Do you suffer from neck pain or stiffness? Have you noticed your back and shoulders are more hunched or rounded than they used to be? Do you get an annoying almost burning sensation in between you shoulder blades? Sore jaw? Constant headaches?

You could be developing upper crossed syndrome.

What is upper crossed syndrome?

Upper crossed syndrome is a new player on the scene. There are many other names used to describe this condition, tech neck, hunch back, rounded shoulders and others. It’s a configuration of overlapping, overactive and under active muscles surrounding the neck, chest and shoulders. This condition gives an individual the look of ‘bad posture’, rounded forward shoulders, forward head and almost looks like they’re ‘slouching’. Typically, poor posture causes the syndrome, including the forward head posture, which can occur when people use electronic devices, read, and drive. We are only just scratching the surface of how serious this condition is within the community. The majority of us work at a desk 8 hours a day. We drive to and from work, and in our spare time how many of us are guilty of sitting with our heads buried in our phones and other devices. Those with upper crossed syndrome usually have the same or similar set of postural irregularities. The good news is these can be reversed in most people!

Do you suffer from this condition? Are you noticing you may be heading there? Typically, symptoms include a stiff neck and back, sometimes accompanied with pain. The condition may not be serious but in chronic cases of pain and muscle dysfunction, treatment is recommended.

Various stretching and strengthening exercises exist that can offer relief from symptoms of upper crossed syndrome. Treatments such as Massage, Physiotherapy or Chiropractic are often sought out to provide relief but nearly all cases can be eliminated through exercises which strengthen weaker muscles.

So what muscles are usually responsible for upper crossed syndrome?

With upper crossed syndrome the muscles of the shoulders, neck, and chest have become deformed.

Specifically, the back muscles of the neck and shoulders (upper trapezius, and levator scapulae) become extremely overactive and strained. The muscles in the front of the chest (the major and minor pectoralis muscles) become shortened and tight. If you imagine the muscles in the back of your neck pulling your shoulder blades up, then your chest muscles pulling the front of your shoulders forward to create that rounded look.

Because of these overactive muscles, the surrounding counter muscles become underused and weakened. This causes weakened muscles in the front of the neck (cervical flexor muscles) and in-between the shoulder blades area (rhomboid and lower trapezius muscles).

The condition gets its name from the “x” shape that develops when regions of overactive and underactive muscles overlap.

Physically visible symptoms include:

  • the head is consistently or often in a forward position
  • inward curvature in the portion of the spine containing the neck (increased cervical lordosis)
  • outward curvature in the part of the spine that includes the upper back, shoulders, and chest (increased thoracic kyphosis)
  • elevated, protracted, or rounded shoulders, where the muscles are in a continuous state of being pulled or stretched forward
  • the visible portion of the shoulder blade sits out instead of lying flat (scapula winging)

Treating the problem:

Exercise is the best medicine for upper crossed syndrome. Some people may find discomfort in particular movements and with stretching, but it’s important to work on this to improve the condition. It’s important to warm up the surrounding tissues before performing many stretches and exercises. You can warm up either by gentle movement or even by taking a warm shower or bath before activity.

There is an simple way to gently ease into reversing this syndrome. LYING DOWN can significantly assist in reversing this syndrome. Lie down with something such as a thick pillow placed about a third of the way up your back, aligned with your spine. Allow your shoulders and arms to roll out and release and your legs to fall open naturally. Make sure your head is neutral and does not feel strained or stretched. If it does, use a pillow or support your head.

This is super simple and can be effective for most people. Passive stretching of the upper trapezius and pectoral muscles will also aid in releasing the tension.

My PERSONAL FAVOURITES to combat this problem:

#1 SEATED WALL ANGELS: This is a great exercise to get your interscapula muscles to fire up BIG TIME! At first, this exercise may seem difficult but persevere and you’ll be amazed at how much your posture changes and how good you feel having greater mobility throughout your neck and shoulders.

To perform this exercise you sit on the floor with your back pressed against the wall, legs out straight in front of you or bent at the knee. In this position have 3 points of contact against the wall, lower back, shoulder blades and head. Raise your arms out to the sides of your body against the wall with your elbows bents at 90 so your forearms remain perpendicular to the floor. The goal is to then extend your arms up above your head while remaining in contact with the wall the whole time. Then slide your arms back down to the start position so your elbows are just below your shoulders at the bottom position.

The picture below demonstrates the exercise. If you’re a gym goer, which I’d say most of you are, this exercise is an amazing warmup for nearly any workout!


When I say develop your back muscles, I don’t mean just go into the gym and do some rows and lat pulldowns. If you’re already thinking this and you are suffering from upper crossed syndrome then there is a high chance that you are not executing these exercises effectively. All these exercises are great but it’s very simple to do these inefficiently and not activate the right areas. Small things to keep in mind with these exercises are to ACTIVATE THE LOWER TRAPEZIUS before you lift the weight, in other words actively try to depress your scapula and bring your shoulder blades closer together. Exercises like a seated cable row are very commonly performed incorrectly. I’ve conducted countless sessions where I ask people to complete a set how they normally would, then ask them to get ready for another set but first pull their shoulders down and together with a neutral spine. They do this and then realise ‘holy S#@t, I can’t pull that weight at all’. Generally, we then half the weight and do 2-3 sets with this new technique. The next day I’ll often get a call, ‘Lachlan, my lats and muscles between my shoulder blades actually have DOMS today’. Ideally I don’t want DOMS, but this shows just how ineffective their old habits were. If you do any bodybuilding style training, or focus on hypertrophy but never seem to get a ‘PUMP’ in your lats or rhomboids, think about this before you start your next session. You’ll thank me later.


There are further guidelines we can follow that will help to prevent upper crossed syndrome:

#1 GET ENOUGH EXERCISE. Exercise 30 minutes each day. This can include resistance exercise, cardio, swimming etc.

#2 LIMIT TIME USING YOUR PHONE OR WATCHING TV. You’ll get more benefits from this than reducing your neck pain. You’ll become more productive and your partner will love it as well!

#3 TAKE BREAKS FROM SITTING. Every 20-30 minutes make sure to get up and move around. Even at work. You may be concerned that your boss will be upset, but in countless studies it ‘s been proven that with as little as a 2-5 minute break from the computer screen we get back to work with more productivity! A lot of my clients even throw in a STIM session during their day to break things up and get a body ‘reset’. A STIM session is a small circuit (5-10 minutes) with resistance bands to stimulate the muscle systems.

In Conclusion:

We are really only touching the surface of how serious a problem upper crossed syndrome might be and just how common it is. In society today we are not only seeing an increase in adult patients with this condition, we are also beginning to see children with upper crossed syndrome. Unfortunately, it’s the way our society has evolved. Nearly every child under the age of 10 has an iPad or iPhone and they’re not just using it for short phone call to Mum or Dad. Over time, the excess usage of these technologies could be a precursor for development of this condition at a young age.

The more active portion of the population generally don’t have a problem. If they do it seems to be easily corrected. A short trip to the local Massage Therapist, Physio or Chiropractor and they’re all good for another few months. After a few months they generally notice the common trends that lead up to their pain redeveloping: increased hours at work, in the car driving or using their technologies at home.

The most important point to take home from all this is to identify the condition early and do something about it before it becomes a chronic problem. Be PROACTIVE not REACTIVE, movement is medicine.


About the Author: Lachlan McPhee owns and runs Xceed Sports Clinic in Maitland. For more information on the services that Lachlan offers head to his website and check it out