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Understanding and Alleviating Upper and Lower Crossed Syndrome

During treatment many of you may ask, why are you treating and focusing on my chest muscles (pec major and minor) and my neck when my upper back is tight and sore? Although you may not be familiar with the term Upper Crossed Syndrome (UCS), it is highly likely that you may suffer from it or have come across people who have it.

What is Upper Crossed Syndrome?

UCS is described as a muscle imbalance pattern located at the head and shoulder regions. The muscles of the human body are interconnected. When one muscle becomes weak, another muscle takes over the work. This can lead to postural changes and movement dysfunction.

The main features of UCS are rounded shoulders, a forward head and an evident curve in the neck and upper back, elevated and protracted shoulders often referred to as scapula winging.

UCS is one of the most common postural issues. Individuals who work at a desk or who sit for a majority of the day and continuously exhibit poor posture. Teenagers, the elderly and even athletes can suffer from UCS.

What Muscles are involved? From a musculoskeletal perspective, UCS results when there is tightness of the upper back (trapezius), neck (levator scapulae) and chest (pectoralis major and minor) muscles. This is accompanied by muscle weakness in the neck (deep cervical flexors) and the back (middle lower trapezius).

This pattern of imbalance can also result in joint dysfunction and skeletal issues in the head, neck, cervical and thoracic segments of the spine and at the shoulder (glenohumeral joint).

The stability and integrity of the shoulder, which is a freely moving ball and socket joint, can be compromised by UCS. It is this reduction in stability of the shoulder that requires the muscles of the neck and upper back (levator scapulae and upper trapezius) to work harder to keep the shoulder centered.

What are the Symptoms of Upper Crossed Syndrome?

The compromised and unfavorable posture evident in UCS results in added stress to the structure and tissues surrounding the shoulders. This stress can manifest as: active trigger points, neck pain, jaw pain, upper chest pain, shoulder pain and strains as well as an increased incidence of headaches and migraines.The pain can be burning or aching in nature, neural (pins and needles), or refer to the arms.

What is Lower Crossed Syndrome?

Lower Crossed Syndrome (LCS) is described as a muscle imbalance pattern located in the lower part of the body.

LCS can be the result of prolonged sitting, particularly with bad posture, physical inactivity, uneven sports activities, poor exercise technique and imbalanced strength training. Genetic predisposition may also play a role.

What Muscles are involved?

From a musculoskeletal perspective, LCS occurs when there is tightness of the hip flexors (Iliopsoas and tensor fasciae latae) and lower back (thoracolumbar extensors such as erector spinae, multifidus, quadratus lumborum and latissimus dorsi). The hamstrings are also frequently found to be tight in LCS. This is accompanied by muscle weakness in the abdominals (rectus and transverse abdominus and the oblique’s) and all of the gluteal muscles (particularly gluteus maximus).

This pattern of imbalance can give rise to joint dysfunction and skeletal issues in the lower back (particularly L4-L5 and L5-S1 segments), the sacroiliac joint and the hip joint).

What are the Symptoms of Lower Crossed Syndrome?

The symptoms of LCS can include lower back pain, hip pain, knee pain or hyperextension. Like UCS, the pain can vary markedly from person to person.

What can be done?

If you have Upper or Lower Crossed Syndrome, initially it is important to stretch what is tight, and considered short, and then work on strengthening what is weak.

How can Crossed Syndrome be Treated? Integrative treatment is most effective and can include:

· Massage Therapy and Acupuncture for Myofascial Release;

· A Stretching, Strengthening and Stabilization Program via a Physical Therapist;

· Postural, Functional or Sensorimotor Training;

· Range of Motion Exercises

· Chiropractic Care and Joint Mobilization;

· Attending Yoga or Pilates Classes may also be beneficial.

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