Spotlight: Upper Crossed Syndrome

Upper Crossed Syndrome (UCS) is a common posture which can lead to shoulder and neck pain and also affect how we move, including running technique.

Typically signs are a forward head position, forwardly rounded shoulders, and a hunched upper back. It is often a result of prolonged periods of sitting with poor posture at a desk or looking down at a phone.

What Is Upper Crossed Syndrome?

UCS involves a specific pattern of muscle imbalances:

• Tight/Overactive muscles: Upper shoulders (upper trapezius, levator scapulae) and chest (pectoralis major and minor)

• Weak/Underactive muscles: Neck (deep neck flexors) and scapular/thoracic spine area (lower trapezius, serratus anterior, rhomboids)

These imbalances create an "X" pattern when viewed from the side, hence the term "crossed."

How UCS affects running technique and posture

For runners, UCS can have several negative impacts:

• Breathing efficiency: A forward head and rounded shoulders can restrict chest expansion, leading to shallow breathing.

• Arm swing mechanics: Poor posture and tight chest muscles can reduce our ability to drive our arms back with tight shortened pectoral muscles meaning our arms are more likely to swing round our body, reducing running efficiency.

• Neck and shoulder discomfort: Our heads are really heavy! A forward head position when running places even more load on the already tightened muscles in the neck and shoulder which can lead to neck and shoulder tension and pain during and after runs.

  
  

Exercises and stretches

A combination of stretching tight muscles and strengthening weak ones can help manage and reduce the impact of UCS. 

Stretches for the tight muscles

1. Chest (pectoral muscle) stretch

   • Stand in a doorway with your arms at shoulder height, elbows bent at 90 degrees.

   • Place your forearms on the doorframe and gently lean forward until you feel a stretch in your chest.

   • Hold for 30 seconds; repeat 2–3 times.

How to do a pec stretch

2. Upper shoulder (upper trapezius) stretch

   • Sit or stand upright.

   • Tilt your head to one side, bringing your ear toward your shoulder.

   • Use your hand to gently deepen the stretch.

   • Hold for 30 seconds; repeat on both sides.

How to stretch your upper trapezius

Strengthening exercises for the weakened muscles

1. Chin tucks

   • Sit or stand with your spine straight.

   • Gently draw your chin backward, creating a "double chin" without tilting your head.

   • Hold for 5 seconds; repeat 10 times.

How to do a neck retraction exercise

2. Scapular retractions

   • Stand or sit with your arms at your sides.

   • Squeeze your shoulder blades together, holding for 5 seconds.

   • Repeat 10–15 times.

Scapular retration exercise

3. Wall angels

   • Stand with your back against a wall, arms raised to shoulder height, elbows bent at 90 degrees.

   • Slowly raise and lower your arms, keeping them and your back against the wall.

   • Perform 2 sets of 10 repetitions.

Wall Angel

Can sports massage help?

Yes!! Sports massage can be hugely useful in both assessing and treating UCS.

Assessment

Through palpation and movement testing sports massage can identify:

• Areas of muscular tightness and restrictions in soft tissue

• Postural asymmetries

• Restricted movement patterns in the neck, shoulders, and upper back

This hands-on insight can help tailor an effective rehab or training program.

Treatment

Sports massage techniques can:

• Release tight muscles like the pectorals, upper traps, and levator scapulae

• Stimulate underactive areas by improving circulation and neural engagement

• Improve mobility and posture by freeing up adhesions and encouraging proper alignment

• Support recovery by reducing tension and promoting relaxation

When combined with corrective exercises and posture work, sports massage can make a real difference to discomfort and restrictions experienced, and perhaps running performance too.

Runners: Tips to combat UCS impacting your runs

• Posture checks: Regularly assess your posture during runs.

• Strength training: Incorporate exercises targeting the upper back and neck muscles.

• Stretching routine: Include chest and shoulder stretches in your post-run cooldown.

• Ergonomic adjustments: Ensure your workspace promotes good posture to prevent UCS.

• Book a massage: Consider adding sports massage to your routine, especially during high-volume training blocks or if you’re experiencing recurrent shoulder/neck tightness.

Conclusion

By addressing UCS through a combination of stretching, strengthening, postural awareness, and hands-on therapies like sports massage, runners (and everyone!) can improve their form, reduce discomfort, and enhance overall performance.

For personalised advice or more information, please get in touch by calling Mary on 07909 551191, emailing on mary@marybrooking.co.uk or clicking on the link below.

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