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UPPER CROSSED SYNDROME (UCS)


Upper crossed syndrome (UCS) occurs when the muscles in the neck, shoulders, and chest become deformed, usually as a result of poor posture.


First, they become extremely strained and overactive. Then, the muscles in the front of the chest, called the major and minor pectoralis, become tight and shortened.


When these muscles are overactive, the surrounding counter muscles are underused and become weak. The overactive muscles and underactive muscles can then overlap, causing an X shape to develop.


Weak muscles :


  • Lower and middle trapezius muscles.

  • Serratus anterior muscles decreased SA activity will be accompanied by a reduction in control of the scapula in static and dynamic states.

  • Infraspinatus muscles.

  • Deep neck flexors play a key role in maintaining the neck's posture. These muscles are weak and prolonged in people with FHP and are not properly recruited.


Tight muscles :


  • Upper trapezius muscles, increase in the UT activity increases the anterior tilt of the scapula and elevates it, leading to a decrease in subacromial space, which increases the probability of shoulder pathology.

  • Pectorals, tightness of the pectoralis major muscle create an anterior force on the glenohumeral joint with consequent decrease stability. A tight pectoralis minor limits scapular upward rotation, external rotation, and posterior tilt, thereby reducing SAS.

  • Levator scapulae muscles, shortness of the levator scapulae may affect muscle coordination and increase shear force and compressive load in the cervical spine.



What are the causes?


Most cases of UCS arise because of continual poor posture. Specifically, standing or sitting for long periods with the head pushed forward.


People often adopt this position when they are,

  • Reading

  • Watching TV

  • Biking

  • Driving

  • Using a laptop, computer, or smartphone


In a small number of cases, UCS can develop as the result of congenital defects or injuries.


Symptoms


Most of the People with UCS display symptoms such as,

  • Neck pain

  • Headache

  • Weakness in the front of the neck

  • Strain in the back of the neck

  • Pain in the upper back and shoulders

  • Tightness and pain in the chest

  • Jaw pain

  • Fatigue

  • Lower back pain

  • The trouble with sitting to read or watch TV


Individuals who present with the upper crossed syndrome will show,

  • A forward head posture (FHP)

  • Hunching of the thoracic spine

  • As well as changed function in the shoulder girdle

  • Elevated and protracted shoulders

  • Scapular winging

  • Decreased mobility of the thoracic spine.


Treatment options


The treatment options for UCS are chiropractic care, physical therapy, and exercise. Usually, a combination of all three is recommended.


Chiropractic care


UCS can cause your joints to become misaligned. A chiropractic adjustment from a licensed practitioner can help to realign these joints. This can increase the range of motion in the affected areas. An adjustment also usually stretches and relaxes the shortened muscles.


Physical therapy


A physical therapist uses a combination of approaches. First, they offer education and advice related to your condition, such as why it’s occurred and how to prevent it in the future.


Exercises


Patient with UCS must do a few Lying down exercises & Sitting down exercises


How is upper crossed syndrome diagnosed?


UCS has a number of identifying characteristics that will be recognized by your doctor. These include,

  • The head often being in a forward position.

  • The spine curving inward at the neck.

  • The spine curving outward at the upper back and shoulders.

  • Rounded, protracted, or elevated shoulders.

  • The visible area of the shoulder blade sitting out instead of lying flat.


Prevention


UCS is usually a preventable condition. Practicing proper posture is of vital importance in both preventing and treating the condition.


  • Be aware of your posture

  • Correct your posture if you find yourself adopting the wrong position.


The symptoms of UCS can often be relieved or completely eradicated with treatment. Some people go on to suffer from the condition repeatedly throughout their lives, but this is usually because they are not following their exercise plan or paying attention to their posture on a daily basis.


When the individualized treatment plans for UCS are followed precisely, it is an entirely manageable condition.


References


https://www.healthline.com/health/upper-crossed-syndrome.



Supun Udara

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