Upper Crossed Syndrome | Tight Shoulders and Sitting

Esports isn’t a competition to see who the healthiest gamers are, it’s a competition to see which players are the best at the given esports title.

Whenever I search “exercises for gamers” or something along those lines I get inundated with patronizing articles that have generic fitness advice being applied to “video gamers”.

If you’re a competitive gamer looking to boost performance then preventing injuries should be a priority for you. Injuries stall progress and reduce performance and athletes are wise to make efforts in reducing their likelihood of getting injured.

Competitive gamers, or anyone using a computer for long hours, experiencing Upper Crossed Syndrome can expect pain, discomfort and potential injuries. In competitive gaming and esports, players are prone to developing Upper Crossed Syndrome (UCS). This is due to the nature of the sport and the amount of time spent being sedentary in chairs.

Competitive gamers can take certain preventative steps to reduce their likelihood of developing UCS, but the risk will always be present.

What Is Upper Crossed Syndrome

Around the 1970’s/80’s Dr. Vladimir Janda recognized a predictable pattern of muscles with abnormal function in the upper body. Dr. Janda recognized that these dysfunctional muscles were causing specific postural changes in the individual experiencing them and that certain spinal and shoulder joints were also being affected as a result.

A lot of people, gamers included, haven’t heard about UCS despite its prevalence among the general population. More and more people are developing UCS and it continues to affect younger and younger age groups.

In UCS, there is a crossing pattern right around the neck area where underactive weak muscles cross with overactive tight muscles. Think of one line representing tight muscles and one line representing weak muscles.

The muscles in the upper back area, specifically the upper trapezius and levator scapula, become extremely overactive, tight and strained. At the same time, the muscles in the pec, or chest (pectoralis major and minor muscles) become shortened and tight.

As these muscles become more tight and overactive they begin causing a weakening of opposing muscles. This weakening is due to the overactivity of the tight muscles, which have become overactive due to working harder and longer than the opposing muscles.

The weakened muscles weaken as a result of being underused. These muscles are in the front of the neck, the cervical flexor muscles (longus capitis and longus coli muscle, or, the “deep flexor” muscles), and in the lower shoulder/upper back area, the rhomboids and lower trapezius muscles.

See where it gets the name from? This condition basically forms an “X”. The upper traps are tight and overworked, causing the lower traps to become underused and weak.

The chest/pecs become tight and overworked, causing the front of the neck to become underused and weak. Once the pattern starts developing, it will likely get worse as certain muscles continue being overworked resulting in certain muscles continuing to be underused and get weaker.

What Causes Upper Crossed Syndrome

You may be thinking, why are these certain muscles becoming so tight resulting in the weakening of their opposing muscles? Well, healthy normal posture will have your ears in line with your shoulders and hips when standing upright.

When the body is in this proper posture position, the neck muscles are supporting roughly ten pounds.

As the head and shoulder start to drift forward while in bad positions, additional weight is put onto the muscles in the back of the neck, those upper traps and levator scapula muscles. With every inch of forwarding head posture, roughly ten additional pounds is put onto these muscles and the front of the neck takes less and less of the brunt.

This is the beginning stage of UCS. With the head leaning forward, the pecs are in a shortened position and begin to tighten and end up wanting to stay in that shortened position.

In order for these muscles (upper trap, upper neck and chest) to become tight, their opposite muscles have to relax (lower trap, rhomboids and front of the neck). This relaxing causes them to become underused and thus weakened.

Now, if you haven’t guessed it by now, your posture or your very poor posture is the culprit for getting UCS. It’s not entirely your fault, our society and its day to day activities promote the development of UCS.

Almost everything we do requires us to use something in front of us and usually while seated. Proper posture during these activities is rarely promoted, and it becomes easier to just neglect it.

In school, children slouch over their desks all day and when they got home, they slouch over to eat, slouch over to play video games and slouch while texting. Even if they participate in some physical activity, one hour won’t combat the twelve or so other hours spent in a crappy position.

In fact, a sedentary lifestyle is the biggest risk factor for developing UCS. Combine a sedentary lifestyle with poor posture and it’s pretty hard to avoid getting UCS. Some of the common activities that promote UCS are:

  • computer use
  • driving
  • watching tv
  • cellphone use
  • reading
  • biking

I do want to point out that UCS isn’t reserved solely for inactive and sedentary population. UCS is not uncommon among athletes, particularly athletes whose sport promotes UCS, like swimmers and Olympic weightlifters. Athletes who get UCS often have overworked muscles in the shoulder, neck and back.

Why Upper Crossed Syndrome Is A Problem

Speaking of athletes who get UCS, let’s now look at esports athletes. If this phrase bothers you, check out my post Should Professional Gaming be Considered a Sport? In that post, I discuss Professor Ingo Froböse who has been studying esports at the German Sports University of Cologne for over five years now.

In fact, Professor Ingo Froböse was one of the first scientists to study individuals who compete in esports. Instead of simply balking at pro gamers and thinking that it’s the furthest thing from a sport, Professor Ingo Froböse actually studied the demands placed on players who compete in esports and the results may surprise you.

I think it’s fairly obvious that esports athletes and competitive gamers are at pretty high risk for developing UCS. The nature of the sport places the individual in a very UCS like position.

Now I know gamers could take more proactive steps in ensuring they have good posture, but they most likely lack the required muscle strength and endurance to even maintain good posture for an extended period of time.

Additionally, competitive gaming isn’t about proper posture and health, it’s about winning. I promote esport specific training not to make gamers healthier, but to make them more prepared for competition and to improve performance.

If you want to be healthy, don’t compete, end of the story. Cyclists who race in the Tour de France are not “healthy” and a four-hundred-pound strongman is not “healthy” when he competes in the world’s strongest man.

Athletes push their bodies to the limit and beyond but if they can find something to include in their training that helps boost performance and reduce injury they’re going to do it.

Am I saying competitive gamers should neglect their posture? No, certainly not. A lot of competitive gamers end up with injuries due to their bad posture over long periods of time. All I’m saying is that posture alone isn’t going to cut it and a lot of competitive gamers have spent years with poor posture already.

I remember watching a Youtube video on an esports gaming house and they showed the “workout” room where the gamers were doing a spin class. I thought to myself “really? out of all the exercises you could choose from, you go with the one that significantly exacerbates the crappy position gamers are already in?”.

It really opened my eyes to how poor sport specific training was in the esports world.

Why was this a problem? Well, a bike places you in a hunched over position with your arms in front of you and your shoulders rounded, more so than at the computer.

So when competitive gamers use what limited time they have to perform exercises that make problems worse, it’s just foolish and misuse of time and training. I cover more on this topic in my post Top 3 WORST Exercises for Gamers

In fact, this is where I see a lot of competitive gamers mess themselves up more when trying to “be healthy”. Eventually, some competitive gamers take it upon themselves to start training more like an athlete.

The problem is, their bodies and posture have been messed up from prolonged gaming over many years. They take these messed up bodies and posture into the gym and perform exercises that just exacerbate the problem, all in the name of “health”.

They are misinformed and don’t understand how to train specifically to their sport.

If you are looking for more tips on esport specific training, check out the Athletiks and Recommended Gear pages. I put out posts on “esport specific training” and apply strength and conditioning specifically to esports.

Every sport has sport-specific training, and it’s about time esports does too. Football players don’t run marathons and competitive gamers don’t need to be riding spin bikes or focusing on bench pressing.

Is UCS really that bad for competitive gamers? After all, it’s about winning not about health, right? Well, UCS causes more than just a deformation of the posture.

When the body gets misaligned to the degree that it does in UCS, problems start to occur that can affect competitive performance and lead to injury.

Symptoms From Upper Crossed Syndrome

  • Rounded shoulders
  • Hunched upper back
  • Headaches
  • Forward head posture
  • Should pain
  • Upper back pain
  • Neck pain
  • Jaw pain
  • Lower back pain
  • Wrist and hand pain
  • Difficult sitting for long periods of time
  • Restricted range of motions
  • Numbness in upper arms
  • Tingling in upper arms
  • Fatigue

If you don’t think any of these pose a significant risk for you, think again. Esports careers can be destroyed by preventable injuries.

You can check out the interview with olofmeister here and I’ve synched it up to the part where he discusses what he thinks is wrong. You may notice it sounds very similar to what’s going on in UCS.

If you’re trying to be a competitive gamer, any of those above symptoms from UCS will inhibit performance and could lead to you not being able to play.

Reversing UCS and performing exercises to promote proper posture will benefit your competitive gaming performance, as you won’t be feeling aches, pains and all of those other potential symptoms. It’s not about health, it’s about performance.

Exercises To Fix Upper Crossed Syndrome

So how do you fix UCS if you have it and how do you limit your chances of getting it if you’re worried about it? Well, quite simple really. Strengthen the muscles that have become weakened and relax/stretch the muscles that have been tightened.

Reversing UCS won’t happen overnight. The most important thing with the below exercises is to be consistent. Spending ten minutes a day for several months, every day will be far more beneficial than for an hour once a week.

Additionally, the equipment I utilize can be found over on the Recommended Gear section. I only recommend gear that I own or have had experience with. I’m a big fan of resistance bands as they are great for getting the blood flowing. Blood flow is crucial for healthy muscles and tendons which I discuss more in my post Top 3 RECOVERY Tips.

Front Neck

Strengthening the front of the neck, or if you prefer jargon, the cervical flexor muscles (longus capitis and longus coli muscle, the “deep flexor” muscles) is relatively simple.

Neck exercises have a bad reputation in the fitness world, and for good reason. Mistakes when training the neck can be really bad, especially when weight is being used. You don’t see neck isolation machines in gyms anymore due to the liability (although there are plenty of people still messing up their backs while deadlifting with poor form). When starting to train the neck, always start with the easiest variation of an exercise and progress slowly and intelligently.

There are many athletes who do specific neck training:

  • Martial arts
  • Wrestling
  • American football
  • Rugby

This is just to name a few. My point is, neck training is practiced by many different athletes and people and it shouldn’t be neglected due to misconceptions or fear.

With competitive gamers and UCS, neck training is essential. The front of your neck has most likely become very weak and underactive. This weakness will continue promoting a forward head posture and worsening the symptoms associated with UCS.

When I work with new clients, I always recommend starting off with isometric exercises. An isometric exercise means that a muscle/joint does not move as there are no concentric or eccentric contractions. Isometric exercises are done in a static position meaning there is no range of motion.

A good example of an isometric is to picture doing a push-up, getting to the bottom of the movement, then staying at the bottom and trying to hold that position for as long as you can (or while holding yourself at the top of a pull up). Your muscles, joints and tendons are essentially trying to overcome gravity while maintaining a position.

I think isometric exercises are essential for competitive gamers and esports athletes because it mimics the sport and is thus akin to sport specific training, or as I like to call it esport specific training.

Esports and competitive gaming are relatively static. Other than the hands and arms, there is little movement with the rest of the body. This by no means implies that esports is not demanding both physically and mentally, it just means that the body goes through very limited ranges of motions throughout the activity.

In Strongmen, athletes compete in a “crucifix hold” where the athletes hold a static position for as long as they can while bearing weight.

To begin training the front of the neck follow these steps:

  • Lay completely flat on the floor
  • Tuck your chin to the chest while keeping head on the floor
  • Lift head off floor ever so slightly
  • Push your tongue against the top of mouth (hold it there)
  • Hold the head statically off of floor
  • Hold as long as possible
  • Consciously engage and feel the muscles in the front of neck
  • Return head to floor when muscles fatigue
  • Repeat two-three times a day

Some of you may be able to hold this for up to a minute or more. Others, depending on how bad your UCS is, will find it difficult immediately.

If you do find this exercise relatively easy from the beginning, then I would suggest performing it daily for a couple of weeks. If you find it difficult, perform it daily for a few months.

Remember, consistency will always be better than intensity (i.e., doing this frequently will be of greater benefit than doing a “big workout” every now and then).

Once the front of the neck has been conditioned a bit, you can start performing this exercise with weights on your forward. This is a great way to start getting more out of each session with less time.

Below is me using a ten pound and a twenty-five-pound plate.

If you find yourself enjoying the benefits from neck training, head on over to the Athletiks page where I’ve posted articles with more in-depth discussions on neck training for competitive gamers.

Pec Stretch and Release

In order to start tackling UCS, the pecs, especially the upper part closer to the collar bone, needs to be stretched and relaxed. Stretching the pecs is easy to do but seldom done.

The easiest way to start stretching your pecs is called the “doorway stretch”. I like to do one arm at a time for a slightly deeper stretch and you can check out a video for this stretch here.

Always remember, don’t hyperextend your lower back in an attempt to deepen a stretch as it only causes wear and tear on the lower back and will not increase the stretch whatsoever.

I personally prefer doing a thoracic mobility stretch for my upper pecs as I’ve never felt a stronger stretch in that area as I do with this stretch.

If you want to find out how to progress to this stretch, check out my post Exercises for Competitive Gamers – Top 5 BEST stretches.

If you’re looking for something a little more static that can help stretch this area over long periods of time, say hello to Donnie Thompson’s Bow Tie (opens new Amazon tab).

This product is amazing. And although it’s primarily marketed to the powerlifting scene (i.e., people who bench press too much) it can absolutely benefit gamers, and even just plain office workers.

What this device does is bring and hold your shoulders back to the position they’re intended to be in. Since that’s probably not their natural position for most of us, it’s gonna feel like a stretch. You’ll feel it especially in the pecs and the front of the shoulders, the two areas extremely tight on gamers.

What I’ve found particularly beneficial with this product is when I wear it before doing corrective exercises. When doing esport specific training exercises like banded rear delt flies or overhead face pulls, wearing the bow tie before performing them will remind your shoulders and overall posture to be in their correct position.

It’s a great tool for building mental cues on where the shoulders are supposed to be, especially when competitive gamers first start getting into esport specific training.

I wear this device for as long as I can while at the computer or just doing things around the house. It can be uncomfortable at times, especially the longer you wear it. But remember, poor posture didn’t develop overnight.

Once you take this device off after wearing it for a while (I’ve gone as long as three hours), my neck, shoulders and back feel like new again.

If you’re going to start esport specific training, or if you just want to work on correcting UCS, then click Donnie Thompson’s Bow Tie to get a must-have for competitive gamers.

Lower Traps

Let’s get straight to the point here. The lower trap is located around the middle back right around the spine. As discussed with UCS, when the lower trap is weak, the shoulders will round forward more easily and you’ll be more prone to hunching the upper back.

The lower traps’ main role is in moving the shoulder blades and stabilizing the middle part of the spine.

Due to the nature of competitive gaming and esports, however, this area becomes neglected and weakened, forcing the upper traps around your neck to take over, which then causes them to become tight, overworked and strained.

Similar to neck training, I advocate isometrics for the lower traps, especially in the early stages of strengthening them like you trying to bring them back to life.

A great way to start training your lower traps is to lay on your stomach and follow these steps:

  • Depress shoulders (as if you’re sticking your chest out)
  • Feel your upper back pull down
  • Raise your arms upwards making a “Y” shape
  • Have your thumbs pointing upwards
  • Hold your arms up (above the height of your head)
  • Hold for as long as possible
  • Consciously focus on your lower traps
  • Return hands to the ground when fatigued
  • Repeat two to three times daily

This is just one way to start training your lower traps. Isometrics will help bring them back to life and getting them active again. In competitive gaming, most of your activities are static, and so training muscles using static holds with isometrics will carry over to your sport.

Competitive gamers and esports athletes don’t need to be able to have lower traps that help with explosive lifting like in Olympic lifting. They need lower traps that can help maintain their posture over long periods of time.

These are two different functions of a muscle that require different approaches to training.

Using just your hands are going to be relatively easy for most of you. I like to use 2.5 lbs. weights that come in the weight vest I recommend, which you can check out at my Recommended Gear section.

These weights are easy to take off the weight vest and can be used as a dumbbell. Once you’re ready for more weight, you can start putting them in old socks. Hey, it’s not sexy, but it saves money if you’re doing this training at home.

For more tips on how to strengthen your lower traps, check out the Athletiks page.


The rhomboids are a big player in scapula retraction in that they help bring your upper back and shoulders back. When you try and pull your shoulders back by pinching your shoulder blades together, some of that is your rhomboids.

The exercise I just discussed for the lower traps will also target the rhomboids. If you want to add something additional (which, again, will also target the lower traps) try this banded face pull.

The initial phase of this movement is critical for rhomboid activation. With your arms straight out, pull your shoulder blades back while keeping your arms straight. Think of it like you’re doing the initial phase of a pull-up where you begin pulling up with your arms straight.

After you initiate this movement by pulling back with straight arms, finish with your hands coming just under and next to your chin kind of like a double bicep pose. This variation of the face pull will activate and strengthen both the rhomboids, lower traps and even the rear deltoids (back of shoulder).

Upper Trap Stretch and Release

Before stretching my upper trap, I like to take two lacrosse balls and lay down with them underneath my upper traps. Place the lacrosse balls just under and to the side of the base of your neck.

Of course, you can move around and find some tense areas that you want to stay on.

Rock back and forth with the lacrosse ball on your upper traps like you’re giving yourself a massage. Lacrosse balls are a much cheaper alternative to massages anyway.

To stretch the upper trap, I typically perform the stretch pictured below. You don’t need to put your body in any sort of extreme position. Just extend one arm out to the side, palm open and facing slightly up. Next, use your other hand to gently pull your head to the opposite side of your extended arm.

You can slowly move your hand to different positions to find different areas that need stretching. If this doesn’t provide much of a stretch, try it while holding a weight in the hand that’s extended.

Serratus Anterior

These muscles play a crucial role in scapular and shoulder positioning and stability. In a nutshell, the serratus anterior helps to stabilize your scapula. Competitive gamers who suffer from UCS are most likely experiencing some sort of malfunction in their scapula due to their posture and the associated muscles being out of synch.

With UCS, the serratus anterior becomes neglected, weak and difficult to activate. This simple exercise will leave it burning. Simply use a small circle resistance band (or tie a large one into a small circle) and place it around your wrists.

Now go up to a wall with your arms fully out. With your arms fully out, push them out further by rolling your shoulders forward (I know, sounds counter-intuitive after all the UCS talk).

With the resistance band around your wrist, push your arms slightly out so the band creates resistance. Now slowly walk your hands up and down the wall where one hand goes slightly past where the other one is.

Typically, I can get about five to six walks up and then I do the same thing but downwards.

This doesn’t feel like much at first, but after a few “hand walks” up and down you’ll start to feel the serratus anterior underneath your armpits light up. Keep going until it’s unbearable. Repeat two to three times.

Tips For Fixing Upper Crossed Syndrome Faster

UCS and crappy posture don’t happen overnight so don’t expect it to go away fast. Posture plays a crucial role, but I won’t waste your time trying to explain that, I’ll leave that with Esports Physical Therapist Matt Hwu over at 1-hp.org. Additionally, frequent breaks can help, but that’s not always an option in competitive gaming.

I recommend performing the above exercises consistently for the next few months. Don’t make it complicated, start the first few weeks just doing one set for each exercise. By one set, I mean just perform each exercise until you’re fatigued and then move onto the next one.

You will still benefit from just one set and it will help you to create a habit for esport specific training. As it becomes less of a chore, start doing more, say two sets per exercise each day.

When these start to become easier and less challenging, head on over to the Athletiks page for more tips and exercises for esport specific training.

Injury Prevention For Gamers

Injuries are one of the worst things that can happen to an athlete no matter what the sport is. Not only does it mean performance suffers, but it often means time away from competition and training. If you’re an athlete that makes a living with their sport, injuries should be avoided as if your life depends on it (or at least “livelihood”).

Competition does, however, carry the inherent risk for injury. Athletes compete to see how far they can push themselves and their body, esports included. Can injuries be completely avoided in esports? No, of course not. But efforts can be made to reduce the likelihood of injuries occurring for athletes and the severity of the symptoms experienced.

Reversing and/or preventing UCS will help increase the likelihood that competitive gamers and esports athletes stay injury-free. In my post How to be a Pro Gamer – Ultimate Guide, I discuss the often neglected aspects of becoming a pro gamer.

Becoming a professional gamer requires effort outside of the game itself. Preventing injuries is part of that effort. So start training as a real athlete and work towards staying injury-free.

How To Be A “Healthy Gamer”

It drives me crazy reading fitness articles geared towards gamers. They’re often stereotyping gamers as being unhealthy slobs that eat junk food and sit around all day.

And then the article goes on to prescribe some generic workout with silly exercises that have nothing to do with competitive gaming.

I promote esport specific training at Cyber Athletiks for two reasons, boosting performance and reducing injury. If you want to be healthy, don’t compete. Competitive gaming is not healthy, but the same is true for competition in any other sport.

If you consider yourself as more of a recreational gamer, Cyber Athletiks is still a good place to start trying to become healthier as it is geared towards undoing and reducing a lot of the damage gaming can cause while boosting performance.

If you’re a competitive gamer or esports athlete, you’re trying to be the best in your esport. In competition, it takes more than just skill at your sport. Esport specific training is about enhancing what gamers do outside of their esport with the sole intention of improving their performance inside of their esport.



I love gaming and spending time on the computer, I even competed in esports in the early 00s. But I'm also obsessed with fixing the damage heavy computer use can cause, and this is the place where I share these two passions.

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