Upper-cross syndrome, often caused by chronic bad posture, is signified by rounded shoulders, head in front of the body and an apparent curve in the neck and upper back. It is a condition routinely suffered by the elderly, but it is also common in office workers and even athletes.

Do you spend much of your day slumped over your desk in front of a computer screen? Does your occupation require that you remain in a standing position for hours at a time? You could be a candidate for developing upper-cross syndrome.

Simply put, upper-cross syndrome is the weakening and lengthening of the posterior upper back and neck muscles and the coincident tightening and shortening of the opposing anterior pectoral (chest) and neck muscles. The correction of this problem involves the strengthening of the weakened posterior musculature and stretching of the tight anterior musculature.

Prevention and correction:

A conscious effort should be made to maintain correct posture when walking and sitting (shoulders pulled back, head, neck and back straight). This practice is especially important for those working in an office setting and sitting at a desk in front of a computer all day long. The tendency is to slouch forward with head bent. To help support proper posture when working at a desk, the computer monitor should be at eye level, keyboard should not be too far in front of the body so that shoulders can be kept back, and feet should be flat on floor with a 90 degree bend at the knees.

A good stretching program is essential to both preventing and correcting upper-cross syndrome. In particular, the pectoral muscles and anterior shoulder muscles must be stretched often, especially following training of these muscle groups. Stretches must be held for at least 15-20 seconds to be effective and should be performed after muscles are warm (ie. following warm up sets and especially post workout). The goal is to gradually deepen the stretch over time to prevent tightening and to lengthen the muscles. An example of a popular stretch is the “doorway stretch”, which can, as the name suggests, be easily performed in a doorway by placing the arm against the door frame and leaning into the doorway to stretch the pectoral and anterior deltoid areas.

A good practice to follow throughout the day is to periodically, say at least once per hour, pull the shoulders and neck back and hold while squeezing the upper back muscles. In addition to maintaining proper posture, periodically forcing the shoulders and neck back and holding acts to stretch tightened anterior muscles and activate posterior muscles.

In the gym, trainers should focus on exercising and strengthening the numerous upper back muscles to maintain balance with the pectorals and anterior deltoids. It is common for many trainers to focus on “showy” body parts that can be seen from the front (in the mirror) and neglect the back muscles. Lots of bench pressing and shoulder pressing with less attention paid to the back and posterior deltoids will create a strength imbalance and can lead to upper-cross syndrome.

Specific exercises that can be performed to focus on the upper and mid-back musculature include various forms of rowing, which can be done using cables, machines, dumbbells and barbells. When employing exercises to correct upper-cross syndrome, specific attention should be paid to maximizing the contraction of the posterior muscles at the midpoint of the movement.

Although the posterior deltoids are involved in back exercises to a good degree, they must also be trained in isolation. Specific exercises for the posterior deltoids include bent dumbbell lateral raises, cable rear laterals or the use of a rear delt machine.

Specific attention should also be paid to the rotator cuff muscles. Since these muscles are the most often neglected, some examples of exercises including instructions are provided below.

Internal/external rotation – elbow 90 degrees (forearm parallel to floor):

This exercise is most easily performed using a cable apparatus, bands or rubber tubing. Internal rotation: When using cables for example, grasp the handle with the forearm parallel to the floor and elbow bent at 90 degrees. Start with the cable and handle out to the side of the body, pull toward the middle of the body and then return to the starting position, all the while keeping the elbow in tight to the body.

External rotation: Start with the cable crossing in front of the body, the handle at the midpoint of the body (reverse position of internal rotation) and rotate the handle to the outside of the body (again keeping the elbow in) before returning to the starting position.

As an alternative, this exercise can be done using light dumbbells while lying on your side on a bench.

Rotation – elbow 90 degrees (upper arm parallel to floor):

Another good rotation exercise can be done with the upper arm out to the side of the body and parallel to the floor, elbow bent at 90 degrees and forearm perpendicular to the floor (envision a right-hand turn signal). This exercise is most easily performed using a light dumbbell or weight plate. Keeping the upper arm fixed in place, rotate the forearm forward in front of the body until approximately parallel with the floor or slightly past (only as far as it is comfortable) and then reverse the rotation moving the forearm past the initial starting position to a point slightly behind the head.

Both of these exercises should be performed with strict form using a lighter weight. A repetition range of 12-15 is sufficient.

Kevin Ferrell, CA, CFT

Professional Health and Wellness Coach

Team Canada Bodybuilder

Co-founder, CRE8iON Fitness & Wellness Inc.