We see and treat a lot of people who suffer from upper back and neck pain and most of the time this is caused by spending hours sitting ‘hunched’ in front of a computer so therefore it’s 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.
So, what is the name given to the pain experienced from this type of posture?
It is called: ‘Upper Crossed Syndrome’.
It 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 a lot of driving and reading can cause this.
The image above shows Upper Crossed Syndrome and which muscles are typically tight and weak.
Massage can help relieve tension from the overworked muscles and help stop the pain.
This image also shows tightness in the Suboccipital muscles but this is usually when you have ‘Forward Head Posture’ aswell.
Forward Head Posture occurs when the head extends too far in front of the gravity line and it usually coincides with having Upper Crossed Syndrome. In Forward Head Posture, the Suboccipital muscles have to work hard to tilt the head and bring it to “eye level”.
The overused muscles in Upper Crossed Syndrome are The Levator Scapula and Upper Trapezius which are held in a lengthened but tight state and the Pectorals which are short but also contracted.
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 do not help the Upper Trapezius, Levator Scapula and Pectorals. Hereby is the dysfunctional pattern of Upper Crossed Syndrome.
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 are linked it can cause problems to occur in your lower body.
On a positive note though, you can do something about it.
So, how can Upper Crossed Syndrome get treated?
The short muscles ideally should get lengthened, the tight muscles loosened and the weak muscles strengthened. It is also beneficial to work at improving your posture seeing as Upper Crossed Syndrome is 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 anatogonistic muscles to them (the muscles that do the opposing action) are trying to do the Neck Flexors job too and that’s why they become strained.
You can also perform stretches which not only relax your Upper Trapezius and Levator Scapula, but they’ll help to get your Neck Flexors functioning again at the same time.
By flexing your head downwards and in different directions and by holding each position (stretch) you are relaxing the Upper Trapezius and Levator Scapula which has been working hard to elevate the shoulders when slouching and you are also initiating contraction of the Deep Neck Flexors.
Stretches should be held for ideally held for 20 – 30 seconds to allow time for the muscle to be stretched.
The stretch below is 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. 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 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 it 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 that aren’t being used.
The movement can feel subtle, but I believe it is very effective.
You can also utilise the Lower Trapezius muscle by moving your shoulder blades down after pulling them back as it depresses (pulls down) the shoulder blades.
The below exercise helps to strengthen the deep neck flexors (such as the Longus Colli).
Start by standing against a wall with your head also against the wall. You then move your head down as if tucking your chin in which helps to activate your Deep Cervical Neck Flexors and 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 below ‘Scapula Pushup’ is a good exercise to strengthen your Serratus Anterior muscle.
Holding this position for up to 10 seconds is good if you can.
To improve your posture when sitting or standing, you can also imagine there’s a helium balloon attached to the top of your head and that you are being lifted up by the balloon. This allows you 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 and they should help improve Upper Crossed Syndrome.
Experienced Sport and Remedial Massage Therapists can also use tests to find which muscles are weak and which are overused before the treatment and then exercises can be given to you after the treatment that are ideally suited to you and your individual lifestyle.