Upper Crossed Syndrome or upper extremity postural distortion is a very common postural deviation in many business professionals that I see regularly at my studio. A combination of sitting at a desk with knees and hips flexed, and having to type on a computer with hands pronated, shoulders protracted, head forward and cervical spine flexed leads to predictable muscle imbalances that over time alter normal body alignment and lead to postural deviations that cause functional inefficiency of the kinetic chain. These inefficiencies lead to altered joint alignment initiating the cumulative injury cycle and leading to pain and injury. Some of these individuals aren’t even aware that they have an imbalance at all. These clients are my favorite; I can help correct them before they have to endure further pain or injury due to fixable problems.
The treatment plan for upper crossed syndrome, like most muscle imbalances, can by oversimplified into one sentence. Lengthen the short areas and strengthen the weak areas. In the case of upper crossed syndrome the short areas on the anterior side are the pectoralis major and minor, anterior deltoid and stenocleidomastoid. Posteriorly you will find levator scapulae, teres major, and upper trapezius tightness along with tightness in the subscapularis, latissimus dorsi and teres major. The scalene muscles may also be tight which can cause compression of the cervical plexus and present with symptoms of thoracic outlet syndrome. These people will present with protraction of the shoulders, elevation of the shoulder blades with forward protrusion of the head and internal rotation of the humerus. These postural deviations can lead to rotator cuff impingement, shoulder instability and even headaches.
These tight muscles can be addressed by doing side neck static stretches (for the scalene and sternocleidomastoid), upper trap (and levator) static stretches, pectoral stretches (which address the anterior deltoid as well), latissimus dorsi static stretches and myofascial release (which will address teres major and subscapularis).
Upper crossed syndrome also presents with “lengthened” or weak muscles that need to be strengthened. Before attacking these areas it is notable to mention that these muscles usually suffer from decreased neural activation, so neuromuscular activation training should precede weight bearing activities. You can’t stabilize what you can’t neutrally control. Once able to consciously activate, weight bearing exercises focusing on the rhomboids (seated rows with elbows up and shoulders down), lower trapezius (low rows), serratus anterior (shoulder protraction from the push up position), posterior deltoid, teres minor and infraspinatus (rear deltoid flies, external shoulder rotations) should proceed. The exercises given are just examples; there are many varying exercises, devices, and methods that can be employed.
In summary, if you are in anything other than the anatomical position, you are muscularly imbalanced. Given enough time those imbalances can impinge on structure which can alter function leading to pain and injury. Treatment begins with awareness that we are all imbalanced to some degree, and education on how to address your body so that it can return into a more normal balanced state.
Shoulder Protractio
Tags: corrective exercise, pain syndromes, postural deviation, shoulder protraction
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Matt Trudo wrote on August 18, 2010 at 12:34 pm
You can click on the RSS feed on the post page. Also, you can join us on our website at http://www.xfactorfitnesssolutions.com/blog
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Cecille Edgeworth wrote on August 4, 2010 at 1:42 am
My buddy and I have been just talking over this subject, she is always wanting to prove me wrong! I am about to show her this particular write-up and rub it in a little!
Matt Trudo wrote on August 4, 2010 at 5:24 pm
Interesting. What in particular were you discussing about upper crossed syndrome. I would love to clear any areas of misunderstanding up.
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Matt Trudo wrote on July 29, 2010 at 9:56 am
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Matt Trudo wrote on July 20, 2010 at 12:14 pm
I usually do not recommend diet’s as they usually incorporate either unhealthy practices or unmaintainable ones. In order to lose weight and keep it off it is more about finding out how many calories your body is burning (your daily caloric burn), then eating just under that caloric need (between 500-800 calories under). The key is in doing that while maintaining a healthy macronutrient ratio (I like a 50/30/20 ratio) of healthy nutrient dense low glycemic foods. It is a bit of an art and a science, the key is in knowing your numbers and consistently following them. If you need further help on developing a meal plan (as opposed to a diet) just give us a call, we are here to help.
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David wrote on June 23, 2010 at 7:47 am
Barbell chest press is the most overrated exercise. Dumbbell presses are far more effective in building muscle. Flat, incline or decline. Add dumbbell flies and dipping and you have a simple, yet very effictive, total chest workout. I can recommend the following article
http://www.tmuscle.com/free_online_article/sports_body_training_performance/best_of_chest
Regards,
D. Smith
Matt Trudo wrote on June 23, 2010 at 9:55 am
Mr. Smith,
You aren’t wrong that dumbells are an excellant equipment choice for many exercises. There are a few issues that one must remember when developing a workout. The first thing is are the muscles being worked balanced. If one tries to apply an unstable exercise to a muscle group that lacks balance, the risk for injury is much higher. Sometimes a base of strength and balance is required in order to strengthen weak muscles in antagonistic muscle groups. Another issue that must be considered is muscle adaptation. If all one does is dumbell exercises, every week, the muscles will adapt progression will be limited. It is good to incorporate different ways of doing the same things so that the muscles are challanged in different ways. In saying this, dumbells are an excellent equipment choice and my personal favorite. One must be careful not to make general rules about what is “the best” before knowing the nature of the client being worked with.
Continued success in your training and thank you for your voice,
Matt Trudo, BSN, NASM, MFS
Carol Nave wrote on September 19, 2009 at 1:14 pm
I suffered with this syndrome badly when I first started working out with you. It was, most likely, from sitting at an instrument for many hours at a time, and bending forward. My neck and shoulders were tight, and I had pain in many spots in my body. The workouts really changed everything. Thanks for applying what you know to help people who are hurting!