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December 30, 2020 5 min read

Imagine yourself sitting in a slouched posture, with your head placed more in front relative to your body, shoulders drooping forward, and your upper body rounded at the back…

This is the typical, upper body gaming posture, and the basic mechanism for the development of an Upper-Crossed Syndrome (UCS). But what exactly is an Upper-Crossed Syndrome? Why are videogamers prone to develop this condition, and how this results in various musculoskeletal issues, such as pain, muscular tightness, and joint conditions? Read on

Knowing the Culprit: The Gaming Posture

Given the situation above, you would notice exactly how your neck, shoulders, and upper trunk are awkwardly positioned in such a kind of posture. If this posture is sustained for a prolonged time or repeatedly assumed with your daily activities, you are most likely to develop an Upper-Crossed Syndrome. Both console and PC gamers are often seen in this kind of situation, especially if they’re too committed to taking down their opponent, striking that serious pose with an intense look in the eyes and leaning over the computer with their upper body way more forward, as if their competition is just right there in front of them and ready to be punched anytime. They’re too serious in the game that they often ignore the pain of a poor posture and, in the long run, can lead to Upper-Crossed Syndrome.

A faulty posture remains the leading cause of Upper-Crossed Syndrome. Not only the videogamers or console players who are at risk but also those whose jobs or activities leave them to unconsciously assume a forward head and rounded shoulders and upper back. These are the common postural deviations that many people exhibit. Other situations where Upper-Crossed Syndrome tends to develop are:

  • Computer and laptop use
  • Driving and biking
  • Watching TV
  • Overuse of smartphones and tablets
  • Long periods of reading and gaming

The postural changes associated with the Upper-Crossed Syndrome include:

  • Forward head posture – The poking head.
  • Increased cervical lordosis and thoracic kyphosis – The hunchback.
  • Elevated and protracted shoulders
  • Rotation or abduction and winging of the scapula (shoulder blade)

The Consequence of a Faulty Posture: The Cross

Now, in essence, any tissue in the body will adapt to the stress that is placed on it over time. That is, a muscle or joint will most likely be fixed, contracted, or immobile in that position if it stays in that position for an extended period. Musculoskeletal imbalances develop as a consequence, and your muscles become either tight or stretched, and weak, and your joint motions will be restricted.

The term “Upper-Crossed Syndrome” refers to the muscular dysfunction and imbalances that develop in the upper portion of the body. The “cross” results from a combination of tight muscles and weak muscles, which from a side view are seen as an “X.” On one arm of the cross, the “tight line,” which includes those muscles at the back of your neck and your chest muscles, is shortened, and therefore, tight or contracted depending on the duration in which it is sustained in that position. If it’s contracted, it means that these muscles are maintained in that posture for a very long time, and adhesions will be more severe. Tightness on these structures elevates and protracts the shoulder girdle, causing the forward-head appearance. The opposite happens on the other arm of the cross, the “weak line,” which are your neck muscles in the front and your back extensors at the upper back. In contrast, these muscles are stretched or lengthened and are inhibited, and due to the pull of gravity and tension of the tight line, the shoulder girdle is pulled forward. Regardless of their position, both sides become weak due to tight weakness and stretch weakness. The muscles involved in Upper-Crossed syndrome are:

  • Weak and Underactive Muscles: longus capitis, longus colli, hyoids, lower trapezius, serratus anterior, rhomboids, posterior rotator cuff, arm extensors
  • Tight and Overactive Muscles: upper trapezius, levator scapula, pectoralis, sternocleidomastoid, subscapularis, suboccipitals, latissimus dorsi, arm flexors

Some people, especially those whose jobs or activities require long hours of sitting also exhibit Lower-Crossed Syndrome  at the same time.

The joints' structural and functional integrity is also compromised, as well as that of the tendons and ligaments. These structures require movement to stay healthy and maintain their flexibility and will, therefore, become restricted when kept in a fixed position for prolonged periods. Tendons become stiff, which negatively affects the production of muscle force as manifested by weakness and exhaustion. Ligaments also lose their elasticity, severely restricting joint mobility. When this happens, smooth gliding of the joint surfaces will be jeopardized due to loss of movement of synovial fluid, which provides lubrication to the joints.

How to Fix the Cross?...

Stretch what is tight, strengthen the weak, fix your posture, and maintain what you gained from these.

The Upper‑Crossed syndrome can ultimately lead to overactive muscles on one arm of the cross and underactive muscles on the other. These postural imbalances result in muscular dysfunction in terms of tone and timing, often leading to poor movement patterns with increased stress on the neck and shoulder joints, as well as on the upper back area. Of all the technicalities, pain will be the ultimate end result.

Treatments of the Upper‑Crossed Syndrome should address the source of pain. In this case, the tension and spasm built in the contracted or tight muscles, and torn muscle fibers due to long-term stretching. Manual therapy techniques, comprising of massage, mobilization, and stretching exercises, combined with an intensive strengthening program can help correct these imbalances. The manual manipulation techniques will help relax the contracted or tight muscles, while the strengthening exercises will address the weakened and stretched muscles. By stretching and strengthening, your body will take off a lot of strain, and subsequently decreasing perceived pain. These treatment methods along with corrective postural exercises can minimize the recurrence or occurrence of the Upper‑Cross Syndrome.


  • Sit tall comfortably with shoulders up and back.
  • Tuck your chin by bringing it towards your neck, avoiding bending the neck.
  • Place both arms out in front at a shoulder level, then pull your elbows back to the sides while squeezing your shoulder blades together.
  • Bring your elbows and hands down to the sides and then using your elbows, pull your shoulder blades down.
  • Maintain for five seconds, and then repeat the cycle a few times more.

While on a game, you can perform these sequences during breaks to relax and mobilize your muscles, and avoid the onset of Upper‑Crossed Syndrome. These exercises activate your front neck and upper back muscles and stretch your neck extensors and chest muscles while providing quick postural correction during a game. Use Recovapro to fix both sides of the cross and effectively reduce the pain from being double‑crossed!

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