Symptoms of Upper-Crossing The condition known as Upper Cross Syndrome is explained. Now that we know that poor posture does not directly cause neck and back discomfort but rather contributes to it, we can give a precise definition of upper crossing syndrome. To what extent are you reminded of the stereotypical "poor-looking" posture of office employees and the elderly? That's a pretty classic case of upper crossed syndrome. Shoulder and neck pain may be the result of upper crossed syndrome, which is caused by altered muscle activation in the upper body (Bayattork et al., 2020). Many people who spend their days sitting at a desk complain of aches and pains in their chest (the pectorals) and shoulders (the upper trapezius), which are both regarded to be overworked muscles. But the deep neck flexors (the ones that tuck your chin in) and the lower trapezius will be doing too little effort (ones that put your shoulder blades into your back pockets). When viewed from the side, the "tight" or "overworked" muscles may be seen running down the line that cuts across the upper shoulders and chest, while the "weak" muscles can be seen running along the line that cuts across the face and ends in the middle of the back, hence the "cross" metaphor. There will always be muscles that contract in the opposing direction of a given muscle. Such as the biceps versus the triceps or the quadriceps versus the hamstrings. Furthermore, muscles can be (approximately) separated into tonic and phasic muscle groups based on fibre type. Phasic muscles are involved in movement and are more dynamic than tonic muscles, which are responsible for long-term muscle contractions (thus the name "postural muscles") (Mujawar and Sagar, 2019). For best performance, appearance, and possibly pain reduction, you need a degree of balance between different sorts of muscle groups. To what extent does Upper Crossed Syndrome manifest itself clinically? We have to view upper crossed syndrome as mainly a dysfunction disorder, rather than a disorder of pain. As mentioned before, upper cross syndrome is rarely the primary cause of neck and back pain, but it can in fact, limit optimal function of the neck and shoulder joints (Bayattork et al., 2020). An example of limiting function would be a reduction in the range of motion of the neck and shoulder, so you won’t be able to fully flex your shoulders (reach upwards towards the sky with your arms straight). If upper crossed syndrome does relate to pain, then it acts more like a catalyst for pain rather than the cause, meaning it can exacerbate existing pain The main signs and symptoms are: A forward head posture Hunching of the upper-mid back (thoracic) region Elevated shoulders Protracted (rounding) of the shoulders Reduction in thoracic mobility These signs are a result of muscles groups not working in balance. The tonic muscle groups tend to be the ones that get “tight” and overworked which are: Upper fibres of the trapezius – the big meaty upper shoulder neck muscles Pectorals – these are your main chest muscles Levator scapulae – this is a muscle that raises (or “elevates”) the shoulder blade (or “scapula”) On the other hand, the phasic muscles are the ones that can be “weak” as they are not being activated and not being used which are: Lower and middle fibres of the trapezius – the trapezius muscle is actually very large and extends all the way to your lower back Deep neck flexors – these are the ones that tuck in your chin and helps maintain good looking posture Serratus anterior – also known as the “punching” muscle. It lives between your shoulder blade and the ribcage and can often be seen as a fan-like muscle What are the common causes of Upper Crossed Syndrome? As a principle in musculoskeletal anatomy, structure governs function and vice versa. This means the shape and characteristics of bone, ligaments, muscles, tendons, etc, dictate what it does, and it goes both ways as the function can also influence the shape. This is important as we have to look at the onset of injury, as upper crossed syndrome can result from either a traumatic or non-traumatic cause. More commonly, causes of upper crossed syndrome are normally non-traumatic and develop slowly. This is where the function changes the structures of your body. For example, these could include: Long hours of sitting at the desk Long term use of smartphones Favouring to strengthen the tonic muscle groups e.g. at the gym Neglecting the use of the phasic muscles Essentially, if you expose your body to functions that promote the use of these tonic muscle groups, the more you are going to predispose yourself to upper cross syndrome. In rarer cases, recovery from a traumatic injury can cause upper cross syndrome. Examples include: https://myofitness.com.au/upper-cross-syndrome-ucs/