Friday, March 8, 2013

Upper Crossed Syndrome

The 30kg head position

I am sure everyone has seen someone with upper cross syndrome (UCS), whether they knew what it was called or not. A person with UCS will look like they are hunched over with rounded shoulders and head protruding forward. See the image below to get a better visual of what UCS looks like.

upper cross syndrome

Basically, if someone has UCS they will have tight (overactive) upper traps and levator scapula muscle as well as tight chest muscles. Along with these tight muscles, the neck flexors on the front side and the rhomboids and lower traps on the back are weak. The tight or over-active muscles have become shortened and the weak or under-active muscles have been lengthened. This is what happens when there is a muscle imbalance in the body.

muscle imbalance
In the above image, the muscle on the left is the tight (overactive) muscle
and the one on the right is the weak (underactive muscle)

UCS is one of the more common muscle imbalances that people possess and the majority of them don’t know they have it. Someone can get UCS from doing repetitive things such as their job. People who sit in a chair all day tend to hunch over and overtime will start to possess UCS. If your job requires you to stand all day while slightly bending over while working with your hands the same would apply. Also, people that exercise and work out the chest/upper traps a lot more than the lower traps/rhomboids will eventually get UCS. If you already possessed muscle imbalances before you started exercising then it would gradually get worse as you performed exercises, unless corrected.

People with UCS may complain of symptoms such as neck pain, jaw pain, upper thoracic pain and headaches due to the muscle imbalances and altered posture. Over time, poor posture can lead to all the above symptoms as well as more long term complications such as osteoarthritis or degenerative joint disease.

So how do you fix Upper Cross Syndrome? You need stretch the tight (overactive) muscles and strengthen the weak (underactive) muscles. The chest muscles and the upper traps need to be stretched. Here are some examples of stretching exercises that can be done.

Pectoral stretch

pectoral stretch

Stand against an object and form a 90 degree angel with your arm. Draw your navel inward. Slowly lean forward until a light stretch is felt in the front shoulder and chest area. Hold the stretch for 30 seconds. Switch arms. Perform 1-2 sets twice a day.

Upper Trap/scalene stretch
upper trap stretch

Stand in place with good posture. Draw navel inward. Retract and depress scapula on the side being stretched. Tuck chin and slowly flex head to one side, pulling one ear toward the same shoulder. Hold the stretch for 30 seconds. Switch sides. Perform 1-2 sets each side twice a day.

The rhomboids/mid-lower traps need to be strengthened. Here is an example of a strengthening exercise that can be done.

squat to row

Pick a weight that you can perform 12-20 reps easily. You can also you resistance bands. Stand with feet shoulder width apart and with body in good posture. Draw navel inward. Pull bands/cable toward your lower chest area and flex the trap muscles. Make sure to use your back muscles to pull the bands/cable toward you and not your biceps. Lower your body as if you were squatting or sitting in a chair. As you lower your body let the bands/cable go forward. This should be done is smooth motion. Bring your body back up to the starting position as you bring the bands/cable toward your lower chest. Do 12-20 reps for 1-2 sets once a day. *You want to pick a weight or resistance that you can easily perform the 12-20 reps in order to execute proper form. ** Be careful not to elevate shoulders or protrude head forward while performing this exercise.

floor prone cobra

Lie prone(stomach down) on the floor. Activate the gluteal muscles and pinch should blades together. Lift chest off the floor with thumbs pointed up and arms externally rotated. Hold for 1-2 seconds. Slowly return body to the ground keeping chin tucked. Repeat 8-12 times, 1-2 times a day.

Stop by my Courtenay chiropractic clinic for some Upper Crossed Syndrome resolve.


  1. I never heard of UCS but that's totally what I have and what you must have been working on with me. Thanks for passing this on Derek. Gives me two more exercises to add to my repertoire and reminds me that I need to keep stretching daily until it's reversed.

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  3. Hi Dr Derek, thanks for the great exercises, they have helped me a lot. I winder if you have any advice as to how I could adapt them for one shoulder. I have a weak lower trap on my right side. Whenever I do many of the exercises I can feel my stronger side taking over. Any way I can stop this happening? particularly with the last exercise?