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. 

Making Your Plan

By Dale T. Phillips

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“The moment one definitely commits oneself, then providence moves too. All sorts of things occur to help one that would never otherwise have occurred. A whole stream of events issues from the decision, raising in one’s favor all manner of unforeseen incidents, meetings and material assistance which no man could have dreamed would have come his way. Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it. Begin it now.”

Sometimes attributed to Johann Wolfgang von Goethe (though it may be someone else’s)

Since success is far more likely when you have a good plan and follow it, you’ll want to work on this critical part a bit. Realize that the plan will likely change along the way, and that’s okay, as various life events and opportunities arise, especially if you have schedules, which you should. The plan needs to be recorded in some format: I use basic office software spreadsheets. Writing down things makes them real, and sets it more firmly in your mind. Charting your progress keeps you focused and motivated. Do what works for you, and make it easily accessible, because you’ll refer to this frequently, to keep following the plan. 

The plan isn’t hopes or simply dreams, it’s achievable goals that are within your power. You can certainly write down your dreams, or incorporate them as part of a Vision Board, but your plan is doable steps to success. Winning awards, selling 100 thousand copies, being on Oprah, these are outside of your control. What is within your control is easy: what you’ll produce, by when, and how you’ll get it out to the world, and what other steps you’ll take. All while you’re learning more and creating your business. Work by work, win by win, you set each foundation stone to build that house of success.

Series

Series are a great way to get more books out quicker, as you don’t have to rebuild the novel world each time. They’re more likely to get you repeat readers and build your fan base. One writer I know is a smart cookie who has all the keywords and ad campaigns down, knows some of how to market, but all five of his novels are in different genres with no connection. A reader finds one of his books they enjoy, but nothing else like it by the same author, so sales are one-offs. That’s why the books don’t sell, but he doesn’t do anything about it, except gripe about how they’re not selling. So he’s discouraged and wants to give up. People buy my entire mystery series, because when they find a fictional world they like, they enjoy returning to it again and again. Remember, there are many series which survived past the demise of their creator, because people enjoy those worlds, even when written by others. One reason why fanfic is so popular. 

Stories

If you can add stories and collections to your output, that gets you to success quicker. Each story publication is another showcase ad for you when it comes out, as well as a chance for more promotion (and some form of payment). They can be finished and published quicker than novels, and serve as good credit-building. They get you through the long haul between books, and keep you going, a refreshing change of pace from the long grind of a novel. If you get a story into an anthology or collection with other writers, there are good connections to make. Having a book of your stories is a good resume addition, and an inexpensive way for new readers to find you. More in the store! 

Start with making a goal of writing one story a month. At that pace, you’ve got enough in a year and a half to Indie publish a couple of collections. That lets you easily get into the publishing process, and puts some product up, apart from one novel or two. It helps to get the ball rolling. Momentum is nice to have. It’s good to keep a list of ideas and titles for future works, be they novels, stories, or whatever. If I need an idea for a targeted anthology story or get stuck on what to write, I look at the ideas and titles I’ve recorded to see if anything sparks me to begin on that. I always have material to write.

For the master plan, break it down into large segments. First, what you expect to have done by a year from the start date. You can do a lot in a year, more than you think. Second, what you’ll have done three years from now. That gives you enough time to put out some quality work that will get you noticed. Then a future date, by which you’ll have done enough to be successful. Say five to seven years, by which you’ll enough good novels written and published, and a lot of stories. More than many writers. 

Then detail each time segment in your plan, making milestones and goals. First year, first book. Say fifty thousand words, a short novel, only one thousand words a week. When you get to five thousand words, that’s a major milestone— your first ten percent! Hitting these milestones makes you feel like you’re really progressing, and keeps the momentum. As studies show, setting specific intentions greatly increase your chances of success.

Then the other details— how will the book be edited: critique group, beta readers, editor? Have you started on those parts yet? If not, set a period of time to research, and put that in the schedule. If you haven’t done it, it may be difficult to estimate, but it’s good to rough out some sort of time frame, even if preliminary. Remember, you can adjust the plan later as more information becomes available. Set a reasonable time for editing, especially if this is an early novel, which may require some restructuring and story work. One of the great aspects of the Indie world is that you don’t have to publish a book until it’s ready. There have been a number of occasions where I wanted a book done by a certain date, but it needed more work, so it got delayed. Don’t publish until it’s good, but don’t spend eternity on it, either. Get work out rather than let it sit for too many years unpublished. 

Publishing

Apart from editing, do you know how to publish? Print, ebook, audiobook? Do you have a cover artist and know how to format? Do you know what platforms you’ll distribute on? Do you have all your marketing materials planned out? Do you know the other aspects of what comes after? If not, set periods for research. Ebooks can be published quickly, as soon as they’re ready. Print needs more formatting, and time to order a proof copy to verify it looks like it’s supposed to. Audiobooks need to be produced, and take the longest time. Adjust plans accordingly, and if you don’t know, just put a guesstimate or TBD (To Be Determined) in the time frame for now.

Definitely set the schedule for learning, and not just the publishing knowledge you’ll need. Can you absorb a new craft book on writing every 3-4 months? That gives you a few every year, and helps you improve much quicker. Plan on a course, online or in-person event every year, on some aspect of your writing that needs improvement. For that, I recommend at least one live writer conference a year, where you can learn a great deal in a few days. Budget for it, because they’re invaluable in advancing your writing career and making connections with other writers and fans.

And that’s just the start. See what I mean about how most people don’t get that far? It’s daunting to think about all you have to know, in addition to the writing. It took me about two years to learn enough of what I needed to publish my own books and break out as full Indie. Then I just took off and didn’t look back, though I’m still always learning. It does get easier as time goes by, because once you’ve acquired certain knowledge, you don’t have to relearn it.

Getting There

By following a good plan, in three years, you can be set on your success path quite readily. You’ve got some good books published, maybe some other material as well, you have your marketing material all prepared, you know how to contact libraries and bookstores, you’ve learned a lot. You’ve learned how to take feedback and have some trusted advance readers who will help. You’ve got some reviews and been interviewed a few places. After you get many of the preliminaries out of the way, plan to step up your production. Since you need less research time, put it into making your books awesome. 

And the next few years after that should determine how well you’ll do. If you’re always moving forward, making plans and achieving goals, producing good work, you’ll be surprised at how much you can accomplish. 

My original plan was to get a good start on success with ten good novels, ten story collections, and one hundred published stories. 

And that’s just the beginning! 

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Dale T. Phillips has published novels, story collections, non-fiction, and over 80 short stories. Stephen King was Dale's college writing teacher, and since then, Dale has found time to appear on stage, television, radio, in an independent feature film, and compete on Jeopardy (losing in a spectacular fashion). He's a member of the Mystery Writers of America and the Sisters in Crime.