What Upper crossed syndrome is, why it's important, and specifically how to help your clients with it...
✅ Upper crossed syndrome, or UCS, is a muscle imbalance caused by weak, lengthened upper back and neck muscles on the posterior of your body, and tight, shortened chest and neck muscles on the anterior of your body.
✅ The symptoms of upper crossed syndrome can include shoulder pain, upper back pain, neck pain, rounded shoulders and a hunched posture, and headaches.
✅ The author of this article provides a 5-step plan for correcting upper crossed syndrome and helping restore proper posture.
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Do your clients have excellent posture? If they have a desk job, go to school, and/or spend lots of time in front of the computer or TV every day, then the answer is probably no.
So it’s no surprise that so many people show signs of muscle imbalance patterns, such as rounded shoulders, a forward head posture, and excessive anterior pelvic tilt. There’s a mismatch between our ancient physiology and the modern lifestyle. Humans are supposed to move; we’re not adapted for a sedentary life.
The two most common postural problems I’ve encountered when working as a personal trainer are anterior pelvic tilt and upper crossed syndrome (UCS).
Most trainers/coaches have probably experienced the same, and while some might have found effective ways of dealing with these postural deviations, many never seem to pay much attention to these types of syndromes.
It’s essential to be aware of and able to correct muscle imbalance patterns, as they often lead to poor exercise technique, compensation patterns, and injuries.
Treating UCS is also necessary for achieving peak athletic performance, as protracted shoulders will make it hard to train optimally (e.g., getting your chest up in the bench-press), and depression of the sternum could make it more difficult to breathe. Finally, correcting UCS will make you look better, as it will pull your shoulders back and make your chest/breasts look bigger.
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What is Upper Crossed Syndrome?
“In UCS, tightness of the upper trapezius and levator scapula on the dorsal side crosses with tightness of the pectoralis major and minor.
Weakness of the deep cervical flexors ventrally crosses with weakness of the middle and lower trapezius. This pattern of imbalance creates joint dysfunction, particularly at the atlanto-occipital joint, C4-C5 segment, cervicothoracic joint, glenohumeral joint, and T4-T5 segment.”
So, what does this mean exactly? It means that there’s a weakening and lengthening of the posterior upper back and neck muscles and a tightening and shortening of the opposing anterior pectoral (chest) and neck muscles.
What causes UCS?
Upper crossed syndrome is the result of a vicious cycle wherein a sedentary lifestyle (e.g. prolonged sitting with bad posture), poor exercise technique (e.g. biking with rounded upper back position), and/or imbalanced training (e.g. the 20-year-old guy who trains his pecs, often with poor technique, 3 times a week while the upper back is rarely trained) promote UCS, and the muscle imbalance pattern in UCS worsen posture and exercise technique further.
UCS involves reciprocal inhibition, a process where muscles on one side of a joint are relaxing to accommodate contraction on the other side of that joint.
Common symptoms are:
- Forward head posture
- Rounded shoulders
- A hunched upper back
- Shoulder pain, upper back and neck pain
How a Personal Trainer Can Help Treat Upper Crossed Syndrome
There are many good exercises and drills you can use to correct upper crossed syndrome, and I’ve tried many different approaches. While some practitioners and coaches will say that treatment of UCS requires chiropractic intervention, myofascial release, trigger-point therapy and/or a wide range of exercises and mobility drills, I’ve found that a more straightforward approach is also effective. Below is my 5-step plan for treating UCS.
1. Learn how to “set” the shoulders and tuck the chin
Many with UCS don’t know how to correctly retract their scapula and pull their shoulders down, so the first step when correcting this muscle imbalance pattern is to learn to “set the shoulders.” In a standing position, tuck your chin and pull your shoulders down and back by thinking about sticking your shoulder blades in your back pockets.
Having problems? There are a couple possible solutions
– Place a tennis ball under the chin. This forces you to tuck the chin.
– Place your hands on your clients shoulders to initiate the movement.
Begin by performing scapular retraction in a push-up position (pinch the shoulder blades together) or standing position with hands against the wall (think about pushing the wall).
Some people have to stay on this step for a while before they get it, while others get a grasp of things quickly. It’s important to memorize this movement, as it lays the basis for correcting UCS.
2) Strengthen the weakened musculature
Once you’ve learned how to “set” the shoulders, the next step is to perform this movement with added resistance. There are many good exercises for achieving this, but I’ve found seated cable rows and face pulls (begin with a band or use light loads on the pulley machine) to be especially effective.
Don’t go heavy in the beginning — do sets of 10-15 reps, and make sure you’re pulling the shoulders down and back. Hold the contraction at the midpoint for 1-2 seconds (when you’re squeezing the scapulae back/down). When correcting UCS, it’s generally best to avoid too much momentum on these exercises. Instead focus on setting the shoulders. “¨”¨Although it’s generally a good idea to never go too heavy on these exercises, you should be training to near failure as soon as you master the technique. As with resistance training in general, focus on progressive overload (e.g. by increasing the load every time you reach your desired rep target).
3) Stretch the tight musculature
I’ve found that strengthening the posterior musculature is generally more important than stretching. However, stretching is not a waste of time, and it’s easy to perform both at home and at work. Make sure you’re warmed-up, and then perform either static or dynamic stretches for the tight anterior musculature. While there are many different types of mobility drills you can use when correcting UCS, I’ve found that spending too much time on this step is unnecessary. As such, I tend to favor some basic pectoral stretches.
4) Set your shoulders correctly when lifting
As mentioned, people with UCS generally display poor technique in a wide range of exercises. Why? The postural deviation makes it hard for the trainee to get into a position to lift correctly (e.g. inability to set the shoulders in the bench press), and the muscle imbalance pattern often leads to compensation patterns during lifting.
In other words, it’s not enough to target the muscles involved in UCS through specific exercises, you also have to pay extra attention to your exercise technique. Once you’ve worked on the three previous steps for some time, you should now have a good understanding of how to “set” the shoulders. This is something that transfers into many other exercises you’ll be doing at the gym.
Here are some quick tips for the big three:
The bench press: Set your shoulders down and back. Keep your delts locked in during the entire lift.
The squat: Pinch the shoulder blades together, get your chest high, and try not to lose the solid upper back position during the lift.
The deadlift: The deadlift is a tough one. For people with upper crossed syndrome, it’s especially important to get into a good set-up and avoid the flexed upper back position.
–> READ MORE: Troubleshooting the Deadlift
5) Pay attention to posture, and incorporate some mobility drills and corrective exercises.
Although you can achieve a lot by having a workout program that’s specifically designed to correct UCS, it’s important not to forget that most of your time is spent outside of the gym. Naturally, paying attention to your posture — both when sitting and standing — is an important part of treating UCS.
Also, if you sit for prolonged periods of time each day, taking a break here and there to perform some upper back exercises, mobility drills, and stretches is a good idea. Have a band or rope available when you’re at your desk, so you can perform some simple exercises every now and then.
How can you incorporate this plan into a training program?
There are many possible ways to include these steps into a workout routine. Here are a couple of suggestions:
Incorporate step 1 and 3 into your warm-up routine before strength training sessions. This is especially convenient if you generally perform a dynamic warm-up before you hit the weights. Do several sets of 10-15 reps where you “set” the shoulders, and perform some stretches for the anterior musculature.
Spend 10-15 minutes on step 2 every workout by focusing specifically on exercises that target the weak upper back musculature. If you’re training back one day, simply perform these exercises as part of your workout. If not, include seated rows and face pulls at the end of your training session. Also, remember to “set” your shoulders correctly during all the exercises you perform (step 4).
Endurance workouts and group training
Spend 15-25 minutes after you’re done with your endurance workout and/or group training session where you go through the step-by-step plan. Emphasize step 2.
Workouts where the sole purpose is to treat UCS
Spend 10-20 minutes where you perform simple retraction exercises, stretches, band face pulls, etc., and then move on to several sets of seated rows, cable face pulls, and other exercises that specifically target the weak posterior musculature.
Remember, it’s not just about what you do in the gym. Pay attention to your posture throughout the day, and try to make time for some simple exercises (e.g., scapular retractions, face pulls with band) every now and then.
Other Trainers Found These Related Articles Helpful:
- 5 Steps for Dealing With Anterior Pelvic Tilt
- The One Thing You Haven’t Considered About Healthy Shoulders
- Why You Must Not Stretch Hypermobile Clients
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