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Upper Crossed Syndrome: The Preventable Fate of Silicon Valley

AbbyPuente August 18, 2017 Davis, CA 2017

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Abstract

Many people think of Silicon Valley as the innovative city of wealth and opportunity.

However, with the growing population of desk jockey’s, it is no wonder so many people suffer

from chronic pain, immobility, and stress. As a culture, we need to redefine the meaning of

wealth to involve the quality of ones’ life, in a more holistic manner. We need to start making

health, and more specifically movement, more of a priority. Despite the seemingly imminent fate

of poor posture and undesirable health issues this population is destined to have, there is still

hope. In this paper I will discuss what causes upper crossed syndrome, how it affects the body,

and how I would approach a client who suffers from it.

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Table of Contents

Title 1

Abstract 2

Table of Contents 3

Anatomy of upper crossed syndrome 4

Introduction 5

Case study 6

Program 7

Conclusion 11

Bibliography 12

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The Anatomy of Upper Crossed Syndrome

Upper crossed syndrome is characterized by a forward-head and rounded-shoulders, and

it involves an imbalance in the myofascial system that causes poor posture. Figure 1 below

shows how certain muscle groups are relatively: shorter, weaker, overstretched, over-contracted,

and even inhibited. The “X” simply shows the correlation between muscles that tend to be weak

or inhibited (anterior neck muscles, Rhomboids, and Serratus Anterior) and the muscles that tend

to be tight or overactive (posterior neck muscles, pecs, and sternocleidomastoid) as a result of

this postural deviation.

Upper Crossed syndrome involves a physiological response to the nervous system called

reciprocal inhibition. During reciprocal inhibition, a group of muscles on one side of the body

contract, inhibiting muscles on the other side from firing. This causes certain muscle groups to

become overly contracted and others to be weak. If upper crossed syndrome is not addressed,

postural deviations may grow worse over time and lead to a variety of painful issues. Figure 2

shows how upper crossed syndrome can be perpetuated by sitting at a desk all day.

Figure 1 Figure 2

http://humananatomychart.us/category/muscle/page/12/ http://chiro352.com/upper-cross-syndrome/

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Introduction

Upper crossed syndrome is an imbalance that occurs in the soft tissues of the thoracic and

cervical areas of the body. Due to poor ergonomics and the sedentary nature of most jobs these

days, upper crossed syndrome is amongst the most common musculoskeletal imbalances of the

21st century. This unfortunate postural deviation is also known as “tech neck” and is especially

proliferate in the Silicon Valley area.

Upper crossed syndrome is seen at varying degrees of postural deviation. Therefore, as an

individual spends more time in a forward-head, rounded-shoulders position, the condition is

likely to get worse and cause more and more issues. A few of the symptoms likely to arise from

upper crossed syndrome include: headaches, degeneration of the thoracic and cervical spine, and

chronic neck, back, and shoulder pain.

Through the BASI Pilates method, we look at each individuals’ needs and goals in order to

develop a unique program to improve overall health and fitness. It is important to address upper

crossed syndrome, because no matter a client’s larger goals, he or she will be limited in their

ability to progress if they do not address major postural imbalances. The BASI block system

ensures clients will receive a well-rounded session every time. However, it is up to the teacher to

emphasize specific cues, exercises, and homework that will help improve a condition such as

upper crossed syndrome.

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Case Study

Alice, is a 55 year old woman who suffers from upper crossed syndrome. She works 40+

hours a week and spends much of her time sitting at a desk. She was an athlete and avid exerciser

in the past, but has been mostly sedentary for the past 5 years. Alice experiences a lot of tension

and stiffness in her shoulders, neck, and chest area. She suffers from headaches and finds it

extremely difficult to externally rotate her arms. When attempting any sort of back bend, she

habitually hyperextends her neck as a compensation for her hyper-lordodic thoracic spine. She

reports spending much of her time sitting with a rounded back and her head “jutting” forward

while working. Alices’ goals are to lose weight, to feel stronger, more flexible, and to improve

her posture.

Alice has found relief working with a chiropractor and masseuse in the past, however, she is

interested in regaining her strength and finding a more long term solution to her discomfort.

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Conditioning Program

Alice’s conditioning program encompasses a well-rounded routine with a focus on bringing

more balance to her body. Because alleviating upper-crossed syndrome is a priority, I included

exercises that will strengthen her rhomboids and serratus anterior, and that will help lengthen the

muscles of her chest and posterior neck. We also must strengthen her core in order to encourage

a more stable neutral spine while sitting for long hours in a chair. By focusing on proper posture

and alignment, Alice will begin to understand how to adjust her body even as she moves

throughout her day outside of her Pilates sessions. It is important that Alice commits to

exercising at least 5x/week if she wants to see and feel lasting results.

The following represents an exercise program for Alice that honors the BASI block system.

For the next 5 weeks, Alice will come in to the studio 2x/week and will be instructed to do home

exercises for the other 3 days.

Warm-up:

**Each session will begin with a warm-up. We will take this time to prepare the body and mind

for the more challenging work ahead. The warm-up is a chance for Alice to bring more

awareness into her body and her breath**

• Roll down

**We will begin every session with a roll-down in order to assess Alice’s posture and mobility**

• Foundational: Pelvic Curl, Spine twist supine, Chest lift, Chest lift with rotation,

Single leg lifts

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**Because Alice struggles with upper crossed syndrome, to begin we would use the magic circle

to support her head until she acquires more shoulder mobility and core strength. This will help

reduce tension in her posterior cervical region**

Footwork: REFORMER

• Parallel heels & toes, V position toes, open V heels & toes, calf raises, prances,

prehensile, single leg heels & toes

**During footwork Alice will be cued to maintain a neutral spine, a braced core, and her chest

open. We will raise her head rest up in order to diffuse any tension in her neck**

Abdominal Work: STEP BARREL

• Chest lift, reach, & overhead stretch

**These exercises on the step barrel involve extension of the thoracic spine. Getting more

mobile in her thoracic spine and increasing core strength will help bring more balance to Alice’s

posture**

Hip Work: REFORMER

• Frog, Circles (Down, Up), Openings

**While performing hip work I will encourage Alice to maintain a neutral pelvis and spine and

to activate her Lats in order to relax the muscles of her posterior neck**

Spinal Articulation:

**Spinal articulation is not recommended until after the first 10 sessions for any new client**

Stretches:

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• Standing lunge (Reformer)

• Shoulder stretch lying side (Step Barrel)

**BASI block system encourages a holistic approach to each workout and although standing

lunge may not be directly linked to improving upper crossed syndrome it is a valuable exercise

that is helpful for overall flexibility and body mechanics. Shoulder stretch is an excellent

opportunity to improve thoracic spine mobility and to stretch the pecs and lats. I will encourage

Alice to breathe slowly and deep in order to induce a more relaxed state while stretching**

Full Body Integration 1: CADILLAC

• Sitting forward & Side reach

**Although these are intermediate exercises, after a few sessions I think it would be safe to

progress Alice to sitting forward and side reach on the Cadillac. Both exercises help bring more

mobility into the trunk while strengthening the abdominals. These exercises will be beneficial to

Alice’s program**

Arm Work: PED-A-PUL

• Arms standing series: Extension, adduction, circles up, circles down, triceps.

**This standing series encourages great posture while building arm strength. I will be sure to

observe Alice’s posture closely and make adjustments whenever she falls out of alignment**

Full Body Integration 2:

**The FBI-2 exercises will not be appropriate for Alice until she has reached a more advanced

level of competency in the Pilates repertoire**

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Extra Leg Work: MAT

• Gluteals Side Lying Series (ankle weights): Side leg lift, forward and lift, forward

with drops

• Adductor squeeze (magic circle)

**These extra leg exercises promote a more holistic workout**

Lateral Flexion/Rotation: STEP BARREL

• Side lift

**This is a fundamental lateral flexion exercise that will help Alice strengthen her obliques while

bringing more movement into her spine in the frontal plane**

Back Extension: REFORMER

• Cobra & Breast stroke prep

**Because back extensions are very challenging for Alice, for the first few sessions I will have

her work on cobra on the mat. As she gains more mobility in her thoracic spine we will progress

to breast stroke prep on the reformer**

Close:

***Every session will end with a Roll-down as a tool to assess how the body changes after each

session.

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Conclusion

With the implementation of this program, Alice has already experienced profound results.

She reports being able to stand up taller and feels stronger, more flexible, more aware of her

body, and less tense. She rarely feels pain in her upper neck and no longer experiences daily

headaches. Alice has developed a much deeper understanding about how to hold her body and is

much more aware of her posture throughout the day. She knows when to take breaks at work in

order to stretch and regroup, and she is consistent with her home practice. The next step is to

continue to progress Alice into more intermediate exercises, and eventually advanced.

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Bibliography

Myers, Thomas. Anatomy Trains: Myofascial Meridians for Manual & Movement

Therapists. Maine: Elsevier health, 2014.

Clark, Michael. Lucett. Sutton. NASM: Essentials of Personal Fitness Training. Chandler,

Arizona: National Academy of Sports Medicine, 2014.

Isacowitz, Rael. Study Guide: Foundational Apparatus Program. Costa Mesa, California:

Body Arts and Science International, 2016.

Isacowitz, Rael. Study Guide: Graduate Program. Costa Mesa, California: Body Arts and

Science International, 2016.