Dr. Bradley Gueldner Dr. Dana Gueldner Dr.

Morgan Gueldner

101-32630 George Ferguson Way. Abbotsford, British Columbia. V2T 4V6. Tel: 604.852.1820

Postural Correction for Neck and Back

Purpose of Program:
Although you may not be familiar with the term Upper Crossed Syndrome, you’ve
probably seen it in students, office workers, and anyone who spends a lot of time
sitting or driving. Upper Crossed Syndrome, more commonly known as ‘bad posture’,
is signified by a forward head position, forwardly rolled shoulders, abnormal arch in
the neck- either too much arch or too little arch, and an exaggerated upper back
curve giving the back a hump like appearance.

People with this condition frequently complain of stiffness in the neck, headaches,
tension and soreness along the slope of the shoulder, front of shoulder, and tight,
sore, upper back. It may also result in neurological problems (from tingling or pins
and needles to shooting pain and numbness) extending into the arms, hands, and
fingers.

Upper Crossed Syndrome is named because there is pattern of tightness (over-

activation) of certain muscles and weakness (inhibiting) of other muscles; this creates
predictable muscle imbalance in a cross like pattern. The purpose of this program is to correct this muscle imbalance by strengthening the
inhibited muscles (most important), and stretching the tight muscles (less important). This condition shouldn’t be left untreated. It is often a
chronic issue that leads to faulty mechanics and can predispose you to recurrent back and neck pain.

Target Muscles: The muscle groups targeted in this condition program includes
Typical Muscle Imbalances in the
UPPRER CROSED SYNDROME
TIGHT, FACILITATED WEAK, INHIBITED
Pectorals Longus Capititis
Upper Trapezius Longus Coli
Levator Scapula Hyoids
Sternocleidomastoid Serratus Anterior
Suboccipitals Rhomboids
Subscapularis Lower Trapezius
Latissimus Dorsi Posterior Rotator Cuff
Arm Flexors Arm Extensors

Length of Program: This postural correction program should be continues for 4 to 6 weeks, unless otherwise specified by our office.
After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health. Performing the exercises
three days a week will maintain strength and range of motion in your neck.

Getting Started:
Warm Up: Before doing the following exercises, warm up with 5 to 10 minutes of low impact activity, like walking, riding a bike, gentle shoulder
rolls and leg swings.

Stretch: After the warm-up, do the stretching exercises shown on page 1 and 2 before moving on to the strengthening exercises. When you
have completed the strengthening exercises, repeat the stretching exercises to end the program.

Do not ignore pain: You should not feel pain during an exercise. Talk to your doctor, chiropractor, or physical therapist if you have any pain
while exercising

Ask Questions: If you are not sure how to do an exercise, or how often to do it.
Postural Stretches:
Child’s Pose Stretch Start in a kneeling position.

Drop your butt toward your heels as you stretch the rest of your
body down and forward.

In the fully stretched position, rest your arms in a relaxed position

along the floor, rest your stomach comfortably on top of your
You should feel a mild stretch in your shoulders and
thighs, and rest your forehead on the mat.
buttocks and down the length of your spine and arms.
Seated shoulder Stretch Start seated, legs crossed. Place palms down, fingers backward
about a foot off the hip. You can play with how it feels to pull the
palms off the floor and stretch the fingers long.

Keep the arms straight and lean backward toward the floor.

To maximize the stretch you really have to straighten the arms. If

bending the arms cannot be avoided, move the hands further
from the hips to increase the stretch.
You should feel a mild stretch in front of your
shoulders
Neck Stretch- Traps Start with your head neutral.

Tucking your arm behind your back, to lock your shoulder in the
down position.

Using the opposite hand, pull your head to the opposite side.

You should feel a mild stretch on the side of your neck

Neck Stretch- Levator Scapulae Start with your head neutral.

Tucking your arm behind your back, to lock your shoulder in the
down position. Holding the bottom of the chair also works.

Using the opposite hand, pull your head so that your nose is close
to your arm pit. Repeat for the opposite side.

You should feel a mild stretch between your neck and

shoulder blade
Trunk Stretch Start by clasping your hands above your head, head neutral.

Gently move arms to the right side feeling the stretch turn on
along the left side of the trunk. Hold for 30 seconds. Repeat for
the opposite side.

Relax the neck during this stretch.

This stretch may be felt along the sides of your trunk,

along the sides of your shoulder blades, through the
mid or low back
 The door way pec stretch can be done in two ways, either:
Door Way Shoulder Stretch
A) A) Both arms at the same time, or B) One arm at a time.

Regardless of the option you choose, change the angle of your

arms, to facilitate a different stretch. Try below horizontal, at
horizontal, and above horizontal. Changing the angle will stretch
the top, middle, and bottom of the pectoralis major muscle.

Tip: Use your body weight to lean into the stretch for the double
arm version, or rotate your body away from the wall for the single
arm version.
B)

Straight arm- Targets Pec Major

Bent arm- Targets Pec Minor

You should feel a mild stretch in front of your

shoulders

Bruegger’s Stretch/Desk Stretch: This is an excellent stretch for office workers. Start by moving your
buttocks to the edge of your chair.

Keep your feet shoulder width apart. Your knees and hips should
be at 90 degrees each.

Arch your low back and stick your chest up. Tuck your chin and roll
your arms back and reach as far behind you as you can.

Your thumbs should be pointing straight back and the top of your
head should be pointing towards the ceiling. Hold for 20-30
seconds.
You should feel a mild stretch in front and top of your
shoulders
Postural Strengthening:
Chin Tuck Exercise

One of the most effective postural exercises for combating neck

pain is the chin tuck exercise. This exercise not only helps
strengthen the muscles that pull the head back into alignment
over the shoulders (upper thoracic extensors) but it also
stretches the scalene and suboccipital muscles.

The chin tuck exercise can be done numerous times throughout

the day, such as while sitting in the car or at the desk at work.
The repetition of this exercise throughout the day also helps
develop good postural habits. It is especially important to
perform this exercise when the neck and shoulder blades first
begin to hurt.

To perform the exercise for the first time it is often

recommended that patients stand with the spine up against a
surface like a door jam or wall and the feet out about 3 inches
from the bottom.

Keeping the spine against the surface, pull the upper back and head back until the back of the head touches. It is important to
make sure that the chin is down so that the head is pulled straight back and is not looking up.

Hold the head back for 5 seconds. Repeat this ten times. After performing this exercise about ten times, start doing the exercise
in standing or sitting without a door jamb or wall. The exercise can be done 5 to 7 times per day.

TIP: Try doing these exercises at red lights, it can help you remember to do chin tucks daily and it’s no time wasted. When in
the car, use the headrest as a point to aim for when pulling the head back.

Wall Angels

Another important postural exercise is the wall angel

exercise. This exercise is done standing with the back up
against a large flat wall and the feet about 4 inches out from
the bottom of the wall.

Assume the same position as the chin tuck exercise with the
back of the head against the wall.

Bring your arms as far back to the wall as possible, so both

arms are at a 90-degree angle.

Lock the shoulder blades back and down (think of putting your shoulders in your back pocket). Slide arms over the head, while
never allowing arms to lift off of the wall.

Once overhead, bring your arms down so the elbows are flush against the side of your body, never allowing them to come off of
the wall. Keep the shoulder blades squeezed back and down.

The movement is slow and deliberate. Repeat this 10 times, 3 to 5 times per day.
Blackburn Exercises:
These exercises are for training scapular retraction. They are among the most important exercises for conditioning the muscles
between the shoulder blades to pull your shoulders back into ‘good’ posture. Make sure to avoid shrugging your shoulders (aka
lifting your shoulders towards your ears) while doing these exercises, we want to avoid activation of the upper fibers of
trapezius which contributes to postural imbalance.

Perform 3 sets of 2 reps of each, 2 times a day. Use a table, bed, or exercise ball. As strength and endurance increases, add a
small 1 or 2lb weight to hands, progress to more weight (i.e 3-5lbs) if too easy.
Cable rows
Seated Cable Row: Use cable weight with V-bar attachment so palms
are facing each other. Start seated on a bench, with your arms
extended, torso at a 90-deg angle to your legs, and your back slightly
arched with your chest sticking out. Keeping the torso stationary, pull
the handles back towards your torso while keeping the arms close to
it until you touch the abdominals. Breathe out as you perform that
movement. At that point you should be squeezing your back muscles
hard. Hold that contraction for 1s and slowly go back to the original
position while breathing in. Repeat for 12 reps, 3 sets.

Cable Row to Face: Use a cable weight adjust it as high as possible. Tighten your
core, raise your arms, draw your shoulders back, and pull the rope in towards your
mouth. Flare it and pull your rear deltoids as far back as possible. Like the previous
exercise, squeezing your back muscles hard. Your elbows should stay high
throughout. Hold the contraction for 1s and slowly release it back to start. Repeat
for 12 reps, 3 sets.

Tip: If these are too difficult start with a medium resistance therapeutic band wrapped around a door handle, then progress to
the normal cable rows.

Arm Extensors

External Rotators: