This is the follow up for Part 1 Identifying Upper Cross Syndrome from last week.
Treating Upper Cross Syndrome for Dummies (Part 2)
Written by Michele Vieux
So, what can be done to prevent or fix the Upper Cross Syndrome (UCS) problem many of you seem to be coming down with? According to physical therapy protocol, when treating UCS, the shortened muscles must be restored before embarking on training of the weakened muscles. This is based on Sherrington’s Law of reciprocal inhibition which states that when one muscle is shortened or tightened its opposite muscle relaxes. So yes, lengthen before correction but I think you must also become aware of the issue and when you are exhibiting it.
First, you must learn to properly ‘set’ your shoulders so you don’t perpetuate the problem you are attempting to remedy. When we say ‘pinch the blades’, many times athletes will shrug their traps up to their ears. This is NOT what we mean. We want you to set the shoulder, or pack the joint as we sometimes say. This means to pinch them together and down. I like to use the cue that I stole from former Invictus Coach, Mark Riebel, to stick your shoulder blades in your back pockets. The right shoulder blade should go into the left back pocket and the left blade into the right pocket, taking the tension out of the upper traps.
Next, pay attention to how you are getting there and what your upper traps are doing in your daily routine. It is no good if you do a weighted trap raise every time you deadlift before you find the ‘back pockets’ position. Pay attention to how you are moving and always think about packing your shoulder joint when you sit at your desk, lift weights, carry groceries, move, drive, ride a bike, and even when you are just walking around. I have caught myself shrugging my traps at seemingly random times like when I am cruising around my neighborhood on my bike. I constantly have to remind myself to relax my traps. Weird that I have nerve pain in my neck and arms at night.
Third, you must manually work on the area. This could mean taking a lacrosse ball into the traps and thoracic region while leaning on the floor or wall, and chances are your pecs also need to be addressed. Check out pages 230-273 of “Becoming a Supple Leopard” – and if you don’t have it yet, pick up a copy at the front desk. Many of you are too far gone to properly address the situation on your own with a lacrosse ball and stretching band. If this is the case, it is time to call in the big guns – Tara and Heidi – or whoever your healer of choice may be. Have them dig into your neck and upper back. It hurts like hell, but trust me, you will notice a difference immediately following.
And last but certainly not least, you must pre-hab and/or rehab depending on how far gone you are. It could be a matter of retraining yourself and the muscles of the shoulder to properly function by practicing movements in the proper way OR you might need to incorporate some corrective movements into your routine. Here are a few common and easy ones you can do on your own to help facilitate healthy shoulders. You should recognize most of these from our group warm-ups and programming. I would start with mobilizing the scaps with some of the movements from The Supple Leopard (mentioned above). Then, pick one or two of the movements listed below to use as activation drills before you workout or as supplemental movements during and/or after your workout. Two to three sets of 10-15 reps a few times a week should work wonders for your shoulder health!
Scap Pull-Ups/Scap Push-Ups – Get some movement on those shoulder blades! They should slide along the outside of your rib cage and I’m willing to bet that in at least half of you, they do not. Scap pull-ups and push-ups are done with straight arms and initiate very little range of motion – only inches. For the scap pull-up, hang from the pull-up bar with arms completely extended. Pull your shoulder blades down to activate your sub-scap muscles (and lats in this case) and hold for 1-2 seconds in this position. Repeat at least ten times. Same idea goes for the scap push-ups. Hold the top of your push-up position and then spread your blades and then let them sink together all while holding a perfect plank with straight arms. The idea is to just get the blades moving in this one.
Trap 3 Raises – We commonly use trap-3 raises in group coaching – typically paired with a big movement like squats. The contraction is focused on the lowest (inferior) region of the Traps near the bottom tip of the shoulder blades. If you feel this in your upper traps (your shrugging muscles), remember to stick your shoulder blades in your back pockets and relax the upper trap! I’ve found that keeping your hand in a ‘thumbs up’ position and then slightly rotating the thumb back at the top of the movement really helps activate the specific part of the traps we are going for.
Bat Wings – These can be done on a medicine ball or a bench and should be done with a slow tempo that might look something like 5 reps @ 1515 tempo, which means you are pinching and holding the pinch for 5 seconds and resting for 5 seconds up to 30 second holds as pictured above. The up and down motions should be controlled, but only 1 second in length. For this movement, you are laying face down (on a bench) with fairly heavy weights (35 lbs or more) below your shoulders. Use the pinching motion of the shoulder blades to pick the weights up off the floor.
Y’s, T’s and W’s – These have been jokingly called YMCA’s by our funniest coaches, but you should get the idea of what we are looking for with the movement. While standing in a bent-over position or while laying on your stomach, put your arms into a position that forms either a Y, T or W. I prefer T’s and W’s over Y’s because they make it easier to focus on the middle and lower trap instead of the upper trap which can easily take over in the Y position. Once your arms are in position, pinch the shoulder blades together and squeeze for 1-2 seconds at the top position. Repeat ten or so times. Focus on pinching the middle and lower portions of the traps and on not shrugging the upper traps to your ears. These can also be done with very light weight if they become easy.
Seated Dumbbell External Rotations – External rotations are performed while sitting as upright and with the most perfect posture as possible. Start with your ‘weak’ side. Bring the leg on that side up so your foot is flat on the floor then use your opposite hand on the floor behind you to brace yourself into an upright position you can achieve. Make yourself tall! Rest the elbow of your weak side in the groove between the kneecap and the teardrop of the quad – which should be opened up to the ceiling in this position – so that your arm forms a 90 degree angle with knuckles pointed to the ceiling. Holding a very light dumbbell (I started with 5 pounds) slowly rotate the dumbbell downward so that your wrist goes below the level of your knee then turn it around and slowly bring it back upright. The tempo should be no faster than 2020 which means 2 seconds down then 2 seconds up.
Powell Raises – These are one of my favorites and usually leave me sore between the blades the next day. They are performed while in a side lying position like a plank with your hip on the ground or in the ‘Costanza pose’, if you will (Seinfeld reference), but with much better posture and less leather and fur. You will most likely use less weight than with the DB External Rotations so don’t be afraid to grab a 3# DB to start. It might seem light at first but by about 10 reps in, you will be feeling the fatigue. While in your side-lying position with your weak side up, hold the dumbbell straight over your shoulder joint with the arm fully extended and knuckles to the ceiling. Retract the shoulder blade and lower the dumbbell (with arm remaining straight) to the position where the weight finishes just below the chin. The whole time you are lowering your arm you should be pinching that shoulder blade as hard as you can, trying to keep it from losing any retraction. This should also be done with no faster than a 2020 tempo – two seconds down then two seconds up.