Journal of Novel Physiotherapies
Open Access

Abstract

Upper-Crossed Syndrome, described by Vladimir Janda is a consistent pattern of alternating tightness and weakness that produces a forward head and rounded shoulder posture. It is a common condition caused by poor postural habits or activities (like swimming) that produce muscle imbalance. The various therapeutic approaches directed towards restoring tensegrity and regaining unconscious, automatic control of the myofascia to reduce pain, improve function and posture are collectively termed myofascial modulation. For UCS (Upper-Crossed Syndrome) it involves postural correction, ergonomics, corrective exercises and manual therapy techniques. While patients expect a quick fix and indeed lot of symptomatic relief can be obtained in a manual therapy session, UCS returns unless posture/ergonomics guidelines are followed. Exercises focusing on shoulder/head posture (e.g. Slouch-overcorrect), strategies (imagery, cueing), taping (initial few days), a McKenzie roll or a raised seat (as advised by Mulligan) are all essential for effective posture control and it takes about 3 weeks. Treatment of tight and weak structures involves trigger point release (direct pressure, stretch and needling) and stretching the tight structures (MET, MFR) before activating weak muscles. Large muscles like pectoralis major have several sets of fibers which should be stretched separately. Cervical and thoracic joints (C0-C1, C4-C5, C7-T1 and T4-T5) need to be addressed. McKenzie retraction and/or Mulligan��?s Reverse NAGs are useful. Strengthening is a matter of debate but gentle activation of weak muscles facilitates proprioception and help in learning the corrected posture. Additionally, a core stabilization and/or scapular stabilization program may be helpful. Nutritional considerations should not be overlooked.

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