Upper Crossed Syndrome: How to Fix It, Treatments and Corrective Exercises to Try

Upper crossed syndrome is one of the most common patterns of muscle imbalance in the upper body.

It doesn’t take too long to know if you or someone else suffers from it. Common signs include a rounding of the upper back and shoulders, accompanied with the head moving into a forward position.

The most common culprit of this condition is the hunched-over posture adopted by individuals who sit at a desk for prolonged periods of time.

If you have this type of posture or feel you are slowly developing it, it is important to fix this issue right away. Not only is it an undesirable look to have, but it can also affect your over well-being and health.

In this post, we’ll explain what upper crossed syndrome is, how it develops, and what you can do to prevent it.

We’ll also provide you with a few simple exercises that can be done at home to correct upper crossed syndrome.

What is Upper Crossed Syndrome?

The common muscle imbalance known as upper crossed syndrome (UCS) was first identified by Dr. Vladimir Janda, a Czech physician and physiatrist who set out to understand the body’s predictable pattern of muscular compensation a postural imbalance.

Janda’s research suggests that a poor postural base leads to faulty patterns of movement that contribute to overuse of isolated joints while limiting range of movement in others, thereby creating a continuous cycle of dysfunction and injury.

We’ll look at the affected muscle groups of Upper Crossed Syndrome in a later section.

Symptoms of Upper Crossed Syndrome 

The most obvious symptoms of upper crossed syndrome are hunched shoulders and a forward head posture.

These postural changes are often accompanied by pain or stiffness in the neck, shoulders, and upper back.

Other common symptoms of upper crossed syndrome are:

  • Neck strain
  • Jaw pain
  • Shoulder impingement
  • Lower back pain
  • Breathing problems
  • Fatigue
  • Decreased stability or movement of the shoulder joint
  • Tingling or numbness in the arms, hands, and fingers

If not corrected, upper crossed syndrome can lead to secondary health issues like cervicogenic headaches, myofascial trigger points, and even reduced lung capacity.

Upper Crossed Syndrome can also cause damage to the spine if left untreated – specifically in the CTK to CTK segment of the upper back and the T4 to T5 segment in the mid back.

How Does Upper Crossed Syndrome Develop?

Upper crossed syndrome is caused by several factors, including repetitive motions and injury to the joints and muscles in the neck, shoulder, and mid back.

One of the most common causes of upper crossed syndrome, however, is the poor posture that is often adopted by individuals who sit at a desk for long periods of time.

When you sit for long periods of time your body begins to adapt to these unhealthy positions which cause muscle imbalances in the body.

In the case of someone who sits at a desk, the longer they are seated the more the shoulders begin to hunch over and the head moves forwards.

Over time the body will set in this position if not corrected or counteracted in some way.

So What Exactly Happens to the Body with Upper Crossed Syndrome?

In order to understand how upper crossed syndrome develops, it’s important to consider the structure of the rotator cuff (the group of muscles and tendons that mobilize and stabilize the shoulder joint).

Unlike the hip joint, which is stabilized by a cup-shaped cavity on the hip bone, the shoulder relies on a network of muscles in the upper back provide stability to the joint and allow for a full range of motion (abduction, adduction, extension, flexion, lateral and medial rotation, and circumlocution).

These muscles are the levator scapula, the upper trapezius, the lower trapezius, and the serratus anterior.

When one of these delicate muscles tightens due to injury, overuse, or bad posture, the relative opposite muscles lengthen and become weak.

This weakness causes the former muscles to tighten further, thus creating a self-perpetuating cycle of muscular imbalance.

Upper crossed syndrome is characterized by the lengthening and weakening of the posterior musculature of the upper back (levator scapula, serratus anterior, upper trapezius), and the shortening and tightening of the anterior musculature (neck flexor, pectoralis major, pectoralis minor).

The tightness of the neck flexors and pectoral muscles crosses with the tightness of the levator scapula and upper trapezius, while the weakness of the neck flexors crosses with the weakness of the serratus anterior.

This creating a cross-crossed pattern of muscle imbalance, hence the term “upper crossed.” Upper crossed syndrome often results in postural changes such as forward head posture and rounded shoulders.

Too Complicated? Let’s Break It Down

We know that Upper Crossed Syndrome is characterised by two lines, each of these can be thought of as one slanted line that when combined makes up the full cross.

The First Line

We know that when someone sits in front of their computer for too long their shoulders round and their back begins to hunch over.

The body will begin to adapt to this position which causes:

  • The pec muscles become tight as they sit for long periods in a shortened period. These tight pec muscles pull the shoulders into an internally rotated position and cause them to round forward.
  • The muscles which run from your shoulder blade up to the back of your head become tight (Upper Traps and Levator Scapula) as your shoulders move up closer to the back of your head. The upper traps may become overactive as a result.

The above makes the first line of the cross.

The Second Line

The longer you sit the more your head moves forward. This is even more so if you are looking at a screen or even down at a mobile device for too long (also known as Text Neck).

This causes:

  • The front of the neck to weaken, so much so, that it is unable to push the head back so that it sits directly above the spine. The back of the neck may also get tight.
  • The upper back muscles (Rhomboids and lower traps)become long and weak. As a result, they no longer pull the shoulders back but rather allow the shoulders to round forward.

This is the second line. When putting these lines together makes up what is known as Upper Crossed Syndrome.


Upper Crossed Syndrome Treatment Options

The symptoms of upper crossed syndrome can be relieved or even eliminated with an individualized treatment plan consisting of chiropractic care, physiotherapy, massage, or a combination of all three.

Chiropractic care

A chiropractic adjustment is a type of manual therapy that helps realign the joints and increase range of motion in the neck, upper back, and shoulders.

Depending on the severity of the UCS, chiropractic care may be the primary component of the treatment plan.

Physical therapy

Like chiropractors, physical therapists use manual techniques to relieve pain and restore full range of motion to the affected area.

Physical therapists also advise patients on exercises that can be performed at home and lifestyle changes that can be made to prevent UCS in the future.

Corrective Exercise

In addition to chiropractic care, and/or physical therapy, an individualized treatment plan for UCS may include muscle-strengthening exercises for the neck, shoulder, and upper back muscles.

Research shows that performing strength exercises for the middle and lower trapezius, and stretching exercises for the levator scapulae and upper trapezius can be effective in treating upper crossed syndrome.


Exercises for Correcting Upper Crossed Syndrome at Home

Correcting Upper Crossed Syndrome doesn’t always have to involve seeing a professional.

If you are fairly healthy and able to perform a moderate level of exercise you may be able to fix it on your own.

In this section, we’ll discuss briefly how you can fix it using corrective exercises.

Keep in mind that these suggestions are not intended to replace professional treatment and are most effective when performed in conjunction with an individualized chiropractic and/or physical therapy treatment plan.

The Steps to Fix Upper Crossed Syndrome

To fix upper cross syndrome you will need to reverse everything that was described in the sections above.

Below are a series of videos with exercises you may want to add to your daily routine. Please also note that there is no fixed order in which to do these steps.

1. Stretch the Pecs

Since the pecs will be tight you will want to learn how to stretch your pec muscles effectively. You can learn how to do this here.

2. Stretch the Neck & Levator Scapula

The back of the neck will become tight with forward head posture. You will need to lengthen and stretch these muscles.

3. Stretch the Upper Trap Area

Simply put this means creating length between the top of your neck and your shoulders. Currently, the muscles are too short which pulls the shoulders blades up too high.

4. Strengthen the Front of the Neck

This will help push your head up and back on top of your spine.

5. Strengthen the Upper Back

The shoulder blades will most likely sit too far apart from each because the muscles have become too long and weak. If you pinch your shoulder blades together you’ll notice your shoulders move back.

By working the muscles between the shoulder blades (the Rhomboids) you can strengthen these muscles and cause the pulled back shoulder effect to occur naturally. The prone cobra exercise is great at achieving this goal.

You may also need to strengthen the lower traps, which will cause the shoulder blades to move downwards.

There are many stretches and exercises you can do to achieve all these points.

We cover how to accomplish each of these components in two posts.

  1. How to Fix Rounded Shoulders
  2. How to Fix forward Head Posture

It is advisable to take a look at both these posts and try out the exercises and stretches laid out.


How to Prevent Upper Crossed Syndrome

When you begin your journey of fixing upper crossed syndrome you’ll want to remember that any gains you make by exercising and stretching may be lost if you do not get down to the root of the problem that is causing it in the first place.

To fix Upper Crossed Syndrome permanently you will want to avoid putting your body in the position that causes the bad posture in the first place.

Maintaining good posture is the best way to prevent upper crossed syndrome or (if you’re already suffering from the condition) stop it from getting worse.

Other ways to prevent upper crossed syndrome are:

  • Using ergonomic office chairs or use a lumbar support with your office chair.
  • Taking breaks from sitting every 15 to 20 minutes
  • Use a standing desk to break up the long period of sitting
  • Performing stretches that target the neck, chest, upper back, and shoulder muscles on a frequent basis
  • Ensuring your computer screen is at eye level
  • Engaging in low-impact cardiovascular exercise, such as swimming or walking, for at least 30 minutes a day
  • Performing strengthening exercises that target the pectorals, upper and lower trapezius, deltoids, and front neck muscles
  • Avoiding activities and movements that cause discomfort

Make Fixing Upper Crossed Syndrome Your Priority

Poor posture is the most common cause of upper crossed syndrome – particularly for those who work at a desk for extended periods of time.

The good news is that when properly treated with a combination of exercise, chiropractic care, and/or physical therapy, upper crossed syndrome can be corrected, and a full range of motion can be restored to the shoulders and neck.

If you’ve had upper crossed syndrome for most of your life, it can take a while to teach your body to realign to its proper position so be patient.

The other thing that is essential is to maintain proper form and posture during your exercises and stretches. Make sure to keep your head pushed back and neck long, and your shoulders pulled back and down away from your ears.

The more improvements you make the more you’ll notice your well-being improve as well as the other benefits good posture brings!

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