Muscle Tightness in Upper Crossed Syndrome
Exercises and Therapies to Loosen Upper Body Muscles
martin-dm / Getty Images
Medically reviewed by Amy Kwan, PT, DPT
Upper crossed is a condition in which the muscles of the chest, neck, and shoulders become weak and tight, typically due to poor posture. Symptoms of upper crossed syndrome include pain and stiffness in the neck, jaw, and upper back, tension headaches, rounded shoulders, and hunched spine. Certain exercises can help reduce pain, improve posture, and strengthen the muscles in the chest and shoulder regions.
This article will cover what to know about upper crossed syndrome and how to manage it at home as well as other therapies.
martin-dm / Getty Images
How Does Upper Crossed Syndrome Affect Posture?
Upper crossed syndrome affects posture by creating a cross pattern of imbalanced muscles between the upper back and chest. Long and weak muscles in the upper back, shoulders, and neck, and tight, short muscles in the upper chest result in a hunched back, forward shoulders, and protruded neck.
The specific muscles affected include the trapezius muscles (large, triangular muscles that move the head and shoulder blades) and levator scapula (muscles on the side of the neck).
Takeaway
Back pain lasting two weeks or longer should be discussed with a healthcare provider, who will examine you to determine the cause of the pain.
Residual Pain From Upper Crossed Syndrome
Upper crossed syndrome is characterized by pain from ongoing stiffness, tension, and increasing immobility of the muscles in the chest and shoulder. The imbalances in muscle activation and movement as well as poor posture all contribute to pain. The muscle tightness and pulling, paired with weakness over time, can lead to joint damage in the shoulder.
Related: 13 Causes of Upper Back Pain
Activities That Make Upper Crossed Syndrome Worse
There are certain activities that can make upper crossed syndrome worse. There are also certain jobs and career paths that can contribute to risk of developing upper crossed syndrome. Bear in mind upper crossed syndrome is preventable and manageable.
Factors that worsen symptoms of upper crossed syndrome include:
Inactivity or sedentary lifestyle
Physical injury to the area
Overactivity of the muscles in swimmers, weight lifters, and other athletes
Occupations high in physical exertion, heavy lifting, and injury risk
Occupations requiring extended periods of sitting or standing
Watching television or using a smartphone or tablet, or reading book for long periods without a break
Related: Causes of Back Pain and Treatment Options
Exercises to Improve Upper Crossed Syndrome
Retraining your posture with specific exercises is an effective way to improve upper crossed syndrome.
Exercises for improving upper crossed syndrome include:
Chin tucks, which include pulling the head back with the chin tucked downward
Scapular retractions or pulling shoulder blades toward the spine
Corner pec stretch or standing in a corner with your arms raised and bent, palms on a wall, gently stretching forward
Slouch overcorrect exercise or sitting in a chair without back support
Related: 6 Simple Ways to Maintain Perfect Posture
Working with a physical therapist can help determine which strength-building and stretching exercises are most effective and suitable for you. A physical therapist will provide several exercise options, involving:
Posture retraining
Muscle movement retraining
Kinesiology taping techniques (preventive and assistive)
Bracing
Manual exercises targeting soft tissues and joints
Core strengthening exercises
One small study demonstrated eight weeks of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises are more effective for upper crossed syndrome than other exercises.
Takeaway
A small study found adding core stabilizing exercises to posture-correcting exercises was more effective in improving upper crossed syndrome than doing just posture-corrective activities.
Related: The 7 Most Serious Causes of Back Pain
Managing Upper Cross Syndrome at Home
There are ways to manage upper crossed syndrome and associated back pain at home. Common methods for managing back pain at home include:
Practicing proper posture, including when doing chores or watching television
Using topical (on the skin) pain relievers available over-the-counter (OTC) like lidocaine
OTC oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) and Aleve (naproxen)
Muscle relaxants to help ease tension
Cold or heat packs to either relieve pain or increase blood flow to promote muscle healing after exercising
Increasing or decreasing physical activity as necessary
Related: Are Physiotherapy and Physical Therapy the Same Thing?
Therapies for Upper Cross Syndrome
You may be advised by a healthcare provider to avoid bed rest when in this type of pain, and also to limit or avoid the activities that can cause pain or worsen symptoms of upper crossed syndrome.
Additional treatment therapies for upper crossed syndrome include:
Physical therapy to retrain muscles and strengthen core and upper back
Chiropractic adjustments for spinal realignment and posture retraining
Acupuncture to relieve tension
Steroid injections for pain relief to a specific area (i.e., the upper neck)
Prescription anti-inflammatory medication for pain treatment
Takeaway
Upper crossed syndrome also plays a role in spinal health. More research is needed to determine the impact of chiropractic care on upper crossed syndrome. Studies have shown spinal manipulation from a chiropractor effectively reduces neck, spine, and lower back pain.
Related: Spinal Injections for Diagnosing and Treating Pain
How to Get a Referral for Upper Crossed Syndrome
Some of these therapies may require you to get a referral from a healthcare provider either to book an appointment or for insurance purposes. Consult with your healthcare provider to ask what your next steps should be in treating your upper crossed syndrome symptoms.
Related: The 7 Best Posture Correctors of 2023, Tested and Reviewed
Summary
Upper crossed syndrome is a condition that causes neck, back, and shoulder pain. Upper crossed syndrome symptoms include pain, stiffness, loss of mobility, and eventual joint damage if left untreated. Upper crossed syndrome is associated with the following activities: poor posture, extended periods of sitting, sedentary lifestyle, injury, or overexertion in athletics or heavy lifting.
Managing upper crossed syndrome is possible, and involves retraining your posture and strengthening surrounding muscles, including the core. Additional therapies are also available and include acupuncture to relieve tension and steroid injections to relieve severe pain, if necessary.
