Poor Posture Part 2: What is Upper Crossed Syndrome and How to Correct It

The use of electronic devices, gaming, driving, and working sedentary desk jobs is associated with a common postural deviation called upper crossed syndrome. It can be identified by rounded shoulders and  thoracic spine (kyphosis), a forward head position, and protracted and elevated scapula. Upper crossed syndrome is not only common in individuals who spend a lot of time at a desk, but it also can result from training a muscle group disproportionally to others, compensation due to an injury, or even emotional distress. Upper crossed syndrome involves tight, (overactive) muscles, as well as weak, underused, or inhibited muscles. This can be explained by a process called reciprocal inhibition, during which overactive agonist muscles decrease the neurological activation of  the antagonist muscles.  In upper crossed syndrome the upper trapezius, levator scapulae, sternocleidomastoid, pectoralis major and minor, latissimus dorsi, and subscapularis tend to be dominant and tight, whereas the deep cervical flexors, serratus anterior, rhomboids, posterior deltoid, middle and lower trapezius, and infraspinatus and teres minor tend to be weak and passive.¹

As a Certified Personal Trainer (CPT), one can design an exercise program for those with postural deviations such as upper crossed syndrome with exercises that can address these muscle imbalances.  Here are some examples of such exercises:

STRENGTH EXERCISES:

Floor Cobra:  Lie on the floor, arms at sides or in from the body, palms facing toward the ground.  Retract shoulder blades and lift the chest off the floor and hold for two seconds or longer.   

Dumbbell Reverse Fly: Sit with your knees bent and hold a dumbbell in each hand. Lean forward, letting your arms hang down next to your calves with your elbows slightly bent. Slowly raise the weights until your elbows are level with your shoulders. Then slowly lower the weights to the starting position.

Seated Narrow Row:  Sit with tall posture, feet on foot plate or on floor.  Grasp handle in a neutral hand position.  Retract the scapula, then pull the handle toward the torso by extending the shoulders and flexing the arms in the sagittal plane.  Return to start, maintaining neutral spine at all times. 

Cable Shoulder External Rotation: Adjust the pulley height to slightly lower than the elbow.  Position the arm slightly off the side of the body with the elbow flexed at 90 degrees.  Pull handle away from the torso rotating externally through the vertical axis of the humerus to approximately 45 degrees of external rotation.  Return to starting position with the hand near the torso.  Keep the wrist neutral at all times.  Do not allow the elbow to move away from the starting position. 

FLEXIBILITY:

Doorway Pectoral and Anterior Deltoid Stretch:  Stand in a doorway or at the end of a wall. Bend your right arm and place your forearm against the wall with your elbow at shoulder-height. Slowly turn your body away from your arm until you feel a stretch through your chest and shoulder. Hold the stretch then repeat the movement with your other arm.

Overhead Triceps and Latissimus Dorsi Stretch:  Put one arm overhead. Grasp elbow or wrist overhead with other hand.  Bring elbow toward head and back or pull arm down toward opposite shoulder. Lean torso to side, away from direction of arm behind head. Hold stretch. Repeat with opposite arm.

Upper Trapezius Stretch: Gently bend your head forward with your chin toward your neck as if you were nodding. Hold this position for 10 to 15 seconds.  Gently bend your head to the side so your ear approaches the opposite shoulder. Switch sides. Hold. Gently bend your head diagonally forward so your chin approaches the opposite shoulder. Hold this position for 10 to 15 seconds. ²

Do you want to learn more about how to help clients with common postural deviation?  NETA offers an NCCA-accredited Personal Trainer Certification.  Follow the link for details!

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Check out our Poor Posture Part 1 post, where you can read more about how to correct postural imbalances from Lower Body Crossed Syndrome.

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References:

¹ National Exercise Trainers Association. (2018). The Fitness Professional’s Manual, 5^th edition. Minneapolis, MN: National Exercise Trainers Association.

² Bae, W.S., Lee, H.O., Shin, J.W., & Lee, K.C. (2016). The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. Journal of Physical Therapy Science, 28(5), 1636-9.

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Contributed By

Colleen O’Neil is PhD student in Health and Human Performance at Concordia University, Chicago, where she also earned her M.S. in Exercise Science.  She has worked as a Personal Trainer and Group Fitness Instructor for over 20 years.  She holds accredited Personal Training certifications through ACSM, and NASM, and Group Fitness Instructor and specialty certifications for Yoga and Pilates through NETA, YogaFit, and the YMCA.  She worked in corporate fitness for 12 years, and now runs a personal training business, and is a Presenter for NETA.  Her goal is to help clients enhance their health through exercise and education, and by incorporating a variety of exercise formats in personal training and group exercise.