Rounded shoulder, forward head posture is commonly referred to as upper crossed syndrome and is common not only in the de-conditioned, but also with the advanced fitness enthusiast. The more we sit in front of computers, watch TV, talk on the phone, weight train in uni-planar environments (fixed machines), etc., the worse off we are. Because Americans spend most of their awakened day in a seated position, prepare for an increased amount of clients with postural problems seeking your assistance.
To achieve success in the correction of postural abnormalities, fitness professionals must recognize the trend toward NON-FUNCTIONAL LIVING and take measures to stay one step ahead. The client today is not adept to function at a level that was seen 15-20 years ago. Therefore, the CURRENT training programs seen in today’s literature cannot be the same as the programs of the past.
Traditional fitness programs place significant emphasis on cardiovascular fitness, muscle development, and max strength, without regard to postural health. If the de-conditioned (de-conditioned refers to a state in which a person has muscle imbalances, decreased flexibility, and/or a lack of core and joint stability) fitness enthusiast jumps into a hypertrophy, strength or cardio program, they can easily end up with an injury, prior to ever reaching their goal.
In fact, research has been conducted on the effectiveness of traditional training programs on sedentary adults. Watkins notes that the intensity required by a sedentary person who is trying to improve their cardiorespiratory fitness level might put them in a state of excessive overload. Therefore, the stress of most traditional exercise programs can easily cause wear to the de-conditioned body due to lack of postural stabilization or structural integrity (structural integrity is definted as the holding together of the body's musculoskeletal system).
As trainers, we must prepare our clients to succeed in today’s chair-borne society! This requires an understanding of kinetic chain imbalances. Once the imbalances are recognized, the trainer can begin the corrective exercise program. This mini-article will identify imbalances and possible solutions associated with upper crossed syndrome. Due to the fact that everyone is different, this information should not be used as a protocol. It is intended to provide the trainer with a process to follow and manipulate. As with all imbalances, it is important to NOT adopt a local view!
Before reviewing the imbalances associated with upper crossed syndrome, let’s test the effects of incorrect posture.
Stand up, round your shoulders forward, and slouch while looking forward. While maintaining this position, you will notice tension at the base of the skull, restricted breath, and a decreased volume in the abdominal area. The information listed below, explains the possible ill effects of such posture.
- The tension at the base of the skull will limit blood flow to the brain, decreasing brain function.
- The forward head causes the mandible to retract, compressing the temporo-mandibular joint leading to TMJ dysfunction.
- The restricted breath limits oxygen uptake and waste product removal, decreasing our energy and increasing the toxicity of our cells.
- The decreased abdominal volume limits digestion and nutrient uptake, contributing to constipation.
- Rounded shoulder syndrome puts the diaphragm in a shortened state, putting pressure on the aorta and vena cava. This forces the heart to work harder.
UPPER CROSSED SYNDROME
Rounded shoulders and a forward head posture characterize the upper crossed syndrome. This pattern is common in individuals who sit a lot or develop pattern overload from uni-dimensional training protocols. Functionally tightened muscles, as well as functionally weak or inhibited muscles are listed below.
SHORT TIGHT/OVERACTIVE MUSCLES
- Pectoralis major / minor
- Anterior deltoid
- Latissimus dorsi
- Levator scapulae
- Upper trapezius
- Teres major
- Rectus Capitus
WEAK OR INHIBITED MUSCLES
- Lower trapezius
- Posterior deltoid
- Teres minor
- Serratus anterior
- Longus coli/capitus
||CORRECTIVE EXERCISE TRAINING FOR UPPER CROSSED SYNDROME
- Upper traps
- Levator scapulae
*Retraction / depression
Strengthen deep cervical flexors/stabilizers
Re-educate proper diaphragmatic breathing
Teach proper body alignment
After corrective stretches are performed, teach proper body alignment through corrective exercises. The corrective exercises should be a part of your client’s DAILY routine. Exercising in the fitness facility alone will not correct postural abnormalities. Posture improvement should include small but powerful changes in everyday habits. Modify the exercises below to fit into your client’s daily routine.
SEATED POSTURE CHALLENGE
Level 1: Stable platform (bench, chair)
- Seated with arms crossed – for comfort and to nullify any temptation to push with hands.
- Thighs parallel to ground (may have to manipulate to maintain neutral). Thighs too high encourage slouched posture.
- Pick chest up
- Head up over shoulders. Optimal – cheekbone bisecting with collarbone.
- Position pelvis in neutral. Teach pelvic awareness.
- Feet flat with a wide base of support
- Ask how this new position feels. Depending on imbalances, this may be very challenging.
- Progress when seated for 30-60 seconds is no longer a challenge.
- Progress slowly!
Different progressions will depend on their level of control. Can your client maintain optimal alignment of their joints? If client deviates, you must correct!
- Smaller base of support
- Lift one leg up – switch legs
- Unstable object under foot, progressing to two unstable objects (tennis ball, medicine ball, balance board)
- No feet
- Close one eye – switch – close both
- Add manual resistance
Level 2: Controlled unstable platform (stability ball, dyna disk, etc.).
- Same guidelines as Level 1
- Start by sitting for 30-60 seconds, then progress
NECK GLIDE POSTURAL EXERCISE
Goal: To relieve neck strain associated with upper crossed syndrome.
- In a proper standing or seated position, draw your head back over the middle of your shoulders. Do not tip your head back and make sure your chest is up.
- Perform this movement 10-12 times throughout the day, holding each repetition for 5-10 seconds.
- Do not strain in attempt to increase range of motion.
The quality of your client’s posture can make a big difference in their life. Proper posture can make a person look and feel stronger, decrease the risk of injury, advance everyday performance, and over the course of their life, proper posture can prevent painful physical and mental strain.
Done correctly, exercises will strengthen the “holding” muscles and reduce stress on passive structures (joints, bones, ligaments). In the beginning phases of your clients exercise program, the progressive challenge should be proprioceptively- based, NOT weight-based. In other words, instead of increasing the amount of weight used, increase the challenge by reducing artificial support (benches, chairs, etc.). Exercise programming tip: the more outside assistance the body relies on (fixed machines, benches, using the back-rest on a chair, etc.), the less active internal support the body requires! It is the internal support your client needs for optimal posture and functioning.
Postural problems can have a serious negative impact on you client's health and quality of life. In addition to a postural stretch/strength program, you should consult with other professionals (i.e., podiatrists, orthopedic specialists, physical therapists, etc).
- The National Academy of Sports Medicine Integrated Training for the New Millennium Textbook, 2000
- Muscles Testing and Function, 4th edition. Williams & Wilkins, Baltimore, 1993
- Scientific Back Training Correspondence Course, C.H.E.K Institute 1.800.552.8789
- Clark MA: Common Kinetic Chain Dysfunctions. Optimum Performance Institute. Pheonix, AZ
- Chaitow L: Muscle Energy Techniques. New York, Churchill Livingstone, 1997
- Watkins J. Structure and Function of the Musculoskeletal System. Champaign, IL: Human Kinetics; 1999