Part 2 - Upper Crossed Syndrome
So from part 1 of this blog, we know that lower crossed syndrome (weak gluteals and abs and tight hip flexors and low back) can cause a host of issues in your golf game, but what about the upper body version?! I’m sure we can all identify with a typical lazy desk posture: rounded shoulders, hunched upper back and a chin that pokes farther forward than a pigeon strutting across the park!
Have you noticed any loss in torso rotation through your spine, an inability to get the club on the right “plane” that the coach has been suggesting you need to achieve, swinging “over the top” or losing posture at the top of the backswing?! You may not have even noticed these limitations slowly creeping into your game over a number of years.
When you sit at a desk for long periods of time, your chest and upper back muscles can become very tight while the deep cervical flexors of your neck and mid back muscles become very weak. We call this postural dysfunction Upper Crossed Syndrome (UCS) and this can be seen alongside a neutral posture below in figure 2.
Figure 2. Normal posture (left) and UCS (right). Note the forward position of the head in comparison to the neck and the rounded shoulders and upper back.
However, by doing the right exercises, you can overcome the upper body limitations that emerge from sitting for too long at your desk. To reverse UCS you must increase the flexibility in your chest and upper back muscles and increase the strength of your deep neck flexors and mid-back muscles.
I’m throwing out lots of technical terms and muscle names but here are some examples of exercises that can help reduce the effects of your occupational desk-bound duties on your upper body!
One solution to upper crossed syndrome is to strengthen the muscles through the mid-back that sit all around the shoulder blades. Ts, Ws, and Ys are common exercises that you might have tried before, but just in case you've forgotten, take a look at the video below.
Coaching Points: Lie face down on a gym ball with the feet apart and legs almost straight for support. For extra stability, place the feet against a wall. All of the movements in these exercises begin with the hands underneath the eyes with the palms facing upwards. To make the letter T, take the hands and arms out to the side of the body until they are straight and in line with your shoulders. You should make the shape of the letter so that if a bird flew above you, it would see a letter T with your body. Next are the Ws. These are similar to the Ts but with bent arms at the top position forming a W. Finally the Ys, the hardest out of the three, so don't be tempted to raise the upper body or head to help get the arms fully extended out in front of you. Keep the body tight throughout and the head looking down to the floor. Remember not to hold the top positions, simply repeat the movement for each rep continuously until you have done 10 on each letter to begin. To progress, you can add light weights to the Ts and Ws and then later on, add weight to the Ys.
A less common and even more dynamic exercise for strengthening the muscles that sit around the shoulder blades is Crab Walks. The late Ramsay McMaster, a world-renowned golf physiotherapist, originally demonstrated this exercise. It’s an excellent exercise that combines work for the muscles involved in both LCS and UCS.
Coaching points: Place a mini band around both legs just above the knees and hold a piece of tubing or theraband behind your back with a pistol grip. Keeping the elbows tucked into the side and the chin pulled back into a neutral position, begin to circle the hands backwards. Do not force the shoulders back and stick the chest out, as this is not a neutral position. Instead, gently pull the shoulder blades down and in as if sliding them into an envelope on your back. Once you have got the arms going begin some side steps, like a crab! Make sure your feet stay apart throughout the exercise and the closest they should ever get is the width of your stance in your golf address position. You should feel the glutes, mid-back and triceps all burning after doing 2-3 sets of 20 steps in each direction.
With regards to the tight areas in UCS, it is important to stretch out the chest. Prior to this stretch, you can use a spikey ball or massage ball to roll into the pectorals (the chest muscles) to improve the tissue quality and increase the flexibility across this area. As with the LCS hip flexor foam rolling, do not do this every day as it may bruise and your muscles will need time to recover from the massage effects. Follow this rolling by completing the chest stretch using a chair (your office chair perhaps?!) or a gym ball.
Coaching Points: Keep the arm bent to 90° at the elbow and raise it level with your shoulder. Kneeling down, gently press the torso downwards, bending the supporting arm if necessary to increase the stretch felt across the shoulder and pecs. Hold for a minimum of 30 seconds and repeat twice on each side every day when warm.
While certain exercises can help us overcome the negative postures we all adopt at our desks, if you really want to improve these limitations quicker and for the long-term -- you guessed it -- you need to focus on reducing the hours spent at your desk in a poor posture. Whether this means increased desk breaks, more hours spent out on the golf course (!) or simply being aware of how you sit at your desk and how you stand when walking, anything you can do to reduce the negative effects of LCS and UCS will pay dividends out where it counts!
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References for more information on Janda’s work:
Janda V. (1987). Muscles and motor control in low back pain: Assessment and management. In Twomey LT (Ed.) Physical therapy of the low back. Churchill Livingstone: New York. Pp. 253-278.
Janda V. (1988) Muscles in Cervicogenic Pain Syndromes. In Physical Therapy of the Cervical and Thoracic Spine, ed. R. Grand. New York: Churchill Livingstone.