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Upper Cross Syndrome: Causes, Symptoms & Treatments

Upper cross syndrome (UCS) is a painful condition where poor posture has led to the neck, shoulders and chest becoming deformed.

The muscles typically affected most by this are the back muscles of the shoulders and the neck. They firstly become strained and overactive, then the muscles at the front of the chest become shortened.

The muscular imbalances may lead to various musculoskeletal symptoms, including headaches, neck, chest and upper back pain, and a limited range of motion in the neck and shoulders.

In this article, we’ll explore the causes, symptoms and treatments of upper cross syndrome, as well as outline some exercises you can do to relieve any tension you may be experiencing.


Table of Contents

  • What is upper cross syndrome?

  • What causes upper cross syndrome?

  • What are the main symptoms of upper cross syndrome?

  • How is upper cross syndrome treated?

  • Preventing upper cross syndrome

  • Upper cross syndrome exercises

Infographic 1

What is upper cross syndrome?

Upper cross syndrome occurs when the muscles of your shoulders, neck and chest are out of balance. When one muscle becomes weak, another takes over the work. In this case, the serratus and trapezius muscles of the mid and upper back aren’t working as they should, so the pectoral and neck muscles tighten. This created the “cross” pattern which gives the condition its name: the spine will pull forward, increasing the stress on other muscles. This leads to rounded shoulders, a craned head and spinal curvature in the mid-back and neck.


What causes upper cross syndrome?


The main driver of upper cross syndrome is poor posture. Long hours of sitting at a computer, watching television or using a smartphone can all contribute, but it can also impact athletes such as swimmers or weightlifters due to overuse of the muscles around the neck, shoulder and upper back.


What are the main symptoms of upper cross syndrome?

Upper cross syndrome often manifests itself in a physical way as your shoulders hunch and the neck and head slouched forward. However, the surrounding stress on the muscles, joints, bones and tendons can also cause:

  • Difficulty sitting while reading, watching TV or driving for prolonged periods of time

  • Tension headaches

  • Neck pain which may be caused by the strain on the back of the neck

  • Lower back pain, as well as soreness around shoulder blades

  • Numbness, tingling and pain in the upper arms

Infographic 2

How is upper cross syndrome treated?

Treating upper cross syndrome with physical therapy has been proven to work. Exercises that may be recommended to you include lying on large training balls to stretch the back,

Using Thera-bands to stretch the shoulder and arms and weight training using dumbbells and barbells.

Preventing upper cross syndrome

Upper cross syndrome can be prevented by making small changes, including:

Refrain from slouching – having good posture is an easy way to avoid upper cross syndrome. Sitting up straight with your head squarely between your shoulder will help, as will avoiding leaning heavily to one side while sitting or standing.

Raise items to eye level – instead of tilting your head to read your phone or a book for example, try raising items to your eye level if possible.

Take regular breaks – if you’re sitting for long periods of time, try get up every 15-20 minutes.

Exercise – ideally, try to get 30 minutes of daily cardiovascular exercise from low-impact activities such as walking or swimming. This will also help exercise the muscles of your core, back and abdomen that will help with better posture.

Stretching – do stretches that target sore muscles of the back of the neck, shoulders and chest.

The effects of neck and back pain may be more severe in people who smoke or are overweight, as excess weight can add pressure to the muscles.

Upper cross syndrome exercises


There are plenty of exercises that can help with upper cross syndrome, but three simple ones are:

Trapezius Stretch – this will help the muscle from getting too tight and will relieve some tensions.

  1. Sit up straight.

  2. Slowly draw the right ear towards the right shoulder.

  3. Hold for 20 to 30 seconds.

  4. Repeat on the left side.

Infographic 3

Thoracic Twists – this exercise can help open up the chest, improving breathing and reduce tightness in the joints.

  1. Kneel down on your knees with your buttocks touching your heels.

  2. Extend one hand on the floor to support your body and place the other behind your head.

  3. Twist your body toward the extended arm and try to touch your elbow with the arm that is behind your head.

  4. Twist your body to open in the opposite direction and aim to do this 10 times.

Chin tucks – this method is simple yet effective as it helps strengthen the muscles that pull the head back to its normal alignment over the shoulders.

  1. Sit up straight with your neck in a relaxed position.

  2. Look forward and pull your chin backwards, as if you are trying to give yourself a ‘double chin’. Do not tilt the head downwards.

  3. Hold this position for about eight seconds and repeat five times. This can be repeated about three or four times throughout the day.

Wrapping up

Upper cross syndrome is an uncomfortable and sometimes painful condition that can be difficult to deal with. If the root of the problem is not prevented, it can have a physical impact upon your posture and body. If you’ve been struggling with upper back pain, or feel any of the symptoms outlined are true for you, it may be worth contacting a physiotherapist who will be able to correctly diagnose and help treat your condition. At Infinite Health, we have physiotherapists and chiropractors in North Sydney, Chatswood, Sydney CBD and Mosman.


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