A common complaint we see in our practice is upper back and neck pain associated with working a desk job or long hours of sitting. This type of dysfunction is called Upper Crossed Syndrome (UCS). If you are not familiar with what Upper Crossed Syndrome is, it is a postural syndrome associated with long periods of sitting, looking at smartphones and/or computer work.
Upper Crossed Syndrome generally results in the following symptoms:
- Forward head carriage
- Forward rounded shoulders
- Chronic neck pain
- Tension headaches
- Back pain
And will usually present as:
- Tightness in the tops of the shoulders (upper trapezius and levator scapula muscles)
- Tightness of the sternocleidomastoid (SCM) muscles
- Tightness of the pectoralis major and minor muscles
- Weakness of the deep neck flexors
- Weakness of the back muscles between the shoulder blades (rhomboids and mid and lower traps)
Patients with this pattern of muscle imbalance commonly complain that practicing good posture or sitting up straight is physically difficult, fatiguing and feels very forced or unnatural for more than a few minutes. Many try taking preventative measures such as adding a lumbar support to their chairs, making sure their desk and computer monitor are at a good height with their arm supported, etc. Others, who do not take any particular preventative measure will often have the same issues, regardless.
What we have found when evaluating our patients is that even though they have a low back support (built into the chair, or accessory), they are still sitting in a rounded position with their low back (lumbar spine).
The spine is designed in such a way that we have what is called a lordotic curve in the low back and neck and a kyphotic curve in the mid/upper back.
Lordotic = curves forward
Kyphotic = curves backward
The image on the right above is the optimal position for your spine. So when we see someone sitting with their low back rounded (backward) we know this is creating an uphill battle trying to sit with a good upright posture. When the low back is rounded backwards, it changes the base for which the spine sits. This creates a pull in the upper back even further into a kyphosis or backwards curve (i.e. rounded shoulders) and a subsequently more exaggerated forward curve of the neck. Whereas, when the low back is in its optimal lordotic, or forward curve, it creates a solid base for that coveted “good posture.”
Optimal positioning for the low back can be achieved by sitting on your sits bones.
This automatically puts the low back in the optimal position for good posture; making sitting upright much less effort! From here, gently relaxing your shoulder blades down and back as well as doing a mild retraction of your chin to assure you aren’t jutting your chin forward.
As you probably know, especially if you are reading this article, holding any one posture for a full 8-hour work day is virtually impossible! This is why we highly recommend taking mini-breaks from sitting (or standing, if that is your desk type) to move around and give your body a break.
For muscle reprogramming/strengthening for postural support please read our blog, Four Exercises You Should Be Doing For Better Posture!