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Upper Crossed Syndrome - Why Your Desk Might Be Killing You!

  Upper Crossed Syndrome or upper extremity postural distortion is a very common postural deviation in many business professionals. Sitting at a desk requires ones knees and hips to be flexed which shortens some muscles and elongates others. Making the problem worse, most people are typing on a computer with hands facing downward (pronated), shoulders rolled forward (protracted), and your head protruding forward. These typical "desk positions"  lead to predictable muscle imbalances that, over time alter normal body alignment and lead to postural deviations that cause functional inefficiency of the kinetic chain. 

Desk Posture






These inefficiencies lead to altered joint alignment initiating the *cumulative injury cycle and leading to pain and injury. Most people aren't even aware that they have an imbalance at all. These are my favorite clients because I can help correct them before they have to endure further pain or injury due to fixable problems.

The treatment plan for upper crossed syndrome, like most muscle imbalances, can by oversimplified into one sentence. Lengthen the short areas and strengthen the weak areas. In the case of upper crossed syndrome the short areas on the anterior side are the pectoralis major and minor, anterior deltoid and stenocleidomastoid. Posteriorly you will find levator scapulae, teres major, and upper trapezius tightness along with tightness in the subscapularis, latissimus dorsi and teres major. The scalene muscles may also be tight which can cause compression of the cervical plexus and present with symptoms of thoracic outlet syndrome. These people will present with protraction of the shoulders, elevation of the shoulder blades with forward protrusion of the head and internal rotation of the humerus.  These postural deviations can lead to rotator cuff impingement, shoulder instability and even headaches.

Upper and Lower Crossed Syndrome








These tight muscles can be addressed by doing side neck static stretches (for the scalene and sternocleidomastoid), upper trap (and levator) static stretches, pectoral stretches (which address the anterior deltoid as well), latissimus dorsi static stretches and myofascial release (which will address teres major and subscapularis). Put simply, stretch the tight muscles.

Upper crossed syndrome also presents with "lengthened" or weak muscles that need to be strengthened. Before attacking these areas it is notable to mention that these muscles usually suffer from decreased neural activation, so neuromuscular activation training should precede weight bearing activities. You can't stabilize what you can't neutrally control. Once able to consciously activate, weight bearing exercises focusing on the rhomboids (seated rows with elbows up and shoulders down), lower trapezius (low rows), serratus anterior (shoulder protraction from the push up position), posterior deltoid, teres minor and infraspinatus (rear deltoid flies, external shoulder rotations) should proceed. The exercises given are just examples; there are many varying exercises, devices, and methods that can be employed. Put simply, strengthen the weak areas.

In summary, if you are in anything other than the anatomical position (standing erectly with your palms facing forward), you are muscularly imbalanced. Given enough time those imbalances can impinge on structure which can alter function leading to pain and injury. Treatment begins with awareness that we are all imbalanced to some degree, and education on how to address your body so that it can return into a more normal balanced state. This will lead to less pain and risk for potential injury taking you out of the game.


NASM Essentials of Corrective Exercise Training

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Comments (28)

  1. Carol Nave:
    Sep 19, 2009 at 01:14 PM

    I suffered with this syndrome badly when I first started working out with you. It was, most likely, from sitting at an instrument for many hours at a time, and bending forward. My neck and shoulders were tight, and I had pain in many spots in my body. The workouts really changed everything. Thanks for applying what you know to help people who are hurting!

  2. Tiffany Grey:
    Jul 28, 2010 at 03:36 AM

    I thought that was very informative. Thanks for the great content. I'll keep checking back on this.

  3. Shaun Claggett:
    Aug 30, 2010 at 09:56 AM

    Exercise is just as vital as calorie intake when it comes to losing weight, but the one thing which really delivered for me was wu-yi tea, it can be checked out in the resource box underneath, they have a small number of free trials in stock, it was featured in Reader's Digest and CNN. I shed twenty pounds, it really does produce results!

    1. Matt Trudo:
      Aug 31, 2010 at 04:50 PM

      I will look into that. We are always looking for new cutting edge products and techniques. It can be sometimes difficult to find out what works and what is crap. I like to follow the research. I will do some research and check it out.

  4. Matt Trudo:
    Aug 04, 2010 at 05:24 PM

    Interesting. What in particular were you discussing about upper crossed syndrome. I would love to clear any areas of misunderstanding up.

  5. Cecille Edgeworth:
    Aug 04, 2010 at 01:42 AM

    My buddy and I have been just talking over this subject, she is always wanting to prove me wrong! I am about to show her this particular write-up and rub it in a little!

  6. David:
    Jun 23, 2010 at 07:47 AM

    Barbell chest press is the most overrated exercise. Dumbbell presses are far more effective in building muscle. Flat, incline or decline. Add dumbbell flies and dipping and you have a simple, yet very effictive, total chest workout. I can recommend the following article Regards, D. Smith

    1. Matt Trudo:
      Jun 23, 2010 at 09:55 AM

      Mr. Smith, You aren't wrong that dumbells are an excellant equipment choice for many exercises. There are a few issues that one must remember when developing a workout. The first thing is are the muscles being worked balanced. If one tries to apply an unstable exercise to a muscle group that lacks balance, the risk for injury is much higher. Sometimes a base of strength and balance is required in order to strengthen weak muscles in antagonistic muscle groups. Another issue that must be considered is muscle adaptation. If all one does is dumbell exercises, every week, the muscles will adapt progression will be limited. It is good to incorporate different ways of doing the same things so that the muscles are challanged in different ways. In saying this, dumbells are an excellent equipment choice and my personal favorite. One must be careful not to make general rules about what is "the best" before knowing the nature of the client being worked with. Continued success in your training and thank you for your voice, Matt Trudo, BSN, NASM, MFS

  7. New York receptionist position:
    Jul 08, 2010 at 08:45 AM

    Hey we was just looking at your site on my Blackberry and I was thinking about how good it will work on the new ipad coming out . Fleeting thought.... Anyway thanks!

    1. Matt Trudo:
      Jul 08, 2010 at 11:18 AM

      I agree, I have mine ordered as we speak. Should get it in the mail this week.

  8. Jules:
    Jul 19, 2010 at 04:32 AM

    I've been trying to lose weight for years. Actually I have over and over again. It gets old. :( I'm going to try another diet plan, but I'm not sure which one. Have any of you tried the Every Other Day Diet or the Diet Solution Program. If so, how did it work for you?

    1. Matt Trudo:
      Jul 20, 2010 at 12:14 PM

      I usually do not recommend diet's as they usually incorporate either unhealthy practices or unmaintainable ones. In order to lose weight and keep it off it is more about finding out how many calories your body is burning (your daily caloric burn), then eating just under that caloric need (between 500-800 calories under). The key is in doing that while maintaining a healthy macronutrient ratio (I like a 50/30/20 ratio) of healthy nutrient dense low glycemic foods. It is a bit of an art and a science, the key is in knowing your numbers and consistently following them. If you need further help on developing a meal plan (as opposed to a diet) just give us a call, we are here to help.

  9. Hollie Schaller:
    Jul 28, 2010 at 10:17 PM

    Great post, thanks for sharing. Keep up the fantastic work and keep em coming

    1. Matt Trudo:
      Jul 29, 2010 at 09:56 AM

      Thank you, We try to keep bringing up to date and helpful fitness information. Set us know if there is anything specific that would be helpful.

  10. Inno:
    Jul 29, 2010 at 03:49 AM

    Nice Information! I personally really appreciate your article. This is a great website. I will make sure that I stop back again!.

    1. Matt Trudo:
      Jul 29, 2010 at 09:58 AM

      Well thank you, we like it when we are appreciated. Feel free to throw out requests if you have any. We like to give people the information that will help them be successful.

  11. Cristine Podell:
    Aug 06, 2010 at 02:32 AM

    Great stuff here.

  12. Stanley Domnick:
    Aug 17, 2010 at 05:06 PM

    Hey, great site!. How do I subscribe to your RSS feed to ensure I get notifed when you make new posts? Thanks

    1. Matt Trudo:
      Aug 18, 2010 at 12:34 PM

      You can click on the RSS feed on the post page. Also, you can join us on our website at

  13. Tyson F. Gautreaux:
    Aug 21, 2010 at 09:20 AM

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  14. Chadwick Beddo:
    Aug 26, 2010 at 12:24 AM

    Can I repost this on my blog? I'll drop you a backlink. Let me know, thanks!

    1. Matt Trudo:
      Aug 31, 2010 at 05:04 PM

      Sure. I appreciate you asking. If you have any requests for other topics just let me know.

  15. Azzie Ercanbrack:
    Aug 27, 2010 at 06:57 AM

    Great post. Thanks!

  16. Jae Everetts:
    Sep 06, 2010 at 02:22 PM

    Thank yo very much for this awesome article. I've read your articles for a decent time now, and they are always getting better. :) Cheers

    1. Matt Trudo:
      Sep 08, 2010 at 11:05 AM

      Well thank you. We try to provide current and helpful information. Knowledge is power.

  17. John:
    Sep 11, 2010 at 07:58 AM

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  18. Twila Katcher:
    Sep 13, 2010 at 05:43 PM

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  19. Matt:
    Jun 02, 2015 at 03:16 PM

    I was sitting at my desk contemplating this blog today and thought, man...It has been about 2 hours since I have stood up. It sneaks up on us all.

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