In our last discussion, we talked about the causes, posture changes, and symptoms of upper cross syndrome, but how can upper cross syndrome be corrected or prevented? The short answer would be to do exactly the opposite of what causes the condition.
Perfect posture is hard to obtain and requires conscious effort to maintain. Ideally, when looking at a side profile of a patient the ear, shoulder, hip, knee and ankle should all line up vertically. From the front or back, the shoulders, pelvis, knees and ankles should all be in the same horizontal plane.
Utilizing correct posture is essential to combating upper cross syndrome. I like to tell my patients to stand tall, stick their chest out and be proud. To do this, I ask patients to draw the shoulders down and back as if they are trying to pinch a tennis ball between the lower portions of the shoulder blade, while bringing the head back over the shoulders. This places the shoulders and head in an overcorrected position, in an attempt to establish new muscle memory. Another trick is to imagine a string attached to the top of your head, pulling you up towards the celling. I always make a point to remind my patients to avoid shrugging the shoulders while performing this posture exercise, because doing so only contributes to upper cross syndrome. The patient can utilize this technique either sitting or standing, and should have a goal of correcting their posture every half hour.
Stretch It Out!
During the treatment of upper cross syndrome, the muscles that have become tightened or contracted must be stretched and lengthened. Therefore, the upper shoulder muscles and the chest muscles are the key muscles to stretch. Below are a few stretches to utilize at work or home if you think you may have or are developing upper cross syndrome. Each stretch is held for 10-15 seconds and repeated 2-3 times.
- Doorway Chest Stretch – Facing an open doorway, bring one arm up 90 degrees to your side and place the inside of the bent arm on the door frame with the fingers pointing up towards the ceiling. With the arm placed against the frame turn your body away from the bent arm. You should feel a stretch in the chest muscles.
- Sitting Chest Stretch – While sitting in a chair with a low back rest, extend your arms back and interlock your fingers. Next, lift the elbows up towards the ceiling. You should once again feel a stretch in the chest and front of the shoulders.
Upper Back and Neck Muscles
- Upper Trapezius Stretch– While standing, reach across your lower back and use the opposite hand to further pull the arm across the lower back. Next, tilt the head down and away from the lowered shoulder. You should feel a stretch of the upper back and neck.
- Scalene and Sternocleidomastoid Stretch – This stretch is accomplished with the head in three different positions on each side, ear to shoulder, ear to the front of the shoulder and to the back of the shoulder. With the head in one of the three positions, use the hand from the same side to stretch the neck further by pulling on the head. Reaching the opposite arm across the lower back will accentuate the stretch.
Roll It Out!
Not only is it important to stretch the muscles, but also to reverse the increased curve of the thoracic spine. In our office we use a 3 foot long foam roller to accomplish this task. If you don’t have a Foam roller, I personally suggest picking one up due to their versatility in use for all areas of the body. Below are a few exercises that I personally use to keep my back in tip top shape.
- Thoracic Extension – Place the foam roller on the floor so that it will run across your back. Take a seat facing away from the roller and slowly lay back until the shoulders touch the roller. With the roller at your shoulders and your feet placed close to your rear end, slowly bring your rear end off of the floor and hold the plank position. Pushing with your feet will allow you to roll up and down your back with the roller. You can also simply lay over the foam roller and allow your spine to arch over and stretch the upper back. You may even her a few cracks and pops as the thoracic spine shifts into extension, but don’t be alarmed this is a normal occurrence.
- Chest Stretch – Place the foam roller on the floor so that it will run lengthwise up and down your spine. Maneuver yourself so that your spine is resting along the foam roller from your head to your tailbone. Once in this position, reach out with your arms palm facing up and try to touch your elbows to the ground. The stretch can be modified by bring the arms up next to the head and also down towards your sides. You should feel a stretch across the chest.
Pump It Up!
Strengthening the weakened muscles of the lower portion of the shoulder and the deep flexors of the neck are next on our list. The muscles at the bottom of the shoulder blades have become weakened and stretched and the same goes for the muscles of the anterior neck.
Strengthening exercises can be accomplished by using an exercise band and a door. Place the exercise band around the door handle on the opposite side of where you plan to workout. Also make sure to stand on the side of the door that will not swing open and hit you if it opens up. With the exercise band around the handle, close the door so that the band is not in front of the latch. Each exercise is completed 10-15 times and repeated 2-3 times.
- Rows – This exercise is accomplished by facing the door and grasping an end of the exercise band in each hand, while performing a rowing motion against the resistance. Make sure to keep the elbows close to the sides and the hands at the same level as the elbows. The overall goal is squeeze the shoulder blades together at full extension of the arms.
- External Rotation – Grasp the ends of the exercise band with one hand then turn so that the door is at the opposite side of the hand holding the band. With the elbow against the side of the body, rotate the arm away from the door. The goal of this exercise is to work the external rotators of the shoulders.
- Deep neck flexors – Find a comfortable spot on the floor that will allow you to lay down flat on your back. Next, tuck the chin and lift the head about one inch off the floor and hold for ten seconds. You will feel the muscles on the front of the neck contracting.
If you are concerned about your posture or that you are developing upper cross syndrome please stop by the office and we can get you started on treatment.