How Upper Crossed Syndrome May Be the Source of Your Neck and Shoulder Pain.

Many of us people in Franklin and Brentwood have jobs that have us constantly performing tasks that are low and in front of us. This causes us round our shoulders and flex our neck forward resulting in tight upper trapezius and levator scapula muscles of the upper back and neck  as well as tight pectoralis major and minor muscles of the chest. These tight muscles, also referred to as facilitated result in inhibited counter muscles like the deep cervical flexors and the rhomboid muscles. Overall this causes a forward head posture where the ears are no longer centered over the shoulders but rather in front of the shoulders and the shoulders are pulled forward; this condition is known as upper crossed syndrome.

The Causes of Upper Crossed Syndrome

As stated above, frequently performing tasks that bring you arms in in front of you especially when in a lower than shoulder height position contributes to this altered posture. When we sit for long periods of time performing tasks like typing or texting, we reset the resting tone of the muscles involved. Some muscles will become facilitated, meaning that the tension on the muscle at rest will be increased, and other muscles on the opposite side will be inhibited, meaning that the tension is decreased. Since the resting tone is altered, so are the joint positions of the joints that the muscles are attached to.

How Upper Crossed Syndrome Presents

A patient with Upper Crossed syndrome will have rounded shoulders, a flexed lower neck and extension of the upper neck.


Cause of neck and shoulder pain
Muscles that may be involved in posture distortion that causes neck and shoulder pain.

Muscles That Are Facilitated (Tightened)

The pectoralis major and pectoralis minor muscles of the chest, the anterior deltoid of the shoulder, the levator scapulae and upper trapezius muscles of the upper back, the suboccipital muscles of the upper neck, and the sternocleidomastoid muscle of the neck are all facilitated.

Muscles That Are Inhibited (Weakened)

The deep cervical flexors longus coli and longus capitus, hyoid muscles of the anterior neck, posterior deltoid muscle and external rotator muscles of the shoulder, the serratus anterior muscles on the sides of the rib cage,  and the mid back rhomboid and lower trapezius muscles are all inhibited.

The role of Neurology in Upper Crossed Syndrome

An important neurological concept referred to as reciprocal inhibition is responsible for the loss of tension of the muscles opposing the facilitated groups. This concept is what allows us to move and helps us to be in control our movements but when a posture is adopted for long periods of time results in a new resting tone of the muscle groups.

While reciprocal inhibition is the concept that allows upper cross syndrome to occur, it also is also one of the concepts that can be used to treat upper crossed syndrome (more on that below).

The Symptoms

Typically patients will feel tightness in their upper back which may be sore especially in the upper trapezius, suboccipital muscles, and levator scapulae. Often these muscles will develop triggerpoints some of which may refer pain to other parts of the body such as the arms or head. Patients may also feel fatigue usually in the rhomboid and lower trapezius muscles. This is primarily due to the muscles constantly being stretched by the anterior muscle groups. Patients also tend to have limited range of motion of their neck and shoulders. Internally rotated shoulders often lead to rotator cuff issues. Patients may experience tender points at the coracoid process that are painful upon pressure being applied.

Treatment Strategies and Options

There are several things that can be done to combat this condition due to the many symptoms that may occur, but we will focus on two that attack the source problem.

One of the quickest ways to get the body to start a new neurological pattern and reset the resting tone of the muscles is Directional Non-Force Technique Chiropractic care. This technique addresses each muscle involved individually and works to reset tone with each thrust. Directional Non-Force Technique also addresses the malposition of the bones of the joints. Correcting the proprioceptive input helps the body to equalize the system and return to a state of balance.

The other key factor is exercise. Using the concept of reciprocal inhibition to the patients advantage, all the patient needs to do is strengthen the muscles that are inhibited and stretch those that are facilitated. It is important that the patient actively perform these corrective posture exercises throughout the day and not just during short periods. Due to all the muscles involved in upper cross syndrome, it is key to target all the postural abnormalities so as to be efficient and not exacerbate an issue.

For more information on Upper Crossed Syndrome and how it may be causing your neck pain or shoulder pain, consult your chiropractor. For the Franklin and Brentwood area, White Feaher Chiropractic is at your service offering Directional non-Force Technique Chiropractic care and rehabilitative exercises. You may schedule an appointment with Dr. Chance Moore, DC by calling or texting 615-415-0125.