Upper Crossed Syndrome: A pain in the neck!


Upper Crossed Syndrome (UCS) is a condition caused by muscle imbalance around the head, neck and shoulders. It is most commonly suffered by desk workers, students and drivers.

The muscles that attach to the back of the skull (upper trapezius, levator scapulae and sub occipitals) are overactive and tight from holding the head up for prolonged periods

The same happens to the pectoral muscles (pectoralis major, pectoralis minor and sternocleidomastoid) on the front of the chest.

Weakened deep neck flexors and lower trapezius muscles (used in rowing and swimming) result in a hunched posture where the chin protrudes, the shoulder blades move upwards and around the body and the neck seems to be pointing upwards and forwards.

UCS doesn’t just happen overnight. It is usually the result of many hours sitting without participating in exercise or activity. It is like holding your arm out in front of your body for twenty minutes. Not seriously dangerous, but the muscles fatigue easily and then pain lingers long after lowering the arm. The head weighs about five kilograms and holding it out in front of the body for hours (especially in sitting) puts strains on everything from the hips up.

People generally notice a gradual onset of neck pain and upper back pain followed by shoulder pain or even headaches. UCS is often misdiagnosed by doctors as migraines and strong medication is prescribed to block pain messages getting to the brain. If medication is ceased and the pain returns relatively quickly then it is probably posture related. It is always better to treat the cause than the symptoms.

Combatting UCS: what to try

Posture correction:

Have a friend take a photo of you from side on when you are sitting/working. Ideally, your earhole should be vertically over the middle of the shoulder and the hip. The back of the neck should almost be vertical. Adjusting the height of your desk chair can make a huge difference. Most people have their chair too high and end up leaning forwards to get to the right height to see their monitor or laptop.

Stretching and massage: 

Regular stretching of the neck and pectoral muscles (2 minutes every 2 hours) will help prevent chronic muscle shortening. While seated, place a tennis ball between your shoulder blades and the back of a chair to massage tight muscles. It also helps you identify where the stiff and tight areas are. Ensure that your forearms are almost fully supported by the desk. Having only your wrists on the desk means you needing to support the weight of both arms with your muscles and tight trapezius muscles.

A brisk 5 minute walk for every 4 hours sitting would be helpful. Stand as tall as possible and take strides that are 2-3 inches longer than you normally would feel comfortable doing.

Buy a foam roller and increase the amount of thoracic extension you can achieve by arching over the top of it for 30 seconds while breathing normally. Use your hands to support the weight of the head.

If you are a gym user, then focus on muscles that help pull the shoulder blades back. The rowing machine and lat pull down exercise is perfect to strengthen the lower trapezius muscles. Performing press-ups, sit ups and shoulder shrugs only reinforces the patterns of overactive muscles.

If pain on one side of the neck, shoulder or head persists for more than 2 days, it is worth contacting a physiotherapist for an accurate diagnosis and treatment plan.

START Clinic is open to all staff, students and members of the public. Please visit www.startclinic.co.uk for contact details or call 0133 462 190 to book an appointment.



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