mbg Associate Movement & Wellness EditorBy Ray Bass, NASM-CPT

Medical review by Sarah Kostyukovsky, PT, DPT, OCS

If you catch yourself slouching at your desk, you may think that it’s just an instance of bad posture. Hate to break it to you, but there’s a chance it could be more than that. You could have upper crossed syndrome—which, lucky for you, can be corrected. But first you have to diagnose it.

Your formal education (and road to recovery) begins here. 

What is upper crossed syndrome? 

It sounds bad, right? Like this is a syndrome we’re talking about. Not exactly. Upper crossed syndrome is surprisingly common and easy to develop.

So, what is it?

“Upper crossed syndrome is a term coined by a Czech neurologist and physiotherapist who noticed consistent patterns in muscles of the upper body—namely that some are commonly tight and some are commonly weak,” says Sarah Kostyukovsky, DPT. “It’s basically a muscle imbalance of the upper body where our upper back muscles—like the muscles between our shoulder blades—become weak and our neck and pectoral muscles are tight.”

In other words, it is a postural distortion that throws you out of alignment and can cause you pain. Upper crossed syndrome is not a formal medical diagnosis, but it is a term used to describe a musculoskeletal imbalance that can lead to certain symptoms—and often manifests as rounded shoulders and a forward-positioned head. One look at our society, and it’s easy to see why it’s become an epidemic.

What causes upper crossed syndrome? 

When our muscles are tight or weak, there’s usually a clear explanation. In the case of upper crossed syndrome, the symptoms can be traced back to our lifestyle and behavior, as well as our anatomy. We stare at our phones for hours on end. We slouch at our desks and hunch over computers. We walk and watch television with our heads jutted forward. We neglect the muscles in our upper backs during exercise and worse than that, we don’t take time to stretch out or loosen tight muscles. We do this over and over and refuse to address it until we experience pain that inhibits our functioning. Is it any wonder that this syndrome is so common? 

“Anatomically, our bodies are prone to fall into these patterns,” Kostyukovsky adds. “Some muscles have a tendency toward tightness, and some muscles get weak quickly. This is another irony of life. And unfortunately, if we don’t work to counteract these common muscle imbalances, we can develop upper crossed syndrome.”

How to know if you have upper crossed syndrome (and what to do).

Nervous that this might be you? It can be sort of hard to know. If you have neck pain, chronically rounded shoulders, or know for a fact that you have poor posture, you may have upper crossed syndrome.

Other symptoms can include:

  • Shoulder pain
  • Upper back pain
  • Headaches
  • Balance issues

The only way to be diagnosed, though, it to see a physician or physical therapist—so if you’re experiencing any of these symptoms, it would be wise to seek one out. Once you do, you’ll be able to work to counteract the upper body imbalances and prevent the tightness and weakness. 

Now, if you’ve had pain or bad posture for years, it can be tempting to do nothing about it and continue living your life. I’m not sure why we take on this mindset, and it’s a dangerous one. Not only does ignoring an injury or pain almost always make it worse, but not correcting your posture can have some serious (or irreversible) long-term consequences—like chronic pain and fixed postural deformities. 

Our advice? Anyone experiencing pain should see a doctor or physical therapist. Those without pain should take notice of their posture and behavior as it pertains to alignment—do you slouch all the time? Does your neck feel chronically tight? Does sitting up straight feel tiring or effortful? Being aware of your body will help you pick up on patterns and give you an idea of what’s needed to fix your imbalances. Keep strengthening your upper body and be aware of your postural alignment. Awareness, in this case, is half the battle.

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