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Posture & Upper Crossed Syndrome

Upper crossed syndrome (UCS) is a clinical observation characterized by a patient with forward head posture, an abnormally rounded mid-back, and shoulders that are rolled forward. This “syndrome” was first proposed in 1979 by a Czech medical doctor named Vladimir Janda. Since then, his idea of UCS has been scrutinized and refined and is still the topic of much debate within physical medicine today.


The upper crossed syndrome is at its core a problem with soft tissue balance/synergy. These soft tissue imbalances are thought to be caused by habitual, prolonged postures as would be common in office/desk workers (or from staring at your smart phone like you are now). The idea is that over time the tissues in and around the neck and shoulder blade begin to change in response to this habitual, prolonged posture. Specifically, the tissues stretched tend to lengthen/become weak and the tissues slackened tend to shorten/become tight. It is thought that these imbalances can then lead to pain/dysfunction.


However, sometimes individuals with UCS have no symptoms/pain whatsoever. This is one of the main criticisms of labeling patients with UCS and treating patients based SOLELY on that label. Just because that patient exhibits the upper crossed posture does not mean they will have pain, and even if they do… you can’t be 100% certain that “poor” posture (i.e. UCS) is the lone culprit.


It’s in our opinion that UCS can, in fact, be a contributing factor to neck, shoulder, and mid-back pain/dysfunction. BUT… it is more often just a single piece of the puzzle rather than the whole puzzle itself.




Here at SCWC, we take EVERYTHING into account with EVERY patient. We look at the patient as a whole and try to decipher the pertinent pieces of information from the not so important. If you or someone you know is struggling with “terrible” posture then a proper assessment and treatment may be just what they need!


And always remember… the best posture is the next posture! Keep moving and grooving!

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