Our high-tech culture is great for innovating, sharing information—and triggering pain. Sitting perched over a keyboard or digital device for hours on end, day after day, sets you up for imbalances in muscle strength that may increase your risk for injury. Yoga can help.
Muscular imbalances happen. We all have them, to lesser or greater effect, whether we know it or not. You have chronically tight, overworked muscles in one region of your body, and weak, underworked muscles in another. When you do sense a weakness, it’s logical to blame neighboring muscles. (Tight hamstrings? Might be a problem with the quads. Low-back pain? Look to a smooshy core.) But an emerging science within sports medicine suggests it’s just not that simple. “The whole body is connected, and imbalances can have a domino effect,” says Ray Long, MD, orthopedic surgeon, sports-medicine specialist, and author of the book series The Key Muscles of Yoga and The Key Poses of Yoga. “You can have an imbalance that starts in your shoulder and eventually leads to pain in your heel.” For the past year, Long has taught yoga workshops that include discussion of two common patterns, or syndromes, of imbalance involving up to 3o muscles across the upper and lower body. Called upper crossed syndrome (UCS) and lower crossed syndrome (LCS), the imbalances are responsible for most of the shoulder, knee, and back pain yogis experience, he says.
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These patterns of imbalance aren’t a new discovery. They were first identified by Czech physician and physiotherapist Vladimir Janda, MD, in the late 197os and further defined by Shirley Sahrmann, PhD, a physical-therapy professor at Washington University School of Medicine in St. Louis, in the early 2ooos. Yet they’ve only gained widespread attention within the US sports-medicine community within the past few years, mostly among physical therapists and exercise specialists. While the potential combinations of muscles that can be involved is incredibly complex, a main culprit of these imbalances is simple and rampant in American culture: sitting for long periods of time with poor posture. It can all start when you’re seated staring at a computer screen, hunching forward, neck craning, shoulders rounding, belly and butt relaxed. In other words, slouching on the top, slumping on the bottom. Continue this posture pattern day in and day out, and you create muscle imbalances that may lay the framework for injuries, especially chronic ones involving the shoulders and back.
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“When you start to understand these imbalances, you start to understand the genius of yoga poses,” Long says. “When they’re done with proper alignment, you simultaneously stretch the muscles that tend to be tight or overactive and strengthen the muscles that tend to be weak or underactive.” But yoga can also reaffirm imbalances if you practice unconsciously–for instance, frequently doing Chaturanga Dandasana (Four-Limbed Staff Pose) without counter poses to stretch the chest or without working to build core strength can stress shoulder joints. To get the balance right, our simple guide to understanding upper crossed (a.k.a. slouch) syndrome and lower crossed (a.k.a. slump) syndrome, plus how yoga can help halt their progression before they lead to injury.
Muscle Imbalances in Your Upper Body
Picture yourself at your office desk, shoulders hunched, neck craned forward, eyes glued to your computer screen. Your outward appearance of calm concentration belies what’s happening inside your body: The muscles that round your shoulders and internally rotate your upper arm bones (subscapularis, teres major, anterior deltoids), the chest muscles that draw the arms and shoulders forward (pectoralis major and minor), the rear and side neck muscles that hold the head forward (levator scapulae, scalenes, sternocleidomastoid, upper trapezius)–they’re all getting overworked and may become tight. At the same time, the muscles that externally rotate the upper arm bones (infraspinatus, teres minor, posterior deltoids), the muscles that stabilize the shoulder blades and draw them down the back (serratus anterior, rhomboids, middle and lower trapezius), and the deep-neck flexors (longus capitis, longus colli) are underworked and thus may become weak.
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Staying here from 9 to 5, five days a week, in some variation of this position sets you up for physical trouble. Think future neck pain (as your head juts forward to stare at a screen, it puts pressure on neck joints). Or rotator cuff problems, such as rotator cuff syndrome, in which the muscles and tendons of the shoulder get pinched and a small sack of fluid called a bursa becomes inflamed, causing pain. You may even get an eventual rotator cuff tear from the chronic irritation. Use the four therapeutic poses to help lengthen the muscles that tend to be overactive or tight while also strengthening the muscles that tend to be underactive or weak in UCS.
Muscle Imbalances in Your Lower Body
When you sit in a chair, your hips are flexed and the muscles at the front of the pelvis called the hip flexors (psoas, rectus femoris) are shortened. If you stay this way for long periods of time, day after day, week after week, the psoas becomes chronically shortened. “Muscles adapt to the position they’re most often in,” Long says. “Your brain tells your muscle to stay where you habitually put it.” This tightening of the hip flexors causes an arching of your low back (extension of your lumbar spine) and tightening of a group of muscles that run up your back (erector spinae), which can in turn put pressure on discs and inflame soft tissues of the low back (thoracolumbar fascia), potentially raising your risk for a soft-tissue tear or even a collapsed disc.
As you sit with slumped posture, which commonly happens along with slouching your shoulders and UCS, you don’t typically use your butt muscles (gluteus maximus, gluteus medius) or abdominal core muscles, so they weaken and offer little support for your back. One of the hip flexors (rectus femoris) is a quadriceps muscle that runs across the hip and the knee and can put uneven pressure on the kneecap when tight. This uneven pressure means that cartilage of the knee rubs against cartilage of the thigh bone (femur), which may lead to cartilage inflammation and front knee pain (a.k.a. anterior knee pain). We label this zone 1 of LCS. Lower down the body, there is a second region (zone 2 of LCS) that is commonly associated with slouching and slumping in a chair. If you relax your legs forward and only have a slight bend in your knees with heels touching the floor and toes off the ground yet pointed down, you may tighten up your calf muscles (gastrocnemius, soleus) and thigh muscles (biceps femoris of the hamstring, adductor muscles of the inner thigh), and stretch muscles along your shins (tibialis anterior, tibialis posterior). This may then put added stress on bands of tissue in the heel called plantar fascia and lead to piercing pain in your heel (plantar fasciitis).
Use the four therapeutic poses to help lengthen the muscles that tend to be overactive or tight while also strengthening the muscles that tend to be underactive or weak in LCS.