Upper Crossed Syndrome: Causes, Symptoms, & Prevention

upper cross syndrome

2021 is around the corner, are you looking for the solution for your chronic neck and upper back pain?

In this upper crossed syndrome article, we will go over what is an upper crossed syndrome, causes, symptoms, and treatment.

  • Upper Back pain is the Worldwide #1 cause that leads to disability, and many health problems. Back pain can prevent people from engaging in daily life activities, sleep, work, and exercise.
  • Studies show that 80% of the population will experience back pain at least once in their entire lives.
  • Studies show back pain is the most common health problem worldwide and is one of the most common reasons for missing work.

Do you know that technology may be the cause of your pain?

Like many people nowadays, the time we spend using our cellphone, laptop, tablet, or desk computer a lot more than a decade ago.  You probably spend hours and hours looking down at your phone on social media, reading kindle, writing an email for work, or taking notes for your job.

When you spend hours looking down at your screen, your head will be tilted forward.  This will cause a disruption in the alignment of your head with your shoulder.  In order words, we call this Forward Head Posture (FHP).

Poor posture with excessive tight muscles and weak muscle will disrupt the alignment of your normal cervical and thoracic curvature and leads to excessive pressure on your spine, discs, facet joints, muscles, ligaments, and bones.

Forward Head Posture

A Forward head carriage is a common condition that causes your head position with your ears position in front of your normal body’s plumb line.

A normal plumb line is when your mastoid process of the skull (ears), shoulder joint, hip joint, and ankle joint are align if you place a line from head to feet.  Any disruption in the parts above will cause disruption to the alignment.

Forward head carriage is hyperextended of the upper cervical vertebrae and upper back (thoracic) with a round shoulder and slouched forward shoulder position.


Forward Head Posture Caused

The forward head posture can lead to pain and spasm of the neck and upper back muscles.

Pain is the common syndrome, but you main also experiencing headache, dizziness (vertigo), neck and upper back discomfort, shoulder pain, numbness/tingling in the upper shoulder and fingers, and mid-back pain,

What Is Upper Crossed Syndrome?

Upper Crossed Syndrome (UCS) is a disruption of the overactive muscles in your neck and upper back.  The disruption is caused by weak/inhibit and tight/short muscles.

If such a condition is left without corrective treatment, you will experience tight and discomfort pain in the upper back and neck, and if the condition drags on for a long time, it will lead to pain and inflammation in your muscles and joints, numbness, and tingling in your hands.

The good news is upper cross syndrome can be fixed with proper treatments, stretch, and strengthening exercise.  Correcting how you use a cellphone, laptop use, reading, and video game playing will decrease the chance of worsening the condition.

What Are The Muscles Involved in Upper Crossed Syndrome?

upper cross syndrome

Weak and or Inhibit Muscles

  • Deep Neck Flexors
    • Longus Capitis
    • Longus Colli
  • Cervical Multifidus
  • Rhomboid
  • Lower Trapezius

Tight and or Short Muscles

  • Suboccipitals
  • Upper Trapezius
  • Levator Scapulae
  • Pectorals
  • Scalenes
  • Sternocleidomastoid (SCM)

What Causes Upper Crossed Syndrome?

Upper Crossed Syndrome (UCS) or Forward Head Posture (FHP) is the result of looking down over electrical devices such as your cellphones, laptop top for prolonged periods.

Recent studies demonstrated proper stretch and strengthening exercise can help correct upper cross syndrome along with manual therapy by a chiropractor or physical therapist.  The treatment will help train your body to restore correct posture and restore the alignment of your spine.

What are other possible causes of UCS?

  • Carrying heavy backpack
  • Reading with poor light and posture
  • The job requires you to lean forward such as dentist, sewing, packaging, cook, welder
  • The job requires looking up such as electrician, Plummer
  • Exercise such as bicyclist, Swimmer, weight lifter
  • Long distant driver such as trunk driver, long distant commuters
  • Poor posture with prolonging slouch posture
  • Bad sleeping position: stomach sleeper, excessive pillow
  • Reading on a bed or using a laptop on the bed
  • A head injury such as a Car Accident with Whiplash injury, fallen on the head from snowboard injury
  • Diseases such as Arthritis, Disc herniation, Disc degeneration, or bone degeneration

What Are The Symptoms of Upper Crossed Syndrome?

Upper Crossed Syndrome condition is easy to spot by someone who pays attention to your head and shoulder relation with each other.

The deformed of the muscles will cause excessive pressure on the muscles, joints, ligaments, tendons, muscles, and bones.  Most people will experience such as:

  • Neck pain
  • Headache – commonly cause migraine-like headache, occipital headache, or temporal headache
  • Decrease Neck and Thoracic Range of Motion
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  • Neck Strains during sudden neck movement, washing hair, sneezing, or etc
  • Weakness in neck flexors muscles
  • Achy Upper back and shoulders pain with temporary relief of massage or hot shower
  • Chest pain – Tightness and aches in the chest on both side or one side
  • Shortness of breath
  • Anxiety
  • Fatigue
  • Jaw pain – TMJ symptoms
  • Chronic or Acute Lower back pain
  • Can’t sit for a long time due to pain and discomfort in the neck and upper back.
  • The difficulty for long distant driving.
  • A decrease in neck and shoulders Range Of Motion
  • Radiculopathy in Upper Extremity – Numbness and tingling in the upper arm
  • Symptoms worsen with a bicycle, looking down when using a cellphone or laptop
  • Neck spasm


Upper Cross Syndrome Exercises – Corrective Exercises

Upper cross syndrome exercises or the corrective exercise to fix UCS.  The treatment focus on strengthening weak/inhibit muscles and stretching the tight/short muscles. 

What Is Upper Cross Syndrome Stretches and Exercises?

3 Steps to correct upper cross syndrome

  1. Release overactive muscles by self-massage with massage assisted tool or myofascial cross friction treatment
  2. Stretch and lengthening Tight/short muscles – Static Stretch
  3. Strengthening Weak Muscles – Postural Correction Exercise, Target muscles training

Self Massage With Massage Tool or Myofascial release treatment

upper crossed syndrome

The benefits of Self-massage or myofascial release treatment help release the tight and overactive muscles in your upper body. The muscle becomes overactive in UCS because the muscle is constantly overuse during your daily life activity, and even when you sleep.

For example, if you’re a chest breather and not a stomach (abdomen) breather, your unconsciously raise your chest, and shoulders during normal and deep breathing.  This will engage your upper trapezius, scalenes, and levator scapulae muscles during each breath.  These muscles become overuse/overactive over time and become inhibited/tight.

When the muscles are inhibited, it will disrupt the posture in the upper body and lead to the upper cross syndrome.  Inhibited muscles will not function correctly because the function is being inhibited partially or fully.

Myofascial release treatment can restore normal function of the muscle by bringing blood flow to the muscles, increase flexibility, and decrease pain.

Myofascial release treatment can be treated by a trained specialist such as Chiropractors, physical therapists, or massage therapists.

Self-massage myofascial release can be done at home. The benefit of this is convenient and less time-consuming.

You can use massage tools such as the S-Curve tool. foam roller, massage ball, and lacrosse ball for your treatment.

Simply apply the massage tools to the target muscle for 30 seconds to 1 minute.

The muscles we need to treat for UCS are Upper Trapezius, Levator Scapulae, and SCM.

Upper Crossed Syndrome Stretches

Levator Scapulae Stretch

  • Sitting or Standing
  • Reach your left arm behind your back and across to the opposite side
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  • Turn your head 30-40 degree to the right
  • Flex your neck down or bring your chin closer to your chest slightly
  • Use your right hand to apply a gentle downward pull force on your head to assist in the stretch
  • You should feel the stretch on your left upper Trapezius
  • Hold for 30 seconds to 1 minute, repeat on another side

Upper Trapezius Stretch

  • The upper trapezius muscle is one of the commonly tight muscles when you use a computer, phone, or laptop.
  • Sitting or standing
  • Reach your left arm behind your back and across to the opposite side
  • Draw your right ear toward your left shoulder
  • You should feel the stretch on your left upper trapezius
  • Hold for 30 seconds to 1 minute, repeat on another side

SCM Stretch

  • Place your right hand on your left collar bone
  • gently apply downward pressure on your left collar bone
  • Extend your head or lift your head upward
  • You will feel the stretch in front of your neck
  • Caution: you may feel lightheaded if the muscles in the back of your neck are too tight. So the movement of the neck must be slow and steady.
  • Hold for 30 seconds to 1 minute, repeat on another side

Pectoral Stretch

  • Doorway Stretch
  • Stand in front of a door, place both arms on the door frame
  • Gently lean forward to feel the stretch in your pec
  • Avoid overstretching of pec muscle and shoulder injury
  • Hold for 30 seconds to 1 minute, repeat on another side

Suboccipital Stretch

  • Place both hands behind your head
  • Gently apply pressure to flex your head forward
  • Make sure you don’t apply too much pressure to avoid overstretching
  • Hold for 30 seconds to 1 minute

Upper Cross Syndrome Exercises

Cat and Cow Stretch

  • Cat cow stretch is great to stretch out your back, hips, and abdomen muscles.
  • You’re on your ground with both hands and knees on the ground
  • Take a deep breath in, arch your lower back upward, with your head looking up, drop your belly closer to the ground. hold for 10-30 seconds.
  • Breathe out, slowly arch your upper back upward to the sky, tug your tailbone in, your neck and head should flex, and look down on the ground. hold in this position for 10–30 seconds
  • Repeat for 10-15 times

Prone Stroke

  • Prone Stroke or superman pose with a variation is a great exercise to strengthening your posterior upper back muscles
  • Lie on the floor in prone (facing the floor) with both arms raised overhead, Superman pose
  • Your palms are a few inches away from the ground
  • Bring your shoulder blades closer together by squeezing your upper back muscles together (this will train your rhomboid muscles)
  • Hold for 2 seconds, slowly bring your palms around and place it near your hips
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  • Repeat for 10-15 times

T-Y-A arm movements

  • this warmup is great to warm up the shoulder and upper back muscles
  • start with abducting your arm to 90 degrees (a T sign with your arm)
  • Now raise your arm to approximately 130 degrees ( Y sign with your arm)
  • drop your arm down to regular position, and extend your arm to make an A sign

Chin-Tug Exercise

  • Gently look down 10 degree
  • Tugging your chin by bringing your chin straight back by 1 inch
  • Hold for 5-10 seconds
  • Repeat 3 times


Upper crossed Syndrome is mainly cause by postural. So prevention is easy if you’re putting in the effort.  Proper posture when you use the computer, laptop, and cellphone can avoid UCS.

So next time when you use your cellphone, bring your phone 3 inches higher will bring your eyesight 3 inches higher, and this will avoid your head to lean forward overtime.

Use proper lumbar support on your chair will keep your spine in a neutral position. Lumbar support can avoid your body from leaning forward.

Use a Laptop stand to bring the screen close to eyes level, and make sure you have an external keyboard and mouse to avoid using the keyboard on the laptop stand.

Actively pay attention to your posture throughout the day.  Consciously reminding yourself to maintain a proper posture is a great start to prevent UCS.

Don’t stack up pillows when you sleep.  Too much or less pillow will place your neck in an over flexion or extension of the neck.  This will cause an overactive of your neck muscles by actively shortening the muscles over time.

Exercise regularly will strengthen your upper body and lower body muscles.  The stronger your muscles are, the better is it to maintain proper posture.

Questions Related to Upper Crossed Syndrome

Upper cross syndrome vs kyphosis

An upper cross syndrome (UCS) is a disruption in muscles in the neck and upper back. This disruption is caused by tight and weak muscles.  When this occurs, the muscles will disrupt the balance in the upper body position (flexion and extension).  This is where we commonly see a rounded shoulder or forward head posture (FHP) in UCS.

Kyphosis is by definition, a type of curvature of the spine where the spine curves outward when you look from the side. Kyphosis curvature is seen in the thoracic and sacral regions of the spine.

Advance UCS will cause excessive hunching of your thoracic spine. So people with UCS will commonly present with hyperkyphosis or buffalo hump.