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Dr. Krutika Surana

Upper Cross Syndrome

Updated: Mar 15, 2023



The upper cross syndrome is characterized by distorted muscles in the shoulders, neck, and chest.

The back muscles of the neck and shoulders, in particular (the upper trapezius and levator scapula), become very hyperactive and tight. The muscles at the front of the chest (the major and minor pecs) shorten and tighten.

The surrounding counter muscles become underutilized and weaker as a result of these hyperactive muscles. Upper crossing syndrome is characterized by weak muscles at the front of the neck (cervical flexor muscles) and lower shoulders (rhomboid and lower trapezius muscles).

The disease is named after the "x" shape formed when hyperactive and underactive muscle areas meet.


Causes

Upper crossing syndrome can be caused by a variety of motions, but the majority of instances are caused by bad posture, notably extended sitting or standing with the head forward.


These are some of the activities that encourage this posture:

  • Driving

  • computer and a laptop use

  • watching TV for a prolonged time

  • excessive mobile use

  • gaming

  • reading

  • riding a bike

Injury or congenital limitations may also play a role in the development or emergence of the illness in some situations.


Symptoms


Common characteristics of upper crossed syndrome include:

  • the head is consistently or often in a forward position

  • inward curvature in the portion of the spine containing the neck (increased cervical lordosis)

  • outward curvature in the part of the spine that includes the upper back, shoulders, and chest (increased thoracic kyphosis)

  • elevated, protracted, or rounded shoulders, where the muscles are in a continuous state of being pulled or stretched forward

  • the visible portion of the shoulder blade sits out instead of lying flat (scapular winging)

Upper cross syndrome's distorted muscles place stress on the surrounding muscles, tendons, bones, and joints, causing most people to suffer symptoms such as:


  • headache

  • neck pain

  • strain in the back of the neck and frequently a weakness in the front

  • chest pain

  • stiffness pain in the upper back, particularly the shoulders

  • sore shoulder blades

  • pain in the jaws

  • trouble sitting, reading, and watching TV

  • driving for an extended amount of time

  • discomfort muscular stiffness, or soreness

  • limited range of motion in the neck or shoulders

  • numbness, tingling, and pain in the upper arms rib

  • discomfort and restricted range of motion in the lower back

Prevention

Avoiding activities that demand straining the head forward for lengthy periods is the greatest method to prevent and treat upper crossing syndrome.


Other preventative measures include:

  • minimizing time spent watching TV, reading, using laptops and computers, or driving.

  • taking 15-20 minute pauses when seated or engaged in problem-solving activities

  • getting adequate cardiovascular activity, ideally 30 minutes each day of low-impact activities like walking or swimming

  • being aware of and avoiding motions, actions, or activities that aggravate symptoms for as long as discomfort persists

  • practicing stretches for painful muscles in the back, neck, shoulders, and chest

  • exercising to target deficient muscles in the upper front neck and lower shoulders

  • ensuring that the steering wheel, book, TV, or computer screen is at eye level

  • In chairs, use a lumbar roll.

  • When making long phone conversations or transcribing, use a headset.

  • utilizing a single shape-retaining cushion

Treatment


Physiotherapy

Bracing

Cupping

Stretching

Strengthening

Yoga

Posture correction

Electro modalities

Over the counter medications (for pain)



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