Upper Cross Syndrome AKA Forward Head Posture
upper cross syndrome

Upper Cross Syndrome AKA Forward Head Posture


Upper Cross Syndrome also known as Forward head posture is a myofascial imbalance of the body. According to Dr. Vladimir Janda, this imbalance most commonly affects the neck, upper back and shoulders but also has the tendency to affect the elbows, arms and hands.  Developing mostly from daily microtrauma or repetition —- prolonged hours sitting at a desk or on the couch, laptop & cell phone usage, sleeping with 2+ pillows, non-active lifestyle and of course poor posture!  This syndrome is accumulative over time, happening over several months and years!

Features of Upper Cross Syndrome:

  • Forward Head posturing: Your head weights approximately 8-10 lbs and is held up by a conglomerate of structures. Would you believe that when the head is imbalanced, you add an additional 10 lbs of pressure to your body?  This absolutely causes extra stress to spinal joints & muscles attached to the neck, upper back, shoulders and shoulder blades. Not to mention loss of muscle tone.
  • Dysfunctional muscular movement patterns: For instance, when raising your arm, the infraspinatus is chronically stressed or over worked, this makes the work of the deltoid harder. This happens due to the deltoid picking up the slack from the infraspinatus, who is not doing its job. Some of the muscles involved include:  Levator scapulae, deltoids, scalenes, upper & Lower trapezius, subscapularis, pec. minor & major, supra & infraspinatus.

Over extended periods of time, your shoulder muscles begin to shorten developing tension, trigger points or “knots” and begin to weaken. Contrary to popular believe, muscles that chronically tighten are inherently weak! Creating the best environment for injury!

  • Rounding of the shoulders: When UCS starts to set in, you notice your shoulders begin to round forward and drop downward. This is due to de-conditioning (weakening) of the stabilization muscles and over-activity of the muscles that flex the neck. Also, “flaring out” of your scapulae (aka shoulder blades) is another sign of muscle weakness and possible UCS. Alterations with muscle patterns during normal shoulder movement causes more biomechanical dysfunction when moving your arms. Did you know that even when you aren’t using your shoulders, your muscles are still stabilizing your shoulder joint?
  • Difficulty Breathing: yup, that’s right! Some of those same muscles that keep your head on straight are the same muscles that help you breathe! Try it yourself. First hunch over, roll your shoulders forward, then try to take a deep breath. Now, correct your posture, roll those shoulders back, bring the head back and over the shoulders, then take another deep breath. Notice the difference?  Which one was easier to breathe? You see, the lungs have a hard time expanding or taking in air when our posture suffers. As soon you correct this issue, you are able to take in more viable amounts of oxygen, which absolutely effects your daily activity and your overall health!  

Here are a couple of things you can do to circumvent Upper Cross Syndrome:

  • Starting with consciously evaluating your own posture. Get in front of a mirror and look at yourself. What do you see? Notice if your head is crooked or if your shoulders are rounded and if you can see the backs of your hands.
  • Do some neck stretches to loosen those tight muscles in the neck & upper back! Gently bend your head to the right and slowly to the left. If you feel your muscles are tight, use your right hand on the left side of your head (and left hand on the right side of your head) to add some more pressure to loosen your muscles. Be sure to take some deep breathes while stretching. And don’t forget about those PECS! Find a door way, open your arms and lean against the door way. Feel the stretch!!! There are many other soft tissue techniques which can be used to address your muscles including: specific at home exercises, using lacrosse balls, foam rolling, massages and even topical analgesia (like Relief, bio freeze & china gel) for pain control.
  • If you notice your head is forward, lay on a hard surface (like the floor) roll up a bath towel and place it behind your neck as close to the top of your shoulders creating a wedge for the neck. Lay there for 5-10mins. This should not be painful. It should like your neck is being cradled and pulled by gravity.
  • Make sure your work area is set up to be ergonomically correct. Computer or laptops should be at eye level or higher. Your seat should have a lumbar support. And try not to sit on your phone or wallet which sometimes you leave in your back pocket. Remember to take breaks thought your day. Don’t stay seated or any position for long periods of time without breaks to move and stretch!

As with any practice, implementing small daily lifestyle changes will help to counteract upper cross syndrome and achieve better posture. So don’t fret! Rome wasn’t built in a day, nor will correcting your posture! Commit to doing a few stretches or exercises for 5-15 minutes out of your day as a starting point. And over time you should begin to see and notice changes within yourself!

If these tips don’t help to resolve this issue and you need more assistance, I am here to help! Chiropractic care is the next step in correcting upper cross syndrome (UCS) and obtaining better posture!  During your visit, I will conduct a full and complete examination, determining your areas of weakness, postural faults and SUBLUXATION (mis-alignments within your spine). Depending on your history as well as other physical factors, will determine if you may need x-rays for further evaluation. After you have been fully examined, we can determine if you are a candidate for a chiropractic adjustment! The adjustment to the spine can ONLY be administered by the Doctor of Chiropractic (DC) and it is specific to your spinal needs!

Montgomery DC, P. “Upper cross syndrome,” 2018.  Lecture.

About the Author Dr. Moy Parott

Dr. Moynica S. Parott, better known as “Dr. Moy,” was born in Belleville, IL at Scott Air Force Base to parents who were active military service members. She grew up in Saint Louis, MO with dreams of becoming a business administrator before deciding on a career in Chiropractic. Click Here To Read Full Bio

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