Upper cross syndrome is the result of muscle imbalance. Diagnosis mainly is result of history and clinical observation (these are the basis of the diagnostic criteria). There are distinct postural changes
Clinical picture can include:
1. Forward head posture head (the head is leaning forward as the anterior muscles are tightened and the posterior are weaker. The result is the head to be in the upper quadrant of an X or cross)
2.Increased cervical lordosis and thoracic kyphosis
3. Elevated and protracted shoulders
4. Rotation or abduction and winging of the scapula
Patient can give a history of
1. Shoulder instability
2. Numbness of the upper limbs due to nerve pain in the neck and arm(s),
3. Instability of the gait or giddiness while head is extended in trying to see overhead
4. Headaches
5. Pain of shoulders due to Rotator cuff problems
6. Pain of shoulders or C Spine due to degenerative joint disease of ACJ and vertebral facet joints of C Spine
Testing:
1. Janda's Cervical Flexion text – evaluation of the deep cervical muscles (patient supine asked to lift his head from the couch and the smoothness of the movement is observed)
2. Evaluation the strength of the scapular muscles
3. Tightness of trapezius (upper part of the muscle)
The Upper Cross Syndrome is mainly the result of muscle imbalance (Dorsal Upper Body muscles are getting weaker and the Upper Trapezius and Sternocleidomastoid are going to tension) This postural "deformity" is resulting to the head to move forwards and be within the upper quadrant of a side leaning cross or shape of X.
So the main diagnostic criteria are based on history and the clinical picture.
Patients are complaining of Headache, Shoulder pain, Muscle aches and Pain in Upper back and Neck.
Clinical picture (Postural Changes):
Forward head posture
Increased cervical lordosis and thoracic kyphosis
Elevated and protracted shoulders (Rounded shoulders)
A hunched upper back
Rotation or abduction and winging of the scapula
This position can result to Degeneration of the Cervical Vertebrae and the AC Joint at the Shoulder area, occasionally resulting to shoulder impingement.
Test: Janda test: Patient supine tries to elevate the head from the couch. Normally the lordosis will disappear and the chin will touch the sternum. Otherwise pathological picture shows that the head is lifted with the very tense sternocleidomastoids.
So the diagnosis is done only based on clinical grounds.
Apologies for the two entries but the site had a problem and had not register the first answer for more than 10 hours showing to me that I had not answer to you. I am sorry for the repetition.
- Badges
- Science topic
- Similar topics
- Biological Science
- Physiology
- Physiological Processes
- Stress