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Using Pilates for Treating Upper Crossed Syndrome

in Southfield, MI

Left – Upper Crossed Syndrome                                      Right – Straight Posture


Using Pilates for Treating Upper Crossed Syndrome

BY: Stephanie Ruopp

Joseph Pilates knew the importance of upright spinal posture.

He was known for saying, Never slouch, as doing so compresses the lungs, overcrowds the vital organs, rounds the back, and throws you off balance.”

There’s no arguing that Pilates was a visionary. Even then, he had a keen understanding of how sitting or standing for too long could exacerbate slouching.

But there was no way he could have seen how the addition of technology would create a muscle imbalance in the head or shoulders. This is playfully called “tech neck,”  but is more formally referred to as Upper Crossed Syndrome (UCS).

What Exactly Is Upper Crossed Syndrome?

The human body is divided into two basic muscle group types. The tonic muscles which flex, and the phasic muscles which extend.

Tonic muscles are dominant because they engage to resist the forces of gravity. They also tend to become more easily tightened and shorter.

Phasic muscles, on the other hand, are flaccid. They tend be weaker and have less tone. 

The muscles most frequently affected in UCS are the back muscles of the shoulders and neck – the upper trapezius and the levator scapulae. But the pectoral muscles in the chest can also come into play.

All of these tonic muscles become strained and overactive from long hours of sitting or standing and leaning over a device and they become tightened or shortened.

When this happens, surrounding phasic counter muscles such as the lower trapezius are underused and become weaker. This allows for the overactive muscles and under active muscles to overlap – causing an X shape to develop.

Hence the term, Upper Crossed.

What Causes UCS?

There are actually many different movements that can cause upper crossed syndrome. 

Most cases develop due to poor posture with the head forward for prolonged periods of time.

Obviously, logging in many hours on a computer, laptop, phone or any other device every day is one culprit.

But it can also be the outcome of time spent reading, watching TV, driving, and riding a bike.

Add to this the fact that many of us suffer with poor eyesight. So when we squint, we lean forward – thereby creating that forward motion in the head.

Occasionally, injury or congenital disabilities can also contribute to the development or creation of UCS.

Using Pilates for Treating Upper Crossed Syndrome

Pilates is all about supporting functional movement patterns. It focuses on core stability, as well as correct postural alignment and awareness. It also eliminates muscle imbalance.

The elongating yet strengthening movements of Pilates improve muscle elasticity and joint mobility.

All of these factors make it ideal for treating UCS.

UCS requires effective exercises to strengthen lengthened muscles while stretching tight and overused muscles.

There are three key components that comprise the postural distortion pattern in UCS. They are excessive thoracic extension, shoulder girdle protraction, and arm medial rotation.

The following are some movements that highly trained Pilates instructors would incorporate into a UCS treatment plan:

1. Flexing the Lumbar Spine and/or Posteriorly Tilting the Pelvis

Any exercise that decreases the lumbar curve and works to correct excessive thoracic extension can indirectly help reduce the hunched over effect (also known as hyperkyphotic) of the thoracic spine.

Muscles of the anterior abdominal wall are strengthened by movements like posterior pelvic tilt and lumbar spinal flexion. Thus, any Pilates exercises that utilize these movements and strengthen these muscles can be used to treat UCS.

Both the Hundreds and Pelvic Lifts are perfect examples. In fact, almost every Pilates mat exercise where the client is in a supine (face up) position will likely address these muscles.

2. Strengthening Muscles of Shoulder Girdle

In dealing with shoulder girdle protractions, Pilates addresses the posture of the shoulder girdle.

If the shoulder girdle is excessively protracted (as it can be in UCS), then it makes sense to strengthen the muscles responsible for retraction.

Chest expansion exercises work directly to strengthen the musculature of shoulder girdle retraction – the rhomboids and middle trapezius, specifically.

3. Performing Arm Circles

Pilates addresses arm lateral rotation at the shoulder joint by focusing on strengthening the arm lateral rotators.

Arm circles are ideal for this and there are many ways to do these.

Most simply, they can be performed while standing against a wall. This allows for the circles to be done against gravity, which increases strength.

There are other variations that can be performed on the reformer machine that provide the added resistance of the springs. Some focus primarily on the arms, while others use body weight and gravity to help the shoulder girdles fall into retraction.

4. Incorporating Side-Bending Stretch Exercises

In treating UCS, the flexibility of the spine in the frontal plane should be considered. This is where side-bending (lateral flexion) movements can help.

When the body laterally flexes to one side, the soft tissues on the other side of the body, are stretched. This includes tissues that cross the spine anteriorly. Most important in treating UCS is the anterior longitudinal ligament.

So by stretching to one side, the fibers on the other side of the anterior longitudinal ligament are stretched. And vice versa. Stretching and lengthening this ligament increases flexibility toward thoracic extension.

From a purely lengthening/stretching perspective, Kneeling Mermaid is an effective movement. Side Sit Ups, however, go a long way toward strengthening.

5. Mobilizing the Spine into Extension

Directly addressing the flexibility/mobility of the spine into extension through Pilates movements can also be helpful in treating hyperkyphosis in the thoracic spine. 

This approach focuses on breaking up fascial adhesions that might be locking up the thoracic spinal joints and creating mobility limitations. It requires the client’s thoracic spine by laid across a rounded surface.

That’s no problem in the world of Pilates where there are many rounded surface apparatus, including the Spine Corrector, Small Barrel and Ladder Barrel.

A Pilates instructor determines which of these is best and then has the client perform exercises laying back on that surface. Their body weight pushes their spine into extension around the fulcrum point of that rounded surface.

It’s pretty cool stuff!

Looking into Pilates for Treating Upper Crossed Syndrome?

Using Pilates to treat Upper Crossed Syndrome has shown to be very effective. Particularly when working under the expertise of a skilled Pilates instructor.

So if you’ve been diagnosed with UCS and think you could benefit from a Pilates regimen, then contact us today.

And start standing tall again!