In Janda’s upper crossed syndrome (UCS), we will notice relationship; there is a crossedrelationship between the upper anterior and posterior regions of the body. The pectoralis major and minor are facilitated on the anterior side, as well as the upper trapezius and levator scapulae on the posterior side. Conversely, the deep cervical flexors of the anterior side are inhibited, as well as the lower trapezius and serratus anterior on the posterior side. A condition known as winged scapula can arise from UCS, and this impairment becomes pronounced during flexion and extension of the arms (Sahrmann, 2002).
A person with UCS and winged scapula may present with pain in the anterior shoulder area, and symptoms may increase with overhead activities (Sahrmann, 2002). This may be due in part because an overactive upper trapezius disrupts upward rotation of the scapula (Bliven, 2014). The individual may also appear to be hunched forwards due to the facilitated pectoralis minor region, which depresses and anteriorly tilts the scapula (Bliven, 2014). Additionally, because the upper trapezius and other neck muscles (i.e., anterior and middle scalene) are facilitated, the brachial plexus nerves may become compressed causing thoracic outlet syndrome (TOS) (Sahrmann, 2002). Symptoms of TOS include numbness and tingling in the forearm and hand, specifically on the ulnar side of the forearm (Bliven, 2014).
References
Bliven, K. (2014). Functional anatomy of the back and spine. Part 1: Overview [Slideshow Presentation]. Retrieved January 25, 2014 from https://mycourses9.atsu.edu/bbcswebdav/pid-346743-dt-content-rid-7386865_1/courses/13-14WI-ONL-HM502-2-ASHS/Cervical%20and%20thoracic%20spine%281%29/Module%201%20-%20Presentation%20%20Back%20%26%20Spine%20-General%20Overview.pdf
Sahrmann, S. (2002). Diagnosis and treatment of movement impairment syndromes
(1rst ed.). St. Louis, MO: Mosby Inc.
-Michael McIsaac