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Part 1: Upper Back Pain and Tightness

In this series, I want to talk about different patterns of positions & movements that are commonly found in individuals. By having greater self-awareness of our patterns, we can reduce symptoms of pain and tightness, prevent it from coming all together, and enhance the quality of our movements in daily life.

The first pattern I would like to talk about is called the "Upper Cross Syndrome". The typical posture of someone with this syndrome would have the following visual characteristics:

  • over rounding of the upper back

  • head positioned in front of the shoulders

  • rounded shoulders

The typical signs and symptoms of individuals with this syndrome include:

  • Tightness in the chest

  • Tightness in the upper shoulders & neck muscles (upper trapezius muscle)

  • Headaches

  • Upper back tightness/pain

If we look at the illustration below, we observe that the position of the head relative to the rest of the spine can influence the amount of work that is placed on the neck muscles. The greater the distance the head is from the rest of the body, the greater the workload on the neck and upper back muscles.

Holding these types of postures does not necessarily mean that it is detrimental to your body, but it is only when we assume these same positions on a daily basis for a long period of time and don't take on other positions/postures that problems can arise.

If you can resonate with this, there are a few things that can be done right away to counteract these patterns:

  1. Take microbreaks if you expect to be sitting for 6-8 hours in a day. A microbreak would be getting up and moving for 2-5 minutes every 20-30 minutes. It is far better to get up and move for 2-5 minutes every 20-30 minutes rather than moving for 15 minutes after 2 hours.

  2. Change your postural positions. By changing positions you will re-direct the stress to other muscles, thereby allowing other muscles to relax rather than be tense for many hours.

  3. Have a rolled up towel behind your lower back to prevent yourself from slouching.

  4. Incorporate a stretching and strengthening routine.

If you find yourself unable to assume different postures or find it challenging to hold them due to stiffness, pain, or discomfort, then it may require medical intervention. It would be recommended to see a physiotherapist to help figure out what is preventing you from improving your symptoms.

A few things a physiotherapist should consider when evaluating your body:

  1. Identify if there are any history of concussions, car accidents, shoulder injuries and falls that may have caused your body to stiffen up. Sometimes the effects of these injuries don't show up right away, but over time these injuries can begin to become more evident when our bodies become less active and mobile.

  2. Assess whether the stiffness or pain is chronic or acute. Depending on the nature of the condition, it may require a different approach and a varied duration and frequency of treatment. If the condition is acute, it may require more immediate hands on treatment to assist with pain management and limiting of compensations. However, if the condition is chronic, scar tissue and joint tension may appear leading to a longer recovery time.

  3. Identify the work environment. If the work environment is not set up optimally, it would require modifications of the body to fit the environment. For example, if you are staring at a computer screen for 6-8 hours and it is positioned below shoulder level, you will have to look down with your eyes or head to read the screen. This could promote more tension on the upper back and neck.

  4. Identify what postures are being held for extended periods of time. If you like to sit and cross your legs, you will find it more difficult and more tiring to sit up tall while crossing your legs. Consequently, this will cause the rest of the body to follow the rounding of your lower back and lead to upper back and neck tension.

Take Home Points

  • Changing sitting positions will reduce stress and tension on your neck and upper back

  • Take breaks throughout the day if you are expecting to sit for an extended period of time

  • Engage in activities (yoga, pilates, sports, stretching and strengthening exercises) that promote strength and mobility in your whole body

I hope you learned a few things today and found it helpful for your journey to recovery! If you have any questions about anything I wrote about today, please email me at

Interested to learn personally about how I work and how I can help you? - Come in for a free 15 minute consultation!

Ready to learn more about your body at a deeper level? - Book your appointment today!


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