatigue
  • Irritability
  • Sleep disorder
  • Non-working muscular tension
  • Hyperventilation
  • Adaptation failure
  • Cognitive dysfunction

The brain struggles to identify physical stress’ and imagined stress’. Anxiety of an electricity bill, job cuts at work or relationship issues will fire up the SNS.

Throughout exercise/sport our PNS and SNS working in balance. Depending on particular stressors like speed, distance, duration, the SNS may start to have a greater influence. It’s important to get into our PNS state for improved decision making, better oxygen delivery and for achieving optimal recovery.

Ways of Activating the Parasympathetic Nervous System

The PNS is the system we should be using most frequently . Therefore finding methods of staying in this state even when put under perceived levels of stress are important.

1. Breathing Mechanics

The way we breath has a deep connection to the autonomic nervous system. Shallow, apical breathing has a direct link to our SNS. But taking Deep diaphragmatic breaths stimulates the PNS. Using breathing exercises daily can help train you into a more relaxed state.  Methods such as….

Wim Hof Method

Apnea Breathing

Kapalbhati Breathing

2. Meditation Practices

Through channeling your thoughts and breathing, meditation can help induce a state of relaxation. Following this 5-10 minutes daily can help improve many different functions. Easy to use apps for this are…

Head Space

Wildflowers

                      SoundCloud – Mindfulness Works

3. Muscle relaxation

Using methods like meditation or yoga are ways of achieving muscle relaxation. Having massages and soaking in a hot bath also offers a way of relaxing muscles. The release of tight muscles indirectly sends signals to the brain to activate the PNS and switch off the SNS.

Read moreUnderstanding your Nervous System

Lunge Hip Mobility

This is the second part of the hip series. These hip shapes are positions that we should all be striving for to have confidence and feel safe to function if exposed to complex positions. 

Following on from the blog hip opener for the hinge shape is our next hip position we should try to achieve. The lunge shape is full extension and internal rotation of the hip with the knee positioned behind the hip and foot pointing forwards. This shape is most seen in lifters doing split jerks, kicking a football, ball throwing. But most commonly seeing this lack of range with runners, not utilising the full hip extension in the push off at the end of stance phase.

Over the years adaptive changes happen either through injury or more with positions we adhere to. The most common being sitting, which results in anterior structures of the hip becoming limited. Lacking the end range of this movement could mean we’re selling our self short of momentum, power or endurance.

Running-lunge

Using the picture of long distance runner Mo Farah, he demonstrates a great lunge shape at the hip. While maintaining a neutral spine he manages to reach full hip extension and toes are pointed forwards, maintaining the internal rotation of the hip. Lacking hip extension can compromise running form of the upper limb and spine. But as you can see he reaches a good press shape of the opposite shoulder in the arm swing making his running style extremely efficient and balanced.

Below are a series of stretches and mobility exercises to help improve your lunge shape.

Couch stretch

If hip flexors are tight this is one of the best stretches for improving length back. A long sustained hold of this stretch with full diaphragmatic breathing over 2 minutes is extremely effective.

COUCH STRETCH ❌ There are few better exercises to open the hip flexors than the couch stretch. It's not everyone's favourite but it's effective. ❌Take one leg up the wall or box so your shin is resting on it and the knee is on the floor. If you don't already feel the quads stretch. Take the opposite foot through. While keeping the abdominals and gluteus tight, gently push the hip forwards. Hold this stretch for up to 2 minutes. #fundamentalPhysio #physio #physiotherapist #physiotherapy #crossfitnewmarket #crossfit #gym #fitness #squat #hiphinge #lunges #auckland #newmarketnz #mobility #mobilitywod #flexiblehips #strongerhips #injuryprevention #athelete #rehab #sprints #boxjumps #football #basketball #hipflexors #running

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Illiopsoas Trigger Point Release

This muscle sits within the abdominal cavity and if tight it will feel sore with pressure through the abdominal wall towards the muscle. At first the pain can be quite high but relaxing into the pressure overtime the pain subsides and will feel looser once released. Aim for 1-2 minutes hold.

Hip flexor stretch (with band)

Another hip flexor stretch with a joint mobilisation using a band. Position the knee behind the hip. Allow the band to pull the hip forwards, contract the glutes to get the best anterior hip stretch.

Quads and inner thigh release with LaX ball

A lacrosse ball is a great tool for isolating sections of tight muscle. Rolling on the ball like you would a foam roller will be more effective, if tolerated. Then opening up inner thigh/hip adductors using the kettle bell handle. The knee flexion/extension stretches the muscle through range while being tacked down.

Suspended split stretch

This is for the more adventurous. It will help your lunge go deeper while increase stretch through the hamstrings. Throughout this movement, it is important to keep the glutes switched on to avoid hanging of the hip capsules. Spend around a minute each direction.

Read moreLunge Hip Mobility

Hip Opener for Hinge Shapes

Many lifting injuries result from a lack of movement awareness and weakness of the posterior muscles. The hip hinge is a foundational movement for so many actions like deadlifts, squats, sprinting, jumping. Lacking an effective hip hinge is like racing a formula 1 car on flat tyres.

Developing a good hip hinge will improve the strength of the posterior chain. This includes muscles like the glutes, hamstrings and back extensors. The hinge movement is primarily coming from the hip. The goal is to maintain a neutral spine throughout the movement, the hips start to bend with your butt moving backwards and minimal flexion in the knee. This will increase the tension on the hamstrings and glutes.

The majority of people find this pattern of movement unnatural, as it’s rarely practiced and in most cases, are quad dominant. This quad dominant pattern causes weight to be distributed anteriorly, which is fine with some activities, but most actions we need to be more engaged with our posterior chain.

hip hinge movements.jpg

 

Below are a series of stretches and strengthening exercises to help Improve your hip hinging abilities.

Weighted Hip Hinge

This exercises is a great way to warm up and encourage the hip back movement while fighting the resistance to maintain a neutral spine.

WEIGHTED HIP HINGE ❌ Practising your hip hinge, can be difficult to maintain position through range. Using a weight on the mid back can encourage more activity from your back extensors. This is a good war up technique if you've programmed some deadlifts or back squats ❌ Place the weight on your mid back. While maintaining the neutral spine, take your hips back, build up tension in the hamstrings, then bend your knee. Keep the knee track over your ankles. Repeat this movement over 10reps 2-3sets. #fundamentalPhysio #physio #physiotherapist #physiotherapy #crossfitnewmarket #crossfit #gym #fitness #squat #hiphinge #auckland #newmarketnz #mobility #mobilitywod #flexiblehips #strongerhips #injuryprevention #athelete #rehab #deadlifts #sprints #boxjumps #stronghamstrings

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Banded Hip Distractions

These two movements are also great for warming up. Both encourage release of the hamstrings but also the band provides a traction force on the hip socket. This should allow the joint to move free’er and help you access more range in the joint.

BANDED HIP DISTRACTION❌ Using a resistance band to distract the hip from its socket is a great mobility technique to do before training. Helping you access more range in the joint without risking impingment ❌ This will help with your hip hinge making deadlifts and squats feel easier ❌ With the band up in your hip crease and pulling from behind. Go onto your hands and knees, find your neutral spine. Maintain the spinal position while moving your hips backwards and then forwards. Repeat this movement on each leg for 1-2 minutes. #fundamentalPhysio #physio #physiotherapist #physiotherapy #crossfitnewmarket #crossfit #gym #fitness #squat #hiphinge #auckland #newmarketnz #mobility #mobilitywod #flexiblehips #strongerhips #injuryprevention #athelete #rehab #deadlifts #sprints #boxjumps

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Banded Hip Hinge ❌ Achieving a good hip hinge with help you out in so many activities. It's particularly important for lifting activities and minimising stress to the spine ❌ Using the band is a great way of assisting the movement, as well as providing a capsule distraction on the hip joint. Allowing you to access greater ranges within the joint safely ❌ For this movement, get the band up close into the groin, with the same leg step out in front. Maintain a neutral spine and bend forwards to wind up the tension on the hamstring. From this point gently straighten and bend the knee to give you hamstrings a stretch. Repeat the process 1-2 minutes on each leg ❌ This is a particularly good movement to do before training. #fundamentalPhysio #physio #physiotherapist #physiotherapy #crossfitnewmarket #crossfit #gym #fitness #squat #hiphinge #auckland #newmarketnz #mobility #mobilitywod #flexiblehips #strongerhips #injuryprevention #athelete #rehab #deadlifts #sprints #boxjumps

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Dynamic Hamstring stretch

This is a deeper stretch of the hamstrings. Having more flexibility here will help you hinge better at the hip which will off load the knees.

SPLIT HAMSTRING STRETCH ❌ The dynamic stretch works deep into the hamstrings. Providing more range for the muscle will help you with a stronger hip hinge, which will improve performance with so many activities, not just for lifting ❌Close to a wall go into this split position, try to get your heel close to the wall. The loop your arm under the front leg and hold the opposite forearm. Now contract your quads and push against the arm underneath. Repeat this hold-relax for 1-2 minutes. #fundamentalPhysio #physio #physiotherapist #physiotherapy #crossfitnewmarket #crossfit #gym #fitness #squat #hiphinge #auckland #newmarketnz #mobility #mobilitywod #flexiblehips #strongerhips #injuryprevention #athelete #rehab #deadlifts #sprints #boxjumps #football #basketball #hamstrings

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Jefferson Curl

This movement is a great way of developing movement segmentally and will help build strength when maintaining a stable spine. It’s important to note if you have a spinal injury to avoid this movement until you have gone through the appropriate phases of rehab.

JEFFERSON CURL ❌ with this movement it breaks the tradition of holding a rigid neutral spine. It teaches you moving the spine sequentially under control. This will help improve the strength of those static nutral positions, like when doing the hip hinge ❌ Standing on a block, hold the kettlebell. From your neck down begin to CURL, eventually bending at the hips, keep the knees straight. You will feel the hamstrings stretch. At the bottom breath out and relax into the stretch more. Then again breath in and then start straightening through the hips, then stacking the segments of the spine until you ware standing straight again. Repeat 5-6 times 2-3 sets ❌ This one comes with a prepackaged warning, anyone with a back injury should avoid this. Anyone with back injury history should approach it carefully. #fundamentalPhysio #physio #physiotherapist #physiotherapy #crossfitnewmarket #crossfit #gym #fitness #squat #hiphinge #auckland #newmarketnz #mobility #mobilitywod #flexiblehips #strongerhips #injuryprevention #athelete #rehab #deadlifts #sprints #boxjumps

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Read moreHip Opener for Hinge Shapes