We see and treat a lot of people who suffer from upper back and neck pain and most of the time this is caused from spending hours sitting ‘hunched’ in front of a computer, so therefore it can mainly be poor posture which is causing this.
Since our move to Central Bristol, we have been seeing even more clients with this problem because of the numerous offices surrounding us.
We have therefore started offering Seated Massage as this treatment is ideal to help relieve pain in the upper body and it is also through clothes, so therefore you can pop in on your lunch break from the office for a no fuss treatment, and the sessions can be shorter.
Pain in these areas is often called: ‘Upper Crossed Syndrome’.
Massage Therapy can help to relieve tension from the overworked muscles and help to stop the pain.
Upper Cross Syndrome is when muscles become deformed and form an over lapping pattern of underuse and overuse.
There is evidence to suggest that as well as sitting hunched in front of a computer all day, a sedentary lifestyle and activities such as driving and reading can cause this.
The image above shows which muscles are typically tight and weak in Upper Crossed Syndrome.
This image also shows tightness in the Suboccipital muscles but this is usually when you have ‘Forward Head Posture’ as well.
What is ‘Forward Head Posture’?
Forward Head Posture (as shown in the above image) is very common and occurs when the head extends too far in front of the gravity line and it usually coincides with having Upper Crossed Syndrome.
Here, the Suboccipital muscles have to work hard to tilt the head and bring it to “eye level”.
“For every inch of Forward Head Posture, it can increase the weight of the head on the spine by an additional 10 pounds.” -Kapandji, Physiology of Joints, Vol.
From reading the above quote, imagine how much pressure this is putting on your spine! This is evidence therefore that having Forward Head Posture can also cause dysfunction further down your body as it can affect your spine which goes all the way to your Coccyx (Tailbone).
The overused muscles in Upper Crossed Syndrome are The Levator Scapula, Upper Trapezius and the Pectorals.
The Upper Trapezius is held in a lengthened, but tight and dysfunctional state and the Levator Scapula and Pectorals are short and tight.
The action of the Upper Trapezius and the Levator Scapula muscles are to elevate the shoulder blades (Scapula) and they work hard during Upper Crossed Syndrome. The Lower Trapezius which pulls the Scapula down (depression) becomes weak because of being underused due to the Scapula being elevated for such a long time.
The action of the Pectorals is to pull the shoulders forward (protract the Scapula) in Upper Crossed Syndrome but when they are doing this for hours, they are bound to be tired.
There’s only so much time that muscles can work hard before they become fatigued and you’ll know when yours are, as you’ll probably feel a dull ache and stiffness in your neck and upper back (as if these muscles are crying out for help).
Unfortunately, the other muscles such as the Rhomboids, Serratus Anterior, Lower Trapezius and Deep Cervical Neck Flexors can forget how to fire up and contract as they haven’t been used for a while and so they cannot assist the Upper Trapezius, Levator Scapula and Pectorals. Hereby is a dysfunctional pattern.
There is evidence to suggest that Upper Crossed Syndrome and Forward Head Posture can also eventually cause headaches, and because every muscle in the body is linked, this can cause problems to occur in our lower body too.
On a positive note though, we can do something about it.
So, how can Upper Crossed Syndrome get treated?
The short muscles ideally should get lengthened and the weak muscles strengthened. It is also beneficial to work at improving our posture seeing as Upper Crossed Syndrome is mainly caused by poor posture.
Every muscle in the body has another muscle that does the opposite action of it and they work together so that’s why dysfunction can occur when one of the muscles is weak and the other is overused and thus there is an imbalance.
For instance, the action of the Deep Cervical Neck Flexors is to flex the head forward and the Upper Trapezius and Levator Scapula extend the head backwards. The Rhomboids retract the scapula (bring the shoulder blades back and together) and the Pectorals protract the scapula (bring the shoulder blades forward and away from each other).
In Forward Head Posture and Upper Crossed Syndrome as the Neck Flexors aren’t being used properly, the Antagonistic muscles to them (the muscles that do the opposing action) are trying to do the Neck Flexors job as well and that’s why they become strained.
You can also stretch the short muscles such as your Upper Trapezius and Levator Scapula and this will help to get your Neck Flexors functioning again at the same time.
I am doing some stretches in the images below to stretch the Upper Trapezius and the Levator Scapula. This helps to relax them and it also initiates contraction of the Deep Neck Flexors.
I recommend doing these if you work at a desk for long periods of time, drive a lot or if you feel tension in your shoulders and tension in between your shoulder blades.
Ideally, please try and hold these stretches for at least for 20 – 30 seconds to allow time for the muscle to stretch.
The stretch below helps to lengthen and release tension from your Pectoral muscles and is my favourite Pectoral stretch as it focuses on each side individually. Therefore you only need to stretch one side if you have short Pectorals on one side of your body. To do this, you stand in a open doorway and place one arm on the inside of the door frame and step forward with your leg. As the static door frame is holding your arm where it is, but you are moving your leg, you should feel a stretch in your Pectorals and as if your ‘opening up’ your chest.
The exercise below is a good Rhomboid muscle strengthener as it retracts the shoulder blades and it can also help improve your posture.
I recommend doing this as many times in a day as possible and holding your shoulder blades in this position for about 10 seconds.
Try to imagine there is a finger in between your shoulder blades and then squeeze the imaginary finger by just using your shoulder blades. Try not to use your shoulders to do it too as the aim of this is to utilise the shoulder blade muscles.
The movement can feel subtle, but it can be very effective.
You can also utilise the Lower Trapezius muscle by pulling your shoulder blades down after pulling them back as it depresses (pulls down) the shoulder blades. This works the Lower Trapezius muscles, which often are weak in Upper Crossed Syndrome.
The below exercise helps to strengthen the deep neck flexors (such as the Longus Colli).
Start by standing flat against a wall with your head also against the wall if your able to. You then move your head down as if tucking your chin in (like your trying to make a double chin). This helps to activate your Deep Cervical Neck Flexors.
Then move your head so it is back against the wall again. Repeat this movement about 10 or 20 times and perform it several times a day.
Finally, the image below shows the ‘Scapula Push-up’ exercise which can help to strengthen our Serratus Anterior muscles which are usually weak in Upper Crossed Syndrome. It is basically ‘The Plank’ which is a pose well known in yoga practice.
Please make sure you keep your whole spine aligned like a ‘plank’ of wood (from your Coccyx up to your neck) so that your lower back isn’t dropping inwards. This can help to develop a good ‘Core’ too.
Holding this position for up to 10 seconds is good if your able to.
To improve our posture when sitting or standing, we can also imagine there’s a helium balloon attached to the top of our heads and that you are being lifted up into the air by the balloon. This can help us to sit or stand up straight.
Some of these stretches can be incorporated easily into your working day as you can do some of them when sitting at your desk.
Experienced Sport and Remedial Massage Therapists can also utilise tests to locate which muscles are weak and which are overused before the treatment and then exercises can be given to you after your treatment that are suited to you and your individual lifestyle.