Crossed Postural Syndrome is an oft overlooked, under
diagnosed syndrome that is endemic in modern society. Sitting in front of your
computer forty hours per week is a major contributing factor. The 1997
census showed that fifty one percent of individuals worked at a computer for
the majority of their work-day. Eight years later, it’s estimated that over
100 000 Canadians lose time from work as a result of work related repetitive
strain injuries. Increased reliance on automation and computerization means that
these figures are only increasing.
Repetitive strain is the process by which we do something
too much, too hard or for too long. With inadequate rest periods, repetitive
strain ultimately leads to tissue overload; the point at which your body can no
longer compensate for the strain we exact on it. Once we reach tissue overload,
our body has to devise a new strategy to deal with the continued, repeated
strain. The solution that our body comes
up with is both ingenious and problematic, a type of “plan B”: Scar tissue
formation. Small fibrous adhesions accumulate between muscle layers, between
different muscles and between the fascia and muscle itself. Fascia is a thin,
three dimensional mesh-work of in elastin connective tissue that covers each
muscle in our body and influences both a muscles shape and its function. The
accumulation of scar tissue succeeds in tightening muscle and fascia that is no
longer able to contract in a healthy, normal way. Scar tissue build up impairs
the functional range of motion our muscles and ultimately initiates a
dysfunction. The culmination of this chain of events causes a predicable pattern
of alternating tight and weak muscles. Clinicians refer to this pattern as a
“Crossed Postural Syndrome” but most people recognize it as chronically bad
posture! The name “Crossed Postural Syndrome” is literally derived from the
relative location of tight and weak muscles.
Crossed Postural Syndrome presents in two common ways-an
“upper” and “lower” manifestation of essentially the same syndrome. Both
are aggravated by prolonged bouts of poor sitting and standing posture.
invokes images of the classic “slouched over the computer” posture. The
forward arm carriage causes the chest muscles to remain in a consistently
shortened position, while the upper back muscles are continually under a tensile
load attempting to keep your arms stabilized. In order to overcome this slouched
position and look up at the computer screen, we have to activate the muscles at
the base of the skull (the “suboccipitals”). These muscles, like the chest
muscles, are in a shortened position for inordinate amounts of time, while the
deepest neck flexor muscles are being stretched and inhibited at the same time.
The inhibition of the neck flexors and simultaneous tightness of the
suboccipitals is not a coincidence! Inhibition can loosely be defined as
“impairment in efficiency” of a muscle or nerve.
Neurological inhibition is a technical term for a
protective mechanism that your body often employs. Try to contract both your
bicep and tricep muscles maximally at the same time while moving your arm:
you’ll find that you can’t do it! From a neurological stand-point, the
contraction of one muscle “inhibits” the antagonistic (opposite) muscle
group from contracting at the same time. Hence, the shortened, tightened
position of the chest and suboccipital muscle groups in Upper Crossed Postural
Syndrome inhibits the deep neck flexors and upper back muscles from contracting
is characterized by people demonstrating a “sway back” postural stance in
which the buttock and stomach protrude. Tight hip flexors and lower back muscles
characterize this syndrome, while neurological inhibition and constant
stretching of the lower abdominals and gluteal muscles promotes this easily
identifiable posture (see figure). Lower Crossed Postural Syndrome can lead to a
number of complaints, including lower back pain and sacroiliac joint
dysfunction. In fact, the functionality of the gluteal muscles has been linked
to sacroiliac / pelvic joint function. Weak, lengthened and inhibited lower
abdominal muscles subject the joints of your lower back to greatly increased
loads and increased risk of injury.
Managing these syndromes is something that is best done
through a co-operative approach with your practitioner. Through a regime of
treatment, specific strengthening and stretching, you can help restore the
balance of strength and tone in these muscles.
Stretch First! Then
of operations is of significant importance to the success of rehabilitation
programs for Crossed Postural Syndrome. Too often, people with this syndrome
waste needless time and energy trying to strengthen the weak muscles without
first stretching the tight muscles. Stretching first effectively “turns
down” the neurological inhibition, allowing the weak, lengthened and inhibited
muscles the opportunity to contract more normally.
On a more global scale, consider these three determinants
of success when approaching any repetitive strain injury:
Strengthen and stretch the muscles involved in your complaint
Give professional treatment a fair trial
Avoid the offending mechanism of injury!
Neglecting one of these components can slow or stop your
return to normal, healthy activity!