Many of us spend hours a day in front of a computer or hunched over our smartphones. Over time this can cause anterior head carriage (when your head extends out in front of your body), rounding of the shoulders and thoracic spine. Poor posture is more than just an aesthetic issue. Over activity and tightness in certain muscle groups can lead to weakness and inhibition in the opposing muscle groups. The resulting muscle imbalance is a common cause for abnormal neck, mid-back and shoulder biomechanics, which can cause pain and stiffness.

Common postural problems

The most common postural presentation that chiropractors see in practice is called “upper crossed syndrome”. It’s characterized by overactive tight muscles in the chest, shoulders and the back of the neck. The muscles in between your shoulder blades, and the front of your neck become inhibited or weak. There’s a concept of reciprocal inhibition that occurs whenever one muscle group is over active. Your brain will instinctively shut off or inhibit the opposing muscle group so that there isn’t a “tug-of-war” going on between the two groups that pull in different directions.

upper crossed syndrome showing overactive and weak muscles

As you can see when you link the corresponding tight and weak muscle groups it forms an “X” or a cross in the centre. This is how the term Upper Crossed Syndrome came about.

Overactive & Tight muscles

The specific muscles that are prone to becoming stiff and tight are:

  • Suboccipital muscles

  • Upper Trapezius

  • Levator Scapulae

  • Pectoralis Major & Minor

muscles prone to tightness due to poor posture

Inhibited or Weak muscles

The specific muscles that the brain instinctively inhibits due to overactivity of the muscles listed above are:

  • Deep Cervical Flexors

  • Rhomboids

  • Middle portion of the Trapezius

  • Lower portion of the Trapezius

rhomboid muscle prone to weakness due to poor posture

The Rhomboid muscle that is found in between the shoulder blades. 

Note: only the right rhomboid is pictured.

Longus colli muscle prone to weakness

The Longus Colli muscle in the front of the neck that is prone to weakness.

Note: The layers of superficial muscle have been faded in order to show this muscle.

Symptoms

Prolonged poor posture has been known to be responsible for a number of aches and pains throughout the upper half of the body. Some common symptoms include:

Head & Neck

  • Tension headaches

  • Jaw pain

  • Neck pain & Stiffness

Shoulder

  • Rotator cuff tendinopathy

  • Impingement syndrome

  • Subacromial bursitis

Thoracic Spine

  • Rounding of the thoracic spine (hyper khyphosis)

  • Muscular pain & stiffness

How do we correct poor posture?

In order to correct poor posture we need to follow an exercise program that includes stretches for the tight, overactive muscle groups, as well as strength and endurance exercises for the weak muscles groups. This helps improve muscle imbalances and will restore normal biomechanics to the neck, shoulder and thoracic spine.

Stretching & mobility before strength

The reason for performing stretches first is to lengthen out the overactive tight muscles so that there is less inhibition of the opposing muscle group.

This will help with more effective muscle activation when performing the strengthening exercises.

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Stretches & mobility exercises

Self release the pectorals

This self release technique helps get rid of myofascial trigger points or knots in the muscle. Not sure what a myofascial trigger point is? You can read more about it in my blog post about dry needling (click here). With a massage ball or a tennis ball, pin it against a wall and then roll your pecs over the ball paying extra attention to any tender points you find. You can add in horizontal or vertical arm movements to make the drill more effective.

Recommended: Spend about 1 minute on each pectoral muscle

Stretch the pectoral muscles

This stretch can also be done in a door which will allow you to stretch the left and right pectoral muscles at the same time. Perform this stretch once with your upper arms horizontal to the ground. Repeat with your arms and elbows raised above horizontal. Repeat again but with your arms and elbows below horizontal

Recommended: Hold the stretch for 15 seconds then rest. Repeat with the arms in different positions as mentioned above.

Foam roll the lats

With your arm extended overhead, roll along the muscle bulk of the latissimus dorsi muscle. Spend a little more time over any tender points you find

Recommended: 1 minute each side.

Stretch the lats

Recommended: Hold this stretch for 15 seconds on each side. Repeat 3 times.

Foam roll thoracic spine

Gently foam roll your thoracic spine (mid-back) from the bottom of your ribs up to the base of your neck and back down again. Repeat this a couple times. Then start at the bottom of your thoracic spine again in line with your lower ribs, and gently extend your spine and return to a neutral position. Roll the roller up a few centimeters, extend and return to neutral. Move the roller upwards a few centimeters and repeat, you get the idea.

It’s important that you don’t extend lower than your bottom ribs or up onto your neck. Your thoracic spine has the rib cage for support. Your cervical and lumbar spine don’t have the same amount of structural support.

Recommended: 1 minute rolling up and down your spine. 1 minute of thoracic extensions over the foam roller.

 

Open books

Flex your hips and bring your knees towards your chest to lock your lumbar spine and prevent it from rotating. This will ensure that all the rotation is occuring in the thoracic spine.

Open Books are great for improving thoracic mobility.

Recommended: 3 sets of 10 -15 repetitions each side

Stretch the Levator Scapulae

Take note of the correct chin position when performing this stretch. You want to start by tucking your chin inwards then rotate your head about 45 degrees to the side then look down towards that armpit. If you rotate towards the left, use your left arm to gently pull your head down towards that armpit until you feel a gentle stretch.

Recommended: Hold for 15 seconds each side. Repeat 3 times

Strengthening exercises for weak muscle groups

Chin tucks

This modified version of the chin tuck targets the Longus colli and Longus capitis muscles. These are known as the deep cervical flexor muscles and are prone to inhibition and weakness.

Tuck your chin inwards and gently lift your head off the floor about 1 centimeter and hold for 2-3 seconds. Don’t let your chin stick out while lifting your head off the floor.

Recommended: 3 sets of 8-10 repetitions

Reach, Roll & Lift

Kneel on the floor and sit back onto your heels, elbows bent. Reach forward with one arm as far as you can, flip your hand over and then raise your arm off the floor and hold for 2-3 seconds. You want to imagine trying to put your shoulder blade into your back pocket while lifting your arm.

This exercise targets the lower fibres of the trapezius muscle that help to depress the scapula.

Recommended: 3 sets of 8-10 repetitions each side

Prone I T Y’s

It’s important to note that before performing any arm movements that you need to tuck your chin inwards and elevate your face slightly off the ground. You should feel your rhomboids and lower trapezius muscles working hard during these exercises.

Recommended: 1 set of 15 reps for each

Prone Butterfly

This exercise is slightly more advanced compared to the I T Y’s as it requires your arms to move through a full range of motion while contracting the rhomboids, and lower traps. Keep your chin tucked throughout the movement.

You can put two dumbbells on the floor to make sure that your arms are staying high enough to pass over them during the movement.

Recommended: 3 sets of 8-10 reps

Wall Angels

Bend your knees slightly and flatten your lower back against a wall. Next tuck your chin so that the back of your head is resting lightly against the wall. Raise your arms so that your elbows are touching the wall and get your wrists as close to the wall as possible. Slide your arms upwards on the wall and when lowering them you want to try imagine you’re putting both shoulder blades into your back pockets. Hold for 1-2 seconds at the bottom of the movement and repeat.

This exercise can also be done lying flat on the floor. Gravity will help get your wrists and forearms closer to the floor. This is a good starting point if you have limited shoulder mobility or a tight thoracic spine that won’t extend.

Recommended: 3 sets of 8-10 repetitions.

Scapular Depressions

This exercise works the scapular retractors and depressors. It should be done in a 2-2-2-2 tempo.

2 seconds shoulder external rotation (turn your thumbs outwards), 2 seconds shoulder depression (try push your hands towards the floor), hold for 2 seconds at the bottom of the movement, and 2 seconds to return to the starting position.

Recommended: 3 sets of 8-10 repetitions.

Consistency key

 

Consistency is the key when retraining posture and correcting muscle imbalances. Always follow your chiropractor’s recommendations when starting a new exercise rehabilitation program. If you experience any pain or discomfort while performing these exercises or stretches please see your chiropractor and discuss your symptoms so that changes can be made accordingly.

Dr Mike

brisbane sports chiropractor dr michael benporath

 

Dr Michael Benporath is a certified sports chiropractor at Prime Health & Performance in Newstead, Brisbane