As more and more people are transitioning to working from home, many are also experiencing new aches and pains in their neck, shoulders, and upper back. Is it stress? Is it the new puppy pulling you down the block? Or is it from the 8 hours a day working from the couch since that is so much more comfortable than your desk anyway? Well, it could be a combination of all of the above, but most likely upper back, neck, and shoulder pain is a result of sustained poor posture, and a combination of muscle weakness and tightness called upper cross syndrome.

What is upper cross syndrome?

In upper cross syndrome the front muscles are tight and the back muscles are weak. The chest muscles, specifically the pectorals and occasionally upper trapezius, become tight while the muscles in the front of the neck called the flexors and upper back/shoulder blade muscles become weak. Think about a person hunched over a laptop at the dining room table, that is the type of sustained posture that creates this imbalance. Often in this position the upper trapezius muscles, the muscles where many claim they hold their stress, will feel tight but it could actually be the result of the muscle being in a constantly elongated position causing increased muscle tension. This doesn’t allow the muscle to hold the shoulders in their proper position. Frequently, the head will jut forward possibly adding headaches to the cluster of symptoms.

How do I know if I have this?

A quick way to check if this is the case is to look at yourself in the mirror. If you have rounded shoulders and a forward jutting head, you probably have upper cross syndrome. A physical therapist will be able to assess your posture, test any strength deficits and check for tight muscles associated with upper cross syndrome in addition to assessing any other potential causes of neck, upper back, and shoulder pain. We can then put together a comprehensive treatment plan to address the dysfunction and imbalances including strengthening, soft tissue work, joint mobilization, and ergonomic correction with suggestions for your work-from-home space.

Tips for management.

The primary goal for management is to stretch the front of your chest and strengthen the back. A few strategies include laying on your back on a rolled-up blanket or foam roll with your head on one end of the roll and your sacrum on the other. You could also try sitting with a blanket roll behind you to open the chest, realign the spine and get your head back over your shoulders, not in front of them. Check to make sure when you are sitting at the computer, reading or watching TV that you have your arms or elbows supported to improve shoulder positioning. Finally, try to place your computer screen at eye level. This prevents forward flexing of the neck and upper back and can be a simple step towards improving posture. Finally, do specific strengthening exercises to the upper back and shoulder girdle muscles like rowing, lat pull downs and “superman” exercises. The trick is to be consistent with your stretches and strengthening and be vigilant with maintaining good sitting posture.