What is Upper and Lower Cross Syndrome and What to Do?

Updated: Dec 8, 2019

Crossed Syndrome generally refers to the tightness in one area which causes weaknesses in other areas of the body. There are different crossed syndromes for the upper and lower body. It affects posture, joints and overall mobility.

Upper Cross Syndrome (UCS)

It is the most common pattern of muscle imbalance in the upper body and it usually happens due to bad posture. The muscles of neck, shoulders and chest become deformed and restricted. The name of the condition is given because an X is formed across the upper body. On one end the muscles that are tight, are causing the muscles on the other end to become overly inhabited.

Causes of UCS

1. Forward head posture

One of the most common causes is the chronic postural stress to the upper body i.e. sitting for longer periods of time with your head pushed forward. Activities that can lead to poor posture include:

· Reading

· Computer/ laptop use

· Driving

· Watching tv

· Cellphone use

A lot of people’s work usually involves sitting for prolonged periods or driving, and when they are not working; they scroll through their phones with their heads forward and backs hunches, creating a upper cross syndrome.

2. Poor Exercise Techniques

Unbalanced training and poor exercise techniques can lead to UCS as well. Focusing on your core or doing hundreds of crunches without any training can be harmful.

3. In other cases, UCS can also happen due to injuries.

Previous injury (post surgery or left over scar tissue) or repetitive injury (frequent dislocations, ligament instability, or general pain causing guarding) will lead the body towards these distortion patterns as a way to protect the damaged area. In turn while guarding the area from pain leads to poor posture and body positioning.

Symptoms of UCS

People who suffer from upper cross syndrome have hunched, stooped and/or rounded shoulders and a bent- forward neck. The restrained muscles put strain on other joints, bones, and tendons. Symptoms faced by most of the people are the following:

· Weakness in the front of the neck

· Strain in the back of the neck

· Elevated, rounded shoulders

· The shoulder blade sits out instead of lying flat

· Chest pain and tightness

· Numbness and pain in the upper arm, hands and fingers.

· Sore shoulder blades

· Jaw pain

· Fatigue

· Lower back pain

It can also lead to secondary health issues i.e. reduced lung capacity, myofascial trigger points, cervicogenic headaches (caused by neck or injured spinal cord)

Muscles involved in UCS

In upper cross syndrome, the muscles that are chronically shortened and contracted end up becoming overly facilitated/ tight whereas the muscles that are lengthened end up becoming weaker or inhabited. Affected muscles are of two kinds i.e.

Muscles that become tight:

1. Suboccipital

Provides help in the movements of the head

2. Upper trapezius

It is used to tilt and turn the head and neck, twist the arms and shrug the shoulders.

3. Levator scapulae

Skeletal muscles which helps to lift the scapula.

Muscles that become weak:

1. Cervical flexors

These are the small muscles on the front and sides of the neck and supports the weight of the head.

2. Rhomboids

Helps to retract the scapula and pulls it towards the vertebral column.

3. Lower trapezius

It works to create posterior tilt of the scapula.

The pectorals become tight and short whereas the deep cervical flexors become weak. On the other end of the cross (X) are rhomboids and lower trapezius which also become stretched.

Lower Cross Syndrome (LCS)

It is a neuromuscular condition that involves tight and weaker structures of hips, pelvis and lower back. It is a muscular dysfunction that happens in the lower part of the body. It occurs mainly due to the imbalance in the lower segment. It is also called pelvic or distal cross syndrome.

Causes of LCS

Lower cross syndrome is more common than UCS. There are many things that can cause LCS such as

1. Prolonged sitting with a constant flexed forward posture

2. Imbalanced strength training ( focusing more on lower back than abdominal)

3. Genetic predispositions

4. Not using the muscles evenly in sports or other exercises

5. Inactive lifestyle

Bad positioning of the pelvis adds a lot of stress to your lower back and it destabilizes the core which can lead to musculoskeletal injuries.

Symptoms of Lower Cross Syndrome

People who are suffering from this condition may experience these following symptoms

· Tight hip flexor muscles

· Increased curve of the lower back (sway back)

· Bulging abdomen

· Forward tilt of the pelvis

· Knee hyperextension

· Weak abdominals and lower muscles

· Lower back pain

· Tight hamstrings

· Poor exercise technique ( poor movement patterns in exercise such as squat or deadlift)

In LCS, pain is not necessary or we can say that the person does not feel the pain due to the tightness of the lower back extensor musculature.

Muscles involved in LCS

Just like in UCS, Lower cross syndrome involves the tightening and weakening of the muscles again making an X, but on the lower part of the body.

The tight muscles include;

1. Thoracolumbar (low back) extensors (erector spinae):

Helps to straighten the back and provide side to side rotation.

2. Hip flexors (iliopsoas):

Muscles responsible for bending the hip up, lift the knee and bring the thigh up to abdomen.

While the weak muscles involve

1. Abdominals:

Abdominal muscles which support the trunk and hold up your core muscles.

2. Gluteus Maximus:

Bottom muscles that is used to bring the hip back and leg to the side.

The cross is made in such a way that the tightness in the hip flexors crosses with the tightness in the thoracolumbar extensors whereas abdominals’ weakness crosses with the weakness in the glutes. The imbalance in the muscles results in increased bending of the hip joints and also leads to compensatory tight hamstrings.


Both upper and lower cross syndrome can work together but they are treatable by doing exercises and mobility drills such as stretch and release the muscles that are tight and strengthen the muscles that are weak and it will not only improve your posture, physical appearance and will make you feel a lot better. Also, consult a professional as well who will guide you about the exercises and therapy.

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