Effect of Proprioceptive neuromuscular facilitation on upper cross syndrome in office workers

The first person to introduce the term Upper Cross Syndrome was Dr. Vladimir Janda. It describes an imbalance between the muscles of the neck, shoulders and chest which is very common in modern society(1). Nowadays people spend more time sitting than ever before, especially office workers--with their higher educational levels and white-collar status. They typically sit at desks for an extended period of time, chipping away at their brains with work routines that are both monotonous and repetitive. With this type of work posture ever maintained on a long-term basis, the muscles and skeleton bear a definite mark. This is known as Upper Cross Syndrome--muscle tightness and weakness characterizing the syndrome, postural habits, and movement stereotypes(2).

People with UCS frequently suffer from tightness in the muscles of the upper trapezius, levator scapulae, pectoralis major and minor. This is associated with weakness in the deep cervical flexors, lower trapezius and serratus anterior(3). The negative effects of this imbalance lead to a flexed posture of the upper cervical spine, overdevelopment of the accessory muscles, and an abnormal posterior cervical curve. As a result, people with these changes have neck pain, shoulder dysfunction (e.g., scapular winging), and headaches accompanied by reduced functional capacity or work output--disabling syndromes that greatly affect an individual’s quality of life(4).

As for office workers, they are doubly liable to develop UCS. They are engaged in work that is sedentary and computer-based; they often sit for very prolonged periods. With the extra complications of a possible slouching weight against them on a hard desk or against their thighs (in their laps) or even more significantly, motorcycle saddles and low ergonomic setups at best, is modern electronic technology (for instance smartphones and laptops)urging peoples’ bodies introduce further distortion into this pattern: forward head carriage(5). In other words, it makes individuals round their shoulders, crane necks and stoop over computers which leaves the thoracic spine heavily kyphotic. Office workers tend to suffer from sore backs, strained shoulders and stiff necks due largely then to the idiomatic distortions in lifestyle that accompany their occupation.

Proprioceptive Neuromuscular Facilitation (PNF) is a therapeutic approach that has been used extensively in the rehabilitation of a variety of different musculoskeletal and neurological conditions(6). PNF techniques are designed to increase the strength and flexibility of muscles, improve motor control, and facilitate the body’s neuromuscular response to sensory input. The basic principles of PNF require the use of proprioceptive inputs to excite and pattern out functional movement for the neuromuscular system. PNF techniques often combine stretching, resisted movement, and the use of diagonal and spiral patterns to get muscle groups to work in a way that promotes natural movement(7).

The application of PNF in treating Upper Cross Syndrome is of particular interest because it deals with both aspects of the condition’s double bind muscle tightness and muscle weakness. Traditional treatments for managing UCS usually focus on isolated stretching of the muscles and strengthening the weakened ones. However, PNF takes a more global approach by integrating neuromuscular coordination between agonist and antagonist muscles, with potential implications for a cure that is more effective over time for postural imbalances associated with UCS.

Research on the use of PNF for correcting problems like UCS is still in its early days, but preliminary evidence indicates that it can be an effective modality in improving posture, decreasing pain, and increasing the functional capacity of those with musculoskeletal imbalances. The potential advantages derived from PNF are a heightened awareness of proprioceptor activity, better posture, enhanced muscle strength, and increased flexibility in connective tissue and muscle fibers, all things that are essential to managing the symptoms of UCS.