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Upper crossed syndrome is a common postural dysfunctional pattern that describes the dysfunctional tone of the musculature of the shoulder girdle/cervicothoracic region of the body. This condition is given its name because an "X," in other words a cross, can be drawn across the upper body (Figure 1). One arm of the cross indicates the muscles that are typically tight/overly facilitated and the other arm of the cross indicates the muscles that are typically weak/ overly inhibited. The term rounded shoulders is often used to describe the rounded forward shoulder girdle and arm posture that is part of the upper crossed syndrome.
This condition is designated as the upper crossed syndrome because a similar postural dysfunctional pattern called the lower crossed syndrome is found across the pelvic girdle/lumbosacral region. Both the upper and lower crossed syndromes were initially described and named by a Czech physician and researcher named Vladimir Janda.
Causes
The primary cause of upper crossed syndrome is chronic postural stress to the upper body. Most tasks that we perform require us to work down and in front of ourselves, causing us to flex the upper spine, protract the head, protract the shoulder girdles, and medially rotate the arms. Examples include working at a keyboard, using a smart phone, reading a book in our lap, or tending to a baby (Figure 2). Maintaining this posture necessitates the contraction and shortening of certain muscles and the inhibition and lengthening of others (Table 1).
The muscles that are chronically contracted and shortened end up becoming overly facilitated and tight while the muscles that are chronically lengthened end up becoming inhibited and weaker. Ironically, even the lengthened weakened muscles can gradually become tight as they attempt to oppose the shortened facilitated muscles (and even the shortened tight muscles can become weak due to the altered length tension relationship). For this reason, upper crossed syndrome often results in opposing muscle groups that are described as locked short and locked long, neither of which are strong and efficient in their contraction capability.
In addition to the pattern of muscle engagement created by a chronic rounded posture, some sources believe that there is a predisposition for certain muscles in the body to become overly facilitated and tight, and for...