16 April 2014…Upper Cross Syndrome

Through evolution, our bodies were designed to be upright and moving as hunters/gatherers, but with modern society comes a modern posture.  Starting with being hunched over a desk as children, then behind computers as we get older, and now with smartphones and other technology, we seem to be spending more and more time in our days with our heads bent over forwards.  This can lead to one of the more common problems we see in our patients…neck and shoulder pain caused by Upper Cross Syndrome.

Upper Cross Syndrome, sometimes also called Postural Syndrome, is characterized by a prolonged posture where the head is hanging forward, the shoulders round forward, and there is an increasing forward curvature in the upper back.  Unfortunately, simply saying, “Stand up straight!” isn’t enough to help counteract this posture.  Our spines start to stiffen in this position, and over time, this posture becomes reinforced with the weakening of certain muscles and tightening of other muscles.  The following picture shows an example, along with the associated muscles.

image of Upper Cross Syndrome

Maintaining this position for prolonged periods causes an increase in the strain on your neck and shoulder muscles.  As we know with the Leaning Tower of Pisa,  an erect tower is stable and a leaning tower is unstable, much like your neck.  Now, with the added weight of your head hanging on that crooked tower, the strain on the neck vertebrae and muscles increases even more.  The average human head weighs about 5 kg, or 10-12 pounds, and when our bodies are in a good postural position, the weight of your head goes directly downward through your spine with little strain on the body.  However, when our heads are leaning forward, that weight begins to hang on the neck and shoulders.  According to Dr. Adalbert I. Kapandji, and his book Physiology of Joints, Vol. 3, “For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds.”  So even if your head is slightly forward from its optimal position, the stress on your neck increases dramatically.

If you were asked to hold a bowling ball with one arm against your chest, there would be a strain, but if you had to slowly lean that ball away from your chest, the strain on your arm would increase to the point where you would have difficultly holding the bowling ball in position.  Your arm muscles are made for lifting, and they would eventually fail.  The muscles in your neck and shoulders are small and mainly meant for posture, not for heavy lifting, so this continued strain has an even bigger effect on them.  The muscles begin to stiffen and cramp, which leads to the neck and shoulder pain that affects many people every day.

What can be done about this?  Please check our next blog for tips and exercises in Part 2 of our series on Upper Cross Syndrome.