Do you slouch?  Do you have neck or upper back pain?  Do you work at a computer or desk for most of the day?

Unfortunately, most people do work at a desk most of the day.  This will often lead to muscular imbalances in the upper back, neck, shoulders and torso, creating what is known as “Upper Cross Syndrome”.   If left imbalanced, this poor posture will eventually lead to a painful adaptation in biomechanics, earlier degeneration of joints, muscle tension or an injury.   I often see this condition in my office, as patients present to our clinic with upper back pain, shoulder tension, headaches and neck pain.  If left untreated, it may progress into a more serious longterm condition which is harder to fix.  Try to recognize this condition early in anyone who sits for a living to prevent it’s more serious consequences.

Upper Cross Syndrome:

What is upper cross syndrome, and how can you prevent this abnormal looking posture?   This article will attempt to explain what causes this condition as well as how to prevent it.

Upper Cross Syndrome is characterized by the development of muscle imbalances in the chest, back and neck regions. It is referred to as Upper Cross Syndrome by physical therapists but most recognize it as a slouched posture with a rounded upper back and forward-leaning head.  The problem is caused because people are unaware of their incorrect posture, or simply not strong enough to hold their upper body in proper alignment while sitting and standing during daily activities.   Thus this very common issue is completely preventable.

The body is particularly proficient at adapting to the stresses and demands you create for it. Holding a slumped shoulder posture over long periods of time causes the pectoral (chest) muscles to shorten and become immobile and tight. As the body is one harmonized system, this causes the opposing muscles to compensate. The upper back muscles become elongated and weaken resulting in a forward hunch of the upper body. The fix for this condition therefore is to strengthen the weaker muscles of the upper back, and lengthen the shortened muscles of the front.  But before we get to the fix, we should address the cause of the problem in the first place, and that is usually your posture.

Today, we live in a of a sedentary society where it is common for people to sit 10-12 hours a day, if not more.   When sitting for these lengthy times, poor work ergonomics will be the leading contributing factor towards this syndrome. Changing work ergonomics for prevention is cheap and easy.  Take these simple steps to change your work environment and prevent this painful condition.

The top of the computer monitor should be at eye level and the computer screen should be an arm’s length away from you. You should sit with your knees at 90 degrees and feet flat on the floor in a supportive chair that allows you sit slightly inclined at 100-110 degrees. The seat should keep your spine in neutral position and have lumbar support. If your chair does not have lumbar back support you can roll up a small towel and place it in the small of your back so you attain natural spine curvature.  I will always tell my patients though, that even with the best posture, your body wasn’t meant to sit 10 hours a day.

Try and get up frequently from the desk, you are better off getting up more frequently for shorter breaks then getting up for a long break less frequently.. Studies show the actual limit to biomechanical changes from sitting is actually 20-30 minutes, therefore try and get up for 1 minute every 20 to 30 minutes of sitting.  Get a glass of water, take a short walk around the office or a quick washroom break.  Again, frequent short breaks are better then fewer long breaks. The accumulation of small postural practices will yield in the prevention and reverse symptoms of Upper Cross Syndrome.

Stretch!!!

In terms of treating the muscular imbalances associated with this postural dysfunction, it is essential to utilize stretching as part of a daily routine, and strengthening the weakened areas several times a week.   Stretches should be held for 15-30 seconds and gradually be deepened to prevent the tightening of muscles. Try the stretching exercises on work breaks.

The muscles to target are the pectoral muscles, which are simply stretched using a doorframe,  Hold onto a doorframe with your elbow at 90 degrees, and slowly turn away from the frame so that you feel a pull in the front of the shoulder.  Next try an overhead doorframe stretch, where you hold onto the top of the door frame, with the arm slightly bent at the elbow, and take a half step thru the doorway to feel the stretch again in the front of the shoulder.

For the neck, sit tall and rotate your head as far to one side as you can, use your hand on the same side to pull it a little further, while placing the other hand on top of your collerbone and pull down.  The muscle your are trying to stretch here is on the front and side of the neck.  Obviously, you want to repeat to both sides.

For the upper back, the best way to stretch the upper back muscles is with a physio ball or foam roller.  With your feet planted on the floor, roll your upper back over the ball or roller and pause with it directly under the shoulder blades.  Allow the arms to drop or hang to the side, and allow gravity to pull and lengthen the chest and shoulders.

Strengthen!!!

To correct the weak upper back, you can target the area with some reverse flyes with light weights or bands, some seated rowing with trying to bring the shoulder blades together while maintaining an upright posture, or a back extension/superman exercise on a ball.  The keys is to feel the contraction in the upper back as you draw the shoulder blades down and together.  Always aim for doing 10-15 reps with a slow controlled contraction.

In essence, as it takes time to accumulate poor posture and Upper Cross Syndrome, it also takes time to reverse the effects. Daily stretching and strengthening exercises counteract the effects of gravity and a slouched posture. Mainly the sedentary populations who spend hours sitting at computers are affected by this epidemic. It is important to take proactive care of your body before a lifetime of muscle imbalances manifests and you find yourself making a trip to a chiropractor or therapist for a painful injury.

By: Dr. Peter Pain