Upper Cross Syndrome

Upper cross syndrome is a condition that is chronic in nature. It occurs over time with unhealthy posture and poor movement patterns. It is very common among office workers and people who spend hours a day in front of a computer. Signs of upper cross syndrome include forward head posture, rounded shoulders and upper back, pain in the upper back and neck, and tension headaches. This diagnosis describes a condition in which opposing muscles from front to back are out of balance.

The following muscles are overactive: sub-occipitals, SCM's, scalenes, pecs, levator scapulae, and the upper trapezius. The tightness in these muscles is responsible for pulling the head and shoulders forward. Lengthening these muscles is necessary to regain balance.

The following muscles are under active: deep neck flexors, neck extensors, and scapular stabilizers. When these muscles are not being used, they become chronically lengthened and develop trigger points. This can also be a primary cause of tension headaches. Specific exercises designed to target these muscles will activate them. As they regain strength and function, muscle balance will return.

Because of chronic poor posture, people with upper cross syndrome generally have numerous fixations in the upper back and neck. It is very important to get chiropractic adjustments regularly throughout treatment to increase mobility. Strengthening exercises work better when the muscles and joints are flexible and capable of a full range of motion.

What are the implications of a forward head posture secondary to an upper cross syndrome? New studies reveal some interesting insight to how posture not only affects the way we look, but it affects our health potential as well. A study published in the most prestigious orthopedic journal in the world, researchers found that all measures of health status demonstrated significantly poorer scores as the head migrates forward. The study headed by Steven Glassman, MD was published in Spine, Volume 30(18), September 15, 2005. In the study 752 patients were evaluated for spinal deformity which was described as an anterior head posture (upper cross syndrome). Of the 752 randomly selected adult patients, 298 were found to have upper cross syndrome. The researches then designed a method to measure severity of the condition. Some patients obviously had worse posture than others. Key points from this study include:

  • There is clear evidence of increased pain and decreased function as a persons posture worsens, ie. As the head migrates forward.
  • All measures of health status showed significant poorer scores in patients who suffer from upper cross syndrome.
  • The further forward the head migrates, the poorer the health status scores for the patients.


This very recent study documents how your health is directly related to your spinal function and posture. Correcting these problems is not just about neck and back pain, it's about living life free of disease.

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