Upper Cross Syndrome: What is it? Why should you care?

By Mary Lynn Cloghesy & Jason Schembri

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One indisputable truth about writers is that we all sit for long periods of time. Whether you are putting pen to paper or punching keys on a laptop, writers spend hours at their desks. Recent research has shown that part-time writers average 10-15 hours per week, whereas full-time writers range between 21-42 hours per week, with high-output periods reaching 12 hours per day. Regardless of the level of output, the body works hard to accommodate your demands. One way in which the body responds to long periods of focused effort is to adjust to the biomechanical forces on the musculoskeletal system. Can you imagine how difficult it would be to get any work done if you had to think about holding up your head and setting your shoulders to protect your neck while writing? The body is quick to adapt to your working conditions and expectations, yet what seems to be a simple solution can have negative, long-term consequences. As such, starting this month, we are writing a series of articles on the most common conditions affecting writers and offering healthy living advice on what to do about it. We’ll start with one of the most pervasive: Upper Cross Syndrome.

What is Upper Cross Syndrome (UCS)?

UCS is a muscular imbalance in the upper back, neck, and shoulders caused by poor posture over an extended period of time, like when writers sit and slouch for hours. It results in dropped or rounded shoulders, a forward head position, and an exaggerated curvature of the spine in the neck and upper back. If you think about the body as an interconnected system, then the muscles at the top and mid section of your back and the deep flexors in your neck become weaker as the front body muscles work hard to stabilize your position as you naturally lean forward to write. The pectoral or chest muscles and anterior neck muscles shorten due to the strain, which can cause pain and dysfunction, as well as reduce your range of motion. The name “Upper Cross” comes from the pattern where the spine is pulled forward and compressed over time. See the image below: 

Why should you care?

UCS is associated with a variety of pathologies that can affect a writer, many of which cause discomfort or worse. Is there any greater distraction than pain? Here is one example of how UCS can affect you: did you know that every inch forward for your head posture adds 10-12 pounds of pressure on the spine? If you’re wondering whether your head is forward, a simple test is to put the back of your heels and buttocks against the wall and see if you head touches too. Don’t force it. If not, you can start to bring awareness to the condition to remedy it. Head forward position is linked to TMJ pain (temporomandibular or jaw pain), headaches, chronic neck conditions, weak respiratory muscles, and stability and balance issues, among other things. Here is a quick list of the reasons to care about UCS:

• Postural Strain and Discomfort:

  • Writers often adopt a slouched posture over laptops or desks for extended periods. The fascial system (connective tissue throughout the body) can lock in these dysfunctional patterns, which leads to further impairment over time.

  • This posture tightens the pectoral muscles and neck extensors while weakening the rhomboids and trapezius, causing chronic pain in the neck, shoulders, and upper back.

• Decreased Energy and Focus:

  • Poor posture reduces lung capacity and restricts airflow, leading to fatigue.

  • Chronic discomfort or pain can distract writers, reducing productivity and focus.

• Carpal Tunnel Syndrome Risk:

  • Rounded shoulders and forward head posture can compress nerves leading to the hands, exacerbating risks of carpal tunnel syndrome or other repetitive strain injuries.

  • Alternatively, numbness in the hands due to nerve impingement can make it difficult to hold a pen or type, let alone write for long periods of time.

• Headaches and Eye Strain:

  • UCS frequently causes tension headaches due to overactive neck muscles and occipitals.

  • The forward posture often results in additional strain on the eyes and headaches due to misalignment with screens or documents, decreasing working time.

• Impact on Mood:

  • Research indicates that poor posture can negatively affect mood and increase stress levels, potentially influencing creativity and writing output.

What can you do about it?

Most writers suffer from, or are at risk of developing UCS, but there are a number of readily available solutions, some of which you can do at home. First, let’s consider professional intervention, then we’ll look at other options. All physiotherapists and RMT’s (Registered Massage Therapists), will be trained in treating UCS. Costs range from $75 to $150 per consult for an initial assessment, with follow-up appointments potentially at a reduced rate. It’s important to understand any treatment won’t be a “quick fix,” as UCS is a condition associated with habitual movements (or lack thereof) which affect the fascial system or connective tissue throughout the body, which is stronger than muscle. An investment of time and financial resources will be required but ask yourself, what is your health worth? Also, most insurance companies cover this type of treatment. Chiropractic, Fascial Stretch Therapy, and other modalities can help as well. 

If you want to make a smaller investment, then home-based exercise tools and equipment can be beneficial, such as an inversion table (just to hang out), foam rollers, resistance bands, and/or any number of ergonomic aids. There are many health practitioners who offer online subscription services to support your learning with regard to regular movements that target the imbalances of UCS. There are simple protocols that can be incorporated into your workday. While posture braces and other similar tools are marketed as solutions as well, we doubt the efficacy as these devices will not be strong enough to counteract the hours you’ll be writing, when you won’t be thinking about your device or how to work with it. Lastly, here is a list of suggestions that you can try at home: 

• Ergonomic Workspace:

  • Adjust desk and chair height so the top half of the screen is at eye level and your back is fully supported. Change your desk or chair if necessary.

  • Use an ergonomic keyboard and mouse to reduce strain on the wrists and shoulders. There are also desks that raise to standing, and chairs designed for multiple seated positions. 

• Frequent Movement:

  • Take breaks every 30-60 minutes to stretch and move, helping alleviate muscle tightness. One simple trick: stretch your arms overhead and rise up on your tiptoes. This will reenergize you and lengthen your upper spine.

  • Incorporate stretches that target the chest and strengthen the upper back into your breaks from writing. You can learn simple protocols from online practitioners by searching for UCS programs.

• Postural Exercises:

  • Perform exercises like scapular squeezes, chin tucks, and wall angels to strengthen weak muscles and promote correct posture.

  • Practice yoga, Pilates, or something similar, which emphasizes alignment and flexibility.

• Mindfulness and Body Awareness:

• Writers can practice mindfulness or body scanning to become more aware of their posture while writing.

• Ask yourself if you need to make adjustments to your seated posture throughout the day or stand to write, using talk to text for a while.

Healthy Living Top Tip

While most writers will experience some version of UCS, even if it is only short-lived upper back and neck tension, one healthy living practice that will benefit all writers is to add more movements into your day as the hours at your desk increase. Also, do not pull on tight muscles. You need to coax them to flex and stretch, or you run the risk of causing tearing at the insertion points. Think of muscular movement like the flow of water. If you allow the body to respond, it will become more fluid. 

When we became full-time writers, we realized that the only way to be productive was to stay fit, so we began counter-balancing much longer periods of time writing with more time in the gym, running, building muscle, and stretching. Consider the time you spend on supporting your body similar to the investment you make in learning the craft: you need growing knowledge of and active engagement with both to cross the finish line. For UCS in particular, head and neck strain can lead to chronic inflammation and reduced energy due to restriction of lung capacity. When muscles are locked down, your vitality decreases. Writers can only keep doing what they love when they are healthy. If you love to write, learn about UCS and how to prevent it before it becomes problematic. Your writing and readers will thank you for it. 

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 Mary Lynn Cloghesy is the founder of the Leadership Literary Lab (https://leadershipliterarylab.com), and Jason Schembri is a long-term weight loss specialist (https://jasonschembri.coach) Together, they host a luxury writing retreat in the Canadian Rockies.