In the previous post, we explained the great importance of good postural hygiene in health, and we also defined and detailed the "upper crossed syndrome", as well as the problems it causes. In this entry, and as we promised, we will provide a practical proposal to try to solve or prevent this syndrome so widespread in the population. So, without further ado, let us get on with it!
 |
| upper.lower.crossed.syndromes by Beth Scupham. CC BY 2.0 |
How can we correct the upper crossed syndrome?
Since this syndrome is caused by the alteration of two opposing structural groups, which tend to inhibit and shorten depending on the muscle group, the procedure always follows the same patterns. This procedure consists of first releasing the shortened or hypertonic musculature, and then restoring the function of the inhibited or phasic musculature. In addition, we must pay attention to our postural hygiene throughout the day, since, if we perform certain exercises or stretching for 1 hour a day to solve our problem, but then we spend 16 hours with a bad posture, little or nothing will serve the training performed. Therefore, we must emphasise the body attitude of our daily life, with simple solutions such as replacing the office chair with a Swiss ball, which seems to have favourable results in the treatment of these syndromes (Yoo, Yi, & Kim, 2007). This is just one example of how important it is to prevent and adapt our environment to improve postural habits. The most recommended physical exercise based on scientific evidence is the strengthening of the middle and low trapezius, in conjunction with stretching of the upper trapezius and the levator scapulae (Bae, Lee, Shin, & Lee, 2016).
Practical proposal:
We remember that, mainly, the shortened musculature is the pectoralis major, the pectoralis minor, the upper trapezius, the sternocleidomastoid and the levator scapulae. On the other hand, the main inhibited musculature is the lower trapezius, middle trapezius, anterior serratus and deep flexors of the neck. Therefore, by clarifying and structuring the proposal, we are going to provide certain stretching, inhibitions and strengthening exercises, and the order to follow will be as follows:
- Exercises of inhibition of the rigid and shortened musculature (tight muscles).
- Mobility exercises for the joints involved.
- Exercises of activation of the phasic and inhibited musculature (weak muscles).
The selected order is important, since before trying to mobilise or work any structure, we must inhibit the musculature that is shortened and prevents the proper functioning of the joints involved. These inhibition exercises, which we will perform with a Lacrosse Ball, a Tennis Ball, or a Foam Roller, consist of pressing with slight oscillations on the "tension bands" or "trigger points" of the shortened musculature. We propose to perform the Jones technique (Dommerholt & Huijbregts, 2011), which consists of squeezing the trigger point with the muscle in shortening (not to be confused with contraction), i.e. reducing its longitudinal size to a minimum. When we compress this painful point, what is called "ischemic compression" is provoked, preventing irrigation, dilating the peripheral arteries as a physiological response to bring more blood to the compressed area. When we release, the amount of substrates reaching the muscle is much greater than before. We maintain each pressure for about 90 seconds. The inhibitions we propose are as follows:
- Pectoralis with ball.
- Upper trapezius with ball.
- Angular scapulae with ball.
- Suboccipital with Foam Roller.
After performing the inhibition, we will perform mobility exercises and stretching, preferably active or PNF, keeping about 15 seconds each. These stretches and mobilisations will serve to increase the amplitude of movement, limited until now due to the hypertonicity of the shortened musculature. The proposed stretches and mobilisations are:
- Pectoralis stretching.
- Sternocleidomastoid stretch and upper trapezius.
- Shoulder girdle dissociation.
- Shoulders mobility in frontal plane.
Finally, we must activate and strengthen the inhibited musculature, since there is muscular decompensation in the joints involved and it is not enough to relax the tense musculature, but it is necessary to strengthen the inhibition so that the crossed syndrome does not reappear. The proposal includes the following exercises:
- Lower trapezius activation with rubber.
- Band pull apart.
- Face pull.
- External Shoulder Rotators.
- Archer's movement.
- Activating the anterior serratus in push-up position.
- Serratus activation with Foam Roller on wall.
- Activation of deep neck flexors with double chin maneuver.
Without further ado, I leave you with a video that exemplifies each of the proposed exercises,
May the force be with you!
References
Bae, W.-S., Lee, H.-O., Shin, J.-W., & Lee, K.-C. (2016). The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. Journal of Physical Therapy Science, 28(5), 1636–1639. https://doi.org/10.1589/jpts.28.1636
Dommerholt, J., & Huijbregts, P. (2011). Myofascial trigger points : pathophysiology and evidence-informed diagnosis and management. Jones and Bartlett Publishers. Retrieved from https://books.google.es/books/about/Myofascial_Trigger_Points_Pathophysiolog.html?id=eHXaaDR71eAC&redir_esc=y
Yoo, W., Yi, C., & Kim, M. (2007). Effects of a ball-backrest chair on the muscles associated with upper crossed syndrome when working at a VDT. Work (Reading, Mass.), 29(3), 239–244. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17942995
Comments
Post a Comment