Monday, August 13, 2012

Upper Crossed Syndrome

Ever wonder why some people have a “hunchback” look, with rounded shoulders or a jutting head?  It could be due to Upper Crossed Syndrome (UCS).

What’s so bad about a little hunchback?

Thoracic kyphosis not only means one’s head juts forward in a less than supermodel fashion.  It can also cause loss of tension in the shoulder’s joint capsule.  This means that the rotator cuff then must maintain a constant contraction in order to stabilize the arm--it never gets a break!  And, as we all know, when we don’t get to rest, we get irritable, fatigued, run-down, and, in our rotator cuff’s case, degenerative and prone to malfunction and injuries such as “Supraspinatus Impingement Syndrome,” when we aren't able to raise our arms without pain, exhaustion, and/or weakness.

Why is Poor Posture Inefficient?

Muscles are working hard and requiring more energy when they are tight and contracted, an inevitable downside to poor posture.  To sustain this contraction, muscle fibers require more nutrients, oxygen, and hydration.  If there are trigger points in the muscles causing a constant contraction of the muscle, then these nutrients may not even find their way to the muscle.  The body gets tired quickly and other muscles do their best to chip in and help with the burden.  Pretty soon, a much bigger area of the body is in duress--tired, achy, and grumpy.

Muscles can react to pain or stress in a variety of ways.  They can become overactive, spastic, short (or contracted), tight, inhibited, or weak.  Muscle injury, chronic pain, and inflammation create disturbances in normal muscle function and may stimulate a neurologic-based tightness or weakness in a muscle.  In short, when muscles aren’t feeling like themselves, they can affect us in many ways, including screwing up our posture and afflicting other structures in our body.

As when a runner in motion is burning more energy than someone taking a nap, a contracted muscle is constantly having to work and burn more fuel than a relaxed muscle.  Eventually, if the body can’t keep up providing the muscle what it needs to keep going, the muscle will burn out and atrophy (or die)--as would the runner if she never got to take a nap.

Anatomy of the Upper Crossed Syndrome

Upper Crossed Syndrome (UCS) is characterized by certain muscles being overly contracted (or tight and shortened), and their antagonist (or opposing) muscles being too weak or inhibited.  Looking at the picture, we see that those muscles that are tight vs. muscles that are weak form something of an “X”; thus the name certainly fits!

Muscles that are typically tight and short include the levator scapulae, upper trapezii, sternocleidomastoids, suboccipitals, cervical extensors, and pectoral muscles. 

Weak and inhibited muscles are typically the deep neck flexors, mid/lower trapezii, rhomboids, serratus anterior, supraspinatus, and scalenes (although the latter may also be short and tight).

Postural Signs of UCS include:

What can I do if I have UCS?

Assuming the faulty posture is due to muscle imbalance--as opposed to acute pain compensation, nerve compression, or a more serious, perhaps genetic, medical or structural condition (in which case, please consult your physician or physiatrist)--one of the most essential ways we can correct our alignment is through targeted exercises catered toward strengthening the weak and inhibited muscles and lengthening or stretching the tight and short muscles.  Balance exercises can restore proper function of the proprioceptors as well.  Ideally this is done under the guidance and supervision of a trained and qualified professional.

Massage therapy is an excellent way to get the ball rolling.  Bodywork promotes mobility in the cervical spine and facilitates the release of poor postural habits, including stress and tension that builds in our muscles.  Massage also helps to lengthen and relax short and taut muscles and fascia that pull our bodies into inefficient postures. 

Additionally, certain forms of sports massage or orthopedic massage are designed to assess, tone, strengthen, and stabilize weak and inhibited musculature.  Massage can also help disperse excess fluids, restore proper nutrition, and promote realignment and healing of the collagen fibers in the tissue. 


Paying attention to our posture and doing right by our muscles and body on the whole can go a long way toward correcting or avoiding chronic issues such as Upper Crossed Syndrome, kyphosis, weakness, and pain.

Schedule your massage online today at!

References and further reading 

• Hendrickson, Thomas:  Massage for Orthopedic Conditions. 2008.

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