Upper crossed syndrome is a condition associated with people who have a bad posture, presenting pain in the neck, shoulders and chest.

It can occur at any age, but it is becoming more and more common in people who spend a lot of time at a desk, as well as in older people who naturally begin to lose their postural strength.

The muscles of the human body are interconnected. When one muscle becomes weak (with reduced muscle tone), another muscle must take over its activity.

In the condition known as upper crossed syndrome ( upper crossed syndrome) the muscles of the upper back (rhomboid muscle and lower trapezius) become very weak. As a result, the pectoral muscles and anterior muscles of the neck contract. This causes pain in the upper part of the body, including shoulder pain and neck pain, as well as a reduced range of movement.

Simply put, the upper crossed syndrome is a muscular imbalance caused by the weakening and elongation of the postero-upper muscles of the back and neck, combined with the contraction and shortening of the pectoral muscles and neck muscles (the lifting muscle of the scapula, the upper trapezius). This imbalance also leads to joint dysfunction.

People with a sedentary lifestyle are most at risk of developing this syndrome. Long hours spent on the computer, TV or phone can contribute to a bad posture, which in time leads to the weakening of the upper back muscles (rhomboid and lower trapezius muscles) and flexors of the neck, contracting and shortening at the same time the pectoral and upper trapezoid muscles.

This imbalance causes the spine to be projected forward (to the front), significantly increasing the stress on the muscles that have the role of supporting the spine.

Also, people who drive for a long time often adopt a deficient posture due to the fact that they do not get used to resting their head on the headrest, which can be a main cause of the upper crossed syndrome. But the superior crossed syndrome is also found in athletes, especially swimmers and weightlifters. This is due to excessive use of the muscles in the neck area, shoulders and upper back. Also, athletes who practice cycling can develop upper crossed syndrome both due to the position on the bike and due to the force that passes through the upper trapeze muscle.

Over time, the shoulders become rounder and more coiled and the neck and head are projected forward. The spine will also begin to curve inwards (near the neck) and outwards in the upper back and shoulders.

The unbalanced muscles associated with this syndrome put stress on the surrounding muscles, tendons, bones and joints, leading to:

➢ headaches

➢ neck pain or tension in the back of the neck

➢ pain in the upper back, especially in the shoulders

➢ difficulty when sitting and driving for long periods of time

➢ restricted range of movement in the neck and shoulders

➢ numbness, tingling and pain in the upper arms

Upper crossed syndrome is a chronic condition that, untreated, can leave significant muscle imbalances in the body and lead to chronic back pain. Over time, it also causes damage to the spine due to continuous pressure on the front of the vertebrae.

As in most musculoskeletal disorders, the best way to treat upper crossed syndrome is physical therapy, through:

➢ stretching exercises, both for preventive purposes and for stretching (relaxing) the contracted muscles

➢ exercises to tone the weak muscles

➢ improved posture

In order to increase the flexibility of the muscles and joints and to ensure a full range of movement, manual therapy is required, which will remove/relax muscle adhesions and trigger points.

Trigger points are focal, hyperiritable points located in a tense band of the muscle. They cause pain locally and often accompany musculoskeletal disorders.

Heat applied locally, on the contracted muscles or a warm bath, helps relax and de-stress these muscles, but also to relieve pain.

Avoiding activities that cause pain, moving the computer position at eye level or changing the office chair, are important for improving posture and preventing relapses or other injuries.

➢ Stretching exercises and changing as quickly as possible any weak postural positions will prevent the symptoms from becoming chronic.

➢ Seek the advice of a physical therapist as soon as possible to learn the most appropriate exercises.