The Best Prescription
When it comes to living in a sedentary society, we get exposed to a number of different risk profiles. Two of the major ones involve muscular degeneration, they are upper cross syndrome and lower cross syndrome. These phrases describe a degenerative pattern that is commonly seen in sedentary societies.
The phrase Upper Cross, comes from the cross pattern that we see in muscle strength of the upper body, typically the rhomboids, middle traps, lower traps, and deep neck flexors are weak. The upper traps and pectoral muscles are extremely tight. This creates a stark imbalance of tension on the spine, causing an inordinate amount of pressure that is typically focused at the base of the cervical spine, typically C5-C7. This pattern of inhibition forms two separate lines that intersect in the upper back, hence the name upper cross syndrome. Lower Cross Syndrome is exhibited by weak abdominals, glutes and hamstrings. There would also be tightness in the hip flexors and lumbar paraspinals. The hallmark of both of these syndromes is a forward leaning posture. The Upper Cross Syndrome has a forward leaning head, while Lower Cross includes the core leaning forward.
Typically, in the medical community, when we hear the word syndrome, it means we are not exactly clear about how the disease develops. In this case, there are many people who are not sedentary that exhibit these symptoms; however, the majority of these symptoms are posture related.
Many people will show up to a chiropractic office bewildered by the fact that they have the symptoms that line right up with upper or lower cross syndrome. In our society, as soon as we are able to leave our parents, we go into the public school system, one of the first most important lessons learned in a school setting is being able to sit quietly for a long period of time. The students that are able to do this are rewarded with high praises from their teachers. The students that are unable to do this (typically boys), are labeled as problem children from a young age and given prescription drugs to sedate them. In a culture where academic achievement is highly valued, is it a mystery that sitting quietly is one of the first lessons we learn in school? We use sitting for reading, listening, and writing, and we are taught if you want to succeed you just have to sit still. Find me a student that can’t sit still, and more likely than not you will find a child that is an academic failure.
We then spend the next 13-20 years sitting for about 30 hours a week, just at school! We then go home and sit and watch TV, we travel while sitting, and eat in a sitting position. It is impolite to eat in a standing position, it’s impolite to stand up in the classroom, it’s impolite to stand in a movie theater. Our entire society is geared toward this behavior. I have friends and colleagues who are mystified that they are experiencing these signs of physical degeneration in their mid-30s, but that is because they fail to realize just how much of our lives are devoted to the very behavior that creates the degeneration.
By the time someone has reached the age of 35 years, they have sat on average of approximately 70,000 hours! Which is almost one quarter of their life thus far. Factor in the amount of time people spend sleeping, over 50% of a person’s life is devoted to sedentary postures. Is it any mystery that this is a common problem? Not to mention, in just focusing on a person’s waking hours, approximately 50% of those are also spent sitting. Ironically, on average, kids are sitting more throughout the day than adults. 40% of the workforce is in a sitting job. Based on these trends it is safe to say that the long-term effects of sitting have not been factored into the way we structure our modern-day society.
How can we combat this issue in our present society? There are preventative courses of action that can be taken to diminish the effects of upper and lower cross syndrome. First and foremost, would be resistance training. However, the field of resistance training is replete with misinformation, disinformation, and “bro science”, because our focus is on the presentation of the body. People tend to focus on what the front of the body looks like, instead of focusing on balancing muscle strength throughout the body. For the meatheads in the gym, a comparison of strength is often focused on how much a person can bench-press. Unfortunately, this is contributing to the problem of upper and lower cross syndrome, because you are only developing the muscles on the front of the body, or the anterior chain. It is the strengthening of the back muscles (the posterior chain) that is essential for limiting the negative effects of these syndromes. Unless under proper instruction from a personal trainer, physical therapist/chiropractor, where they have learned the proper exercises and techniques to teach you to help strengthen your back muscles, you are at risk for causing further muscle imbalances and exacerbating your problem.
Gone are the days of the holy trinity of bench, squat, and deadlifts, it’s time to usher in a new era of prescriptive exercise. Everyone’s strengths and weaknesses are not the same. We all have different postures and needs. Of course, we can all benefit from a general approach to exercise, but if we truly want to receive the maximum benefit from strength training, it needs to be hyper focused with the aid of an expert. Only then will we be able to uncover our deficiencies that lurk in the periphery.
In addition to resistance and strength training, we have also discussed ways to change up your day of sitting with things like a standing desk. Some individuals will experience pain due to these symptoms where immediate relief can be obtained by chiropractic care. In many cases chiropractic care is essential for resetting the body into proper alignment. Gone are the days that patients can take no responsibility in the healing process. In order experience true recovery and healing a joint responsibility must be taken by the practitioner and the patient. The practitioner should communicate with the patient the chief areas of concern, and then the patient must do their part. True healing comes from a lifestyle change, as are most things health related.
Works Cited
Standing or walking versus sitting on the job in 2016 : The Economics Daily: U.S. Bureau of Labor Statistics. (2017, March 1). Retrieved September 14, 2022, from https://www.bls.gov/opub/ted/2017/standing-or-walking-versus-sitting-on-the-job-in-2016.htm
Nitayarak, H., & Charntaraviroj, P. (2021). Effects of scapular stabilization exercises on posture and muscle imbalances in women with upper crossed syndrome: A randomized controlled trial. Journal of back and musculoskeletal rehabilitation, 34(6), 1031–1040. https://doi.org/10.3233/BMR-200088
Searing, L. (2019, April 28). The Big Number: The average U.S. adult sits 6.5 hours a day. For teens, it’s even more. washingtonpost.com. Retrieved September 14, 2022, from https://www.washingtonpost.com/national/health-science/the-big-numberthe-average-us-adult-sits-65-hours-a-day-for-teens-its-even-more/2019/04/26/7c29e4c2-676a-11e9-a1b6-b29b90efa879_story.html