Treating Upper Cross Syndrome

Upper cross syndrome is a condition that is chronic in nature.  It occurs over time with unhealthy posture and poor movement patterns.  It is very common among office workers and people who spend hours a day in front of a computer.  Signs of upper cross syndrome include forward head posture, rounded shoulders and upper back, pain in the upper back and neck , and tension headaches .  This diagnosis describes a condition in which opposing muscles from front to back are out of balance.

The following muscles are overactive:  sub-occipitals, SCM’s, scalenes, pecs, levator scapulae, and the upper trapezius.  The tightness in these muscles is responsible for pulling the head and shoulders forward.  Lengthening these muscles is necessary to regain balance. The following muscles are under active:  deep neck flexors, neck extensors, and scapular stabilizers.  When these muscles are not being used, they become chronically lengthened and develop trigger points.  This can also be a primary cause of tension headaches .  Specific exercises designed to target these muscles will activate them.  As they regain strength and function, muscle balance will return.

Because of chronic poor posture , people with upper cross syndrome generally have numerous fixations in the upper back and neck.  It is very important to get chiropractic adjustments regularly throughout treatment to increase mobility.  Strengthening exercises work better when the muscles and joints are flexible and capable of a full range of motion. What are the implications of a forward head posture secondary to an upper cross syndrome?  New studies reveal some interesting insight to how posture not only affects the way we look, but it affects our health potential as well.   A study published in the most prestigious orthopedic journal in the world, researchers found that all measures of health status demonstrated significantly poorer scores as the head migrates forward.  The study headed by Steven Glassman, MD was published in Spine, Volume 30(18), September 15, 2005.  In the study 752 patients were evaluated for spinal deformity which was described as an anterior head posture (upper cross syndrome).  Of the 752 randomly selected adult patients, 298 were found to have upper cross syndrome.  The researches then designed a method to measure severity of the condition.  Some patients obviously had worse posture than others.  Key points from this study include: There is clear evidence of increased pain and decreased function as a persons posture worsens, ie. As the head migrates forward. All measures of health status showed significant poorer scores in patients who suffer from upper cross syndrome. The further forward the head migrates, the poorer the health status scores for the patients.  This very recent study documents how your health is directly related to your spinal function and posture.  Correcting these problems is not just about neck and back pain, it’s about living life free of disease.

I typically write and edit my own articles, but opted to use an article from another site (www.massagetherapy.com ) to help enhance the value of this blog entry.  The following article can also be found at http://www.massagetherapy.com/articles/index.php/article_id/468/Benefits-of-Massage.


Originally published in Body Sense magazine, Fall 2001.
Copyright 2001. Associated Bodywork and Massage Professionals. All rights reserved.


As you lie on the table under crisp, fresh sheets, hushed music draws you into the moment. The smell of sage fills the air and you hear the gentle sound of massage oil being warmed in your therapist's hands. The pains of age, the throbbing from your overstressed muscles, the sheer need to be touched -- all cry out for therapeutic hands to start their work. Once the session gets underway, the problems of the world fade into an oblivious 60 minutes of relief and all you can comprehend right now is not wanting it to end.

But what if that hour of massage did more for you than just take the pressures of the day away? What if that gentle, Swedish massage helped you combat cancer? What if bodywork helped you recover from a strained hamstring in half the time? What if your sleep, digestion and mood all improved with massage and bodywork? What if these weren't just "what ifs"?

Evidence is showing that the more massage you can allow yourself, the better you'll feel. Here's why.

Massage as a healing tool has been around for thousands of years in many cultures. Touching is a natural human reaction to pain and stress, and for conveying compassion and support. Think of the last time you bumped your head or had a sore calf. What did you do? Rubbed it, right? The same was true of our earliest ancestors. Healers throughout time and throughout the world have instinctually and independently developed a wide range of therapeutic techniques using touch. Many are still in use today, and with good reason. We now have scientific proof of the benefits of massage - benefits ranging from treating chronic diseases and injuries to alleviating the growing tensions of our modern lifestyles. Having a massage does more than just relax your body and mind - there are specific physiological and psychological changes which occur, even more so when massage is utilized as a preventative, frequent therapy and not simply mere luxury. Massage not only feels good, but it can cure what ails you.


The Consequences of Stress
Experts estimate that 80 percent to 90 percent of disease is stress-related. Massage and bodywork is there to combat that frightening number by helping us remember what it means to relax. The physical changes massage brings to your body can have a positive effect in many areas of your life. Besides increasing relaxation and decreasing anxiety, massage lowers your blood pressure, increases circulation, improves recovery from injury, helps you to sleep better and can increase your concentration. It reduces fatigue and gives you more energy to handle stressful situations.

Massage is a perfect elixir for good health, but it can also provide an integration of body and mind. By producing a meditative state or heightened awareness of living in the present moment, massage can provide emotional and spiritual balance, bringing with it true relaxation and peace.

The incredible benefits of massage are doubly powerful if taken in regular "doses." Dr. Maria Hernandez-Reif, from the Touch Research Institute (TRI) at the University of Miami, is known for her massage research, along with colleague Tiffany Field. Together, they and other researchers have done outstanding work proving the value of massage. While their studies have shown we can benefit from massage even in small doses (15 minutes of chair massage or a half-hour table session), Hernandez-Reif says they know from their research that receiving bodywork 2-3 times a week is highly beneficial. And if we lived in a fantasy world, Hernandez-Reif has the answer. "I feel a daily massage is optimal."

It's undoubtedly a wonderful thing when your therapist begins unwinding those stress-tightened muscles, and your day's troubles begin to fade away. But it's the cherry on top to know this "medicine" only gets better with frequency.


What You Already Know: The Benefits of Massage
In an age of technical and, at times, impersonal medicine, massage offers a drug-free, non-invasive and humanistic approach based on the body's natural ability to heal itself. So what exactly are the benefits to receiving regular massage and/or bodywork treatments?

- Increases circulation, allowing the body to pump more oxygen and nutrients into tissues and vital organs.

- Stimulates the flow of lymph, the body's natural defense system, against toxic invaders. For example, in breast cancer patients, massage has been shown to increase the cells that fight cancer.

- Increased circulation of blood and lymph systems improves the condition of the body's largest organ - the skin.

- Relaxes and softens injured and overused muscles

- Reduces spasms and cramping

- Increases joint flexibility .

- Reduces recovery time, helps prepare for strenuous workouts and eliminates subsequent pains of the athlete at any level.

- Releases endorphins - the body's natural painkiller - and is being used in chronic illness, injury and recovery from surgery to control and relieve pain.

- Reduces post-surgery adhesions and edema and can be used to reduce and realign scar tissue after healing has occurred.

- Improves range-of-motion and decreases discomfort for patients with low back pain .

- Relieves pain for migraine sufferers and decreases the need for medication.

- Provides exercise and stretching for atrophied muscles and reduces shortening of the muscles for those with restricted range of motion.

- Assists with shorter labor for expectant mothers , as well as less need for medication, less depression and anxiety, and shorter hospital stays.

If you have not had a massage recently, maybe it is about time you schedule an appointment.  We have some of the top therapists in the Atlanta right here at The Ravinia Spa.  Check us out.....you will be very happy that you did.

According to The Osteoporosis Foundation (NOF.org), Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist.

Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.

Some disturbing statistics:

• Osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older.
• In the U.S. today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis.
• While osteoporosis is often thought of as an older person's disease, it can strike at any age.
• Of the 10 million Americans estimated to have osteoporosis, eight million are women and two million are men.
• In 2005, osteoporosis-related fractures were responsible for an estimated $19 billion in costs.
• By 2025, experts predict that these costs will rise to approximately $25.3 billion.
• People cannot feel their bones getting weaker. They may not know that they have osteoporosis until they break a bone. A person with osteoporosis can fracture a bone from a minor fall, or in serious cases, from a simple action such as a sneeze or even spontaneously.
• Vertebral (spinal) fractures may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture. In many cases, a vertebral fracture can even occur with no pain.
• Women can lose up to 20 percent of their bone mass in the five to seven years after menopause, making them more susceptible to osteoporosis.

Most studies show that low calcium intake is associated with low bone mass, bone loss and higher fracture rates (broken bones). Getting enough calcium is one of the many things people can do to help reduce bone loss. People who get plenty of calcium during their lifetime may still be at risk for bone loss and osteoporosis due to a variety of factors. These factors include vitamin D deficiency, genetics (family history), physical inactivity, smoking, alcohol abuse, and certain medications and medical disorders known to cause bone loss.

One way to help reduce your risk of decreased bone density is to consume adequate amounts of calcium in your daily diet. If you cannot consume enough calcium from your foods, supplements are a safe alternative.  Avoid taking more than 500 milligrams of elemental calcium at one time to increase absorption. To avoid toxicity, do not take more than 2,500 milligrams of elemental calcium per day.

While calcium is crucial, taking it alone might not be enough. To actually get calcium into your bones, the body relies on other vitamins, minerals, and hormones.  The most important may be vitamin D. Vitamin D helps your body absorb calcium from the kidneys and intestines -- calcium that would otherwise pass out of the body as waste. And according to osteoporosis experts, vitamin D deficiency is disturbingly common.

Recently we have seen the focus for osteoporosis shift from calcium deficiency to vitamin D deficiency.  Vitamin D is actually formed naturally in your body as a result of sun exposure. Usually just 10 to 15 minutes of sun a day will get you enough vitamin D. But your body becomes less efficient at making it as you age. Many of us should be using vitamin D supplements.  But which Vitamin D supplement should you take? There are different types of vitamin D supplements available these days, like "vitamin D2" and "vitamin D3." Is there a difference?  Research has shown Vitamin D3 to be about three times as potent as vitamin D2.

In addition to calcium and vitamin D supplementation , participating in a weight bearing exercise program can have a dramatic effect on bone density status as well as helping to increase balance and strength, which can help prevent or decrease the severity of falls.  Ongoing chiropractic care can also help alleviate pain associated with osteoporosis as well as help treat an osteoporosis-related injury. Chiropractic care helps to increase or maintain mobility and range of motion , which will also help to protect you from falls and fractures.

The typical amateur golfer can swing the golf club 90 miles an hour or more.When golfers, both amateur and pro alike, swing their clubs out of swing path or out of balance, they put tremendous strain on their joints, muscles, ligaments and tendons. When the force applied to the tissues exceeds their ability to resist the force of the golf swing, they most likely will tear.

We call ligament and tendon tears"strains" or "sprains," depending on their severity and whether it is a tendon or ligament injury .

Soft-tissue injuries can heal in six to eight weeks, depending on the severity of the injury and the age and fitness of the patient. However, when soft tissue heals, it replaces the injured tissue with less flexible scar tissue,and becomes weaker than before the injury occurred. Scar tissue replaces the original tissue in and around the injury site in an attempt by the body to stabilize the injured joint . Scar tissue isweaker, less elastic and more pain-sensitive than original soft tissue,making it less resistant to further injury. When challenged by the movement of the body, scar tissue will not stretch like the originaltissue; instead, they get irritated which results in further inflammation of the joint, which in turn leads to more pain and tenderness and decreased range of motion(joint stiffness).

Golf injuries fall under two general categories: acute and chronic. Acute injuries are new injuries, and are usually associated with painful swelling.An acute injury prevents you from playing golf altogether. The first four to six weeks are crucial in the management and treatment of a new joint injury. In addition to pain relief, the goal of treatment is to break down the developing scar tissue in an effort to realign the healing tissue in a way that will lead to proper movement and function of the damaged joint and surrounding tissue, and the prevention of further injury in the future. Failure to treat the injured joint as early as possible may lead to irreversible diminished range of motion of the injured joint.

Golfers with acute injuries should follow the RICE format of treatment immediately. REST, ICE, COMPRESS,and ELEVATE. First of all, rest the injured joint. An ice packs should be applied as soon as possible in an effort to reduce painful swelling.The ice should be applied for as long as 20 minutes per hour (20minutes on and 40 minutes off per hour). Repeat as often as possible during the first 72 hours of an acute injury. To avoid skin irritation,do not apply the ice directly to the skin. Instead, place the ice pack inside a towel before applying to the skin, or apply the ice pack over your shirt. Compress the injury with the ice pack. Compression will assist in the prevention of further joint swelling. Elevate the injured joint above heart level. This step will also assist in keeping the joint swelling to a minimum. Finally, seek professional care. Some Chiropractors, like myself, specialize in specific joint injuries. I have helped numerous golfers over the years with great results.

Golfers with chronic injuries, those that have persisted for years, have a unique problem to overcome. Old injuries are often infiltrated with dense binding scar tissue preventing normal joint function and inhibiting normal range of motion within the damaged joint. Chronic injuries are more difficult to work with and typically take a longer time to see results, but these joints can be returned to a close to normal level of functioning. My goal with chronic injuries is to return the joint to a functional level while decreasing joint pain, and  reducing the risk of further joint injury.

As an avid golfer myself,I know the obsession golf creates. With the help of proper fitness and nutrition, and of course, regular Chiropractic care, I have been able to avoid any golf related injuries.As I continue to live a healthy lifestyle and take care of my body, I look forward to a lifetime of pain free and injury free golf. What else could a golfer ask for?

Can you smell it Dunwoody?

-The freshly cut grass.
-The scent of newly blooming flowers.
-The clean breeze blowing in.

Can you feel it Atlanta?

-The warmth of the sunshine on your face.
-The cool soil between your fingers.
-The pain and stiffness in your low back.

Gardening season is underway in Dunwoody, and we are all looking forward to working in our gardens and planting flowers with the all the colors we have been dreaming about since last summer. Dunwoody lawns are in need of mowing and the shrubs are begging to be trimmed. Mulch needs to be applied after 50pound bags of topsoil are carried from car to flowerbed. Maintaining our lawns and gardens is a national pastime. In my mind it is exercise cleverly disguised as work. To most others it is a hobby, a form of meditation, and a form of stress relief from the long work week.Regardless of your viewpoint, working on the lawn and in the garden is stressful on the low back.

A recent poll of 2,000 adults revealed that greater than 50% of them have suffered low back pain at some point over the past year, and more than half of them attribute the problem to gardening and yard work. Most gardeners fail to realize how stressful this activity is to their spine and joints. Just like any form of exercise (I mentioned my opinion!), warm-up and stretching must be included as part of your healthy gardening experience. This is not to say that warming up and stretching prior to working in the yard will rid you of your backache and stiffness, but rather prepare our body for the hard work ahead and prevent more serious injury that may keep you away from your garden for extended periods of time.

Go  for a walk before starting your work to get your muscles and tendons loose, and to help get the joints moving. Follow up your walk with a simple stretching routine. Stretching is the most overlooked function of health and flexibility. I spend time with many of my patients going over basic stretching movements in an effort to prevent injury and to help assist my spinal adjustments to be more effective. Also, be sure not to remain in the same position for any extended period of time.Movement is the key to staying free of stiffness (This is true as well for sitting in a chair or on the couch for extended periods of time.)and injury.

Chiropractic focuses on movement at the spinal joint level. Just as every joint in your body needs to be freely movable in order to function properly, the same is true for the 32 individual joints that make up your spinal column. If you do experience any joint pain, muscle spasm, or discomfort,apply ice to the region for 15 minutes and give me a call. I will get those stubborn joints functioning properly again, and you will be back to your lawn and garden before the next pruning session.

Being a Chiropractor in the Dunwoody community lends itself to having quite a few patients that are avid golfers. So, in an effort to help all those golfers out there I will dedicate the next few Dunwoody Chiropractor Chronicles to The Prevention and Treatment of Golf Injuries. This installment will focus on Back Injuries due to the ballistic nature of the golf swing.<< MORE >>

I am currently a Dunwoody Chiropractor, working out of the prestigious Ravinia Club. Tackling difficult and challenging cases has always brought out the best in me, and helping patients avoid medication and surgery makes me proud to be a Chiropractor. Being at Ravinia has opened up opportunities to work with golfers(a few aspiring professionals), tennis players and every other kind of athlete out there to help them to improve their games and decrease their chances of injury. << MORE >>