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Upper Cross Syndrome

Upper Cross Syndrome (pic by grittiness.com)

If you are reading this blog, chances are that you already have gone through treatment for a chronic musculoskeletal issue that seems to be lingering and has not responded well to the treatments you have received. In this blog, I will discuss and answer the following:

  • What is Upper Cross Syndrome?
  • What does Upper Cross Syndrome feel like?
  • Can Upper Cross Syndrome be corrected?
  • Is Upper Cross Syndrome curable?
  • How to fix Upper Cross Syndrome
  • Who treats Upper Cross Syndrome?
  • Can Upper Cross Syndrome cause dizziness?
  • Can Upper Cross Syndrome cause chest pain?

What is Upper Cross Syndrome?

Stop for a moment and study the picture above. Upper Cross Syndrome is involved in the upper part of the body above the diaphragm where the chest bone ends. Upper Cross Syndrome does not immediately involve the upper extremities such as your arm, forearm, and wrist but contributes to issues there which I will explain in a bit.

Upper Cross Syndrome happens over time as a result of ignored (intentionally or not), or partly-treated issues in that region. In order to understand Upper Cross Syndrome, you have to understand that in our body, when it comes to movement, we have 2 distinct types of muscles:

  1. The stabilizers are located in the torso and neck, which are designed to stabilize the neck and torso in movement.
  2. Phasic muscles or the upper and lower extremities that are designed to move the body. Phasic muscles are fast-acting muscles that are very precise with their target and get tired easily.

Imagine throwing a dart at a dartboard, your arm does the action part; it throws the dart, fast and precise and that is it. When you use your arms to sit up straight, like most people do when asked to sit up straight, it won’t last long because the arms are not meant to be the do-ers of that command. If your brain assigns the right body parts to fire in the right sequence, the job is done perfectly and lasts as long as the person is conditioned (through fitness) to hold.

The issue rises when the right body parts are fully or partly “out of commission” because of something else. That something else is always (with the exception of genetic issues) limited by injuries and lifestyle. In order to understand this further without digressing from the subject of this blog, I STRONGLY recommend you check out Brain Based Neurology and Posture on my website.

When a muscle overworks and is tight, it gets weak; when a muscle is bypassed (because of the change in the neural command due to injury or lifestyle) and gets skipped in the sequence of movement as an example, it becomes weak. The end result is always a weakness.

Now going to the gym to work it out is like beating a dead horse. You only injure yourself and reinforce the dysfunctional movement vs functional movement, which is the movement pattern we are all automatically designed to follow at birth. It is now time to check out Functional Movement and DNS so I can continue to stay on subject here and not make this blog a 6000-word blog!!

What Does Upper Cross Syndrome Feel Like?

Upper Cross Syndrome is the weakness of the deep neck flexors in the top front side of the body, crossing over to the weak lower shoulder stabilizers in the bottom back portion which comes together with the tightness of the upper back muscles (upper trap) and shoulder stabilizers that elevate your scapula (levator scapula), crossing over to the front pectorals muscles. Best to take a look at the picture above to better understand this. You  can an X or cross between weak and tight.

The person feels tension in the neck and between the shoulder blades, restlessness, lack of energy, and the need to take deep breaths due to the slouched upper body that compresses the abdominal diaphragm (no-one talks about this one for sure). From appearance, you can note the chronic slouching posture.

Headaches and sinus issues are commonly seen among people with Upper Cross Syndrome as well as weak arms or arms with one group of muscles being stronger than others. These individuals have elbow and wrist range of motion issues that they may not even be aware of! It is common to see heaviness of the arms or tingling down the arm(s) especially when sleeping on the sides that go away after getting up.

Is Upper Cross Syndrome Curable?

You may ask yourself: Can Upper Cross Syndrome be corrected? And the answer is, it depends! It depends on the level of damage, if any. For instance, if due to lack of proper functioning of the shoulder blade stabilizers, an actual shoulder joint injury has occurred and you have had surgery of let’s say your supraspinatus muscle (most commonly injured rotator cuff muscle), then some restrictions such as scar tissue are unavoidable.

That means some limitations will be there; if a piece of paper is torn a little bit, we can’t pretend it is not! The goal should be to assure it won’t tear any more so the answer to the question is: ‘it depends’ because it really depends on what is going on. The general answer from my perspective is, YES it is curable as long as the right treatment is rendered.

The right treatment is NEVER isolating the area of complaint and working on just that. If movement is a concert, to improve the concert, all musicians work together to make that happen. If the metaphoric ‘pianist’ consistently messes up, and the rest of the musicians try to ‘cover-up’ so they become conditioned to cover long enough that working on the pianist is only a partial solution and not going to solve the problem alone. The rest of the musicians need to be re-trained to play their part only, which they had to modify for the cover-up for so long. That is why the thorough treatment has to include Postural Neurology and DNS (Functional Movement).

How to Fix Upper Cross Syndrome

To fix Upper Cross Syndrome, we first need to see the extent of the involvement and the peripheral ‘damage’ to the non-stabilizer muscles (see above for what this means). Then we need to see what the map of movement in the brain (aka Homunculus) looks like. You see, we are all born with a map of movement and sensation in our brain called Homunculus.

This map gets fine-tuned especially within the first 2 years of development as we progress in movement from infancy to walking. It also is capable of being modified based on our lifestyle and history of injuries. This adaptability is the reason why someone who misses an arm is still able to live life and move around and not be defined by the missing arm and the associated issues.

Once we know about the current state of movement map in the patient with Upper Cross Syndrome, we can then test the person to see what the functional fitness of the patient is. I am not talking about endurance or the ability to lift more weight here. I am talking about how functional or dysfunctional the patient is with basic movements. Here is a video to better understand what I am talking about:

So to fix the problem we go through a system of checks and balances to see what is weak, what is not firing, what is the blueprint of movement and then go and fix everything that is off. Simple and precise. No guesses and no wasting time.

Who Treats Upper Cross Syndrome?

Chances are by the time you learned the term Upper Cross Syndrome, you have gone through many doctors and ended up with physical therapists. That is typically the way musculoskeletal conditions are treated in our current health/sick medical care model. Occasionally people go directly to chiropractors after their issue does not go away or the pain returns.

Chiropractic adjustments help but do not fully correct the issue. They may see a Sports Chiropractor who is certainly more adept with these conditions. Unless the provider of service is aware of Brain Based Neurology and Posture (Postural Neurology) and Developmental Kinesiology such as Dynamic Neuromuscular Stabilization, I don’t think your problem will be fully resolved.

If you have checked these links already, you know very well my reason behind this. We have to treat the whole body and every ‘malfunction’ related to the movement. The more subtle the problem, the quicker the resolution will be.

Can Upper Cross Syndrome Cause Dizziness?

There are many reasons behind dizziness some of which are not related to Upper Cross Syndrome. Every patient I see in my practice with dizziness, however,  has an upper cross syndrome presentation. I did a video on this very subject since most of the time the correlation is missed.

Can Upper Cross Syndrome Cause Chest Pain?

What do you think? It is fair to say that while chest pain can be caused by other factors (heart attack causes chest pain as you know for example), chest pain as a result of Upper Cross Syndrome is almost always missed. For instance, the lack of balance between the muscles of the front and back of the upper body in upper cross syndrome is a leading cause of limitation in movement of the chest cavity.

Being slouched at the abdominal diaphragm only leads to compression of the internal organs and the lack of proper sequencing of muscles to signal breathing in and out. That means muscles such as deep neck flexors that are short, tight, and weak have to now assist in breathing!! Can you imagine that?!!

Of course, when all muscles, joints, ligaments, and other soft tissues including nerves are under stress, they will be ‘vocal’ with pain. But remember, pain is not always present from the get-go when there is an issue. Chest pain, finding yourself needing to take deep breaths, tension between shoulder blades, and tension in the back of your head where it gets connected to the neck are all common complaints that signal upper cross syndrome.

I wish people would take the time to understand the why’s behind their issues and would investigate their health-related why’s as much as they do for their phones, cars, and vacations. I honestly think we would be in much better shape. I see upper cross syndrome in my teenage patients!! Teenage!! That’s because they have been behind some kind of a digital device all their lives, hardly go out there to play, barely move and ride an “almost dead horse” all the time!!

Hope by reading this blog, you can see the urgency to attend to your upper cross syndrome before it impacts your whole body as it does in Layered Syndrome that I, unfortunately, see too many patients with these days.