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Neuromuscular Therapy 101: Additional symptoms and analysis of Upper Cross Syndrome
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Part 1 examined available online literature on Upper Cross Syndrome (UCS), especially looking at its related postural pattern. This section discusses some missing elements which are just as important.
In its neutral position, the shoulder blade (scapula) rests against the back of ribs 2-8.
Most UCS literature correctly identifies the pectoralis minor as the muscle that moves the scapula up and out from its neutral position (protraction), causing the rounded-shoulder symptom.
What is often overlooked is how biceps tension may also contribute to scapular protraction. Like the pectoralis minor, the short head of the biceps also attaches to the Coracoid process, the protruding round piece of bone coming off the top of the main body of the scapula (see illustration below).
(Illustration courtesy of Wikipedia)
Just like slouching on the chair at work may contribute to UCS, biceps tension is often the result of modern living. The biceps muscle flexes the elbow when it contracts, and the biceps contracts most of the time, including during daily activities such as eating, driving, working, and even sleeping. The weight of the arm, connected via the biceps short head, can pull on the scapula just as effectively as a contracted pectoralis minor. While this condition may require more complex treatment protocols in the short run, addressing this issue produces longer-lasting resolution.
Another problematic issue in the literature is the assumption that the rhomboids muscles are weak. This is a rare condition that usually is related to direct trauma to the muscle or the bones to which it attaches.
A muscle can be stretched beyond its normal resting position and still be strong. The assumption of rhomboids weakness relies upon over-simplified use of the principle of reciprocal inhibition: For every joint movement, there are two muscles (or muscle groups) working in opposition to each other. For example, the pectoralis minor pulls the scapula away from the spine (protraction) while the rhomboids pull it in towards the spine (retraction). When the pectoralis minor contracts, the rhomboids must lengthen.
Reciprocal inhibition, as commonly taught, assumes that if the pectoralis minor becomes permanently tight, the rhomboids therefore become permanently weak. However, because the rhomboids are such key muscles in keeping the entire shoulder girdle functional, they remain strong even when stretched by overwhelming pectoralis minor tension. Not that this is okay: Under this circumstance, the rhomboids commonly exhibit symptoms of pain and soreness.
This brief overview of other issues should serve to help make better choices when seeking help for UCS, and is not intended to replace proper assessment by a qualified professional.
Next: Postural issues contribute to Upper Cross Syndrome
Internet articles are never a substitute for appropriate medical advice.
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Howard Nemerov is the developer of the Nemerov Method of neuromuscular therapy.
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