Rounded Shoulders or Tight Traps-Which One Is It?

upper cross syndrome

Almost everyone has tight shoulders (actually the trapezius muscle group) due to physical and emotional stress. Our natural adaptation to stress is to shrug our shoulders up for extended periods of time without knowing. Sometimes, we have to actively remind ourselves to bring our shoulders back down. But, what do you do when your shoulders or traps are always tight? Is it truly because you’re constantly stressed or is there another underlying cause at play? Below, we’ll explore Upper Cross Syndrome, as well as, losing the proper neck structure that can result in having tight shoulders. This is a situation no amount of massages can help. My name is Dr. Milan Modi and I’m an Upper Cervical (Neck) Chiropractor at East Cobb Upper Cervical Spine Clinics located in East Cobb, Georgia.

Upper Cross Syndrome (UCS)

Upper Cross Syndrome (UCS) is a health condition where the head and neck spine have shifted forward relative to the thoracic spine or rib cage. Additionally, the shoulders will begin to pull forward and round. These people will often present themselves with their head and neck jutted forward. Standing or sitting upright, a normal posture, is often difficult for them.

There are many different reasons why UCS happens. Poor posture, minor/major trauma, and having specific misalignment(s) in the spine, long-term, can result in the spine moving away from normal. Because muscles attach to the spine (and other extremities), if our spine deforms to an abnormal structure, the muscles will follow suit. I want you to imagine or perform while you’re reading this, your head forward. Do you notice or feel that your upper back is stretched? Maybe there is some discomfort in the front of your neck as well. Hold this position for more than a couple of minutes and you’ll notice your back tightening up. For now, let’s go back to the shoulders.

The trapezius muscle group is a diamond-like shape that attaches to a few different points on our back. It attaches to the bump behind our skull, spans across the shoulders, and then also down the back. As you can see, this is a large, superficial muscle group that is responsible for a lot. People with UCS will often have a weak and stretched trapezius muscle while a tight and short front musculature. Additionally, because the trapezius spans across the shoulders, the shoulders will be rounded forward.

Correcting Upper Cross Syndrome

Correcting UCS requires a soft-tissue (PT, massage, etc) therapy, as well as, Chiropractic care to adjust the spine. Fixing UCS takes time because the structure has moved to an abnormal posture over time — often months to years.

Side note: We are seeing this more with the younger generation being glued to their electronic devices.

The first step would be to get an x-ray of the head and neck. While most medical professionals may disagree with this because they want to be more conservative, specific Chiropractic care is for it, since we need to look at the spine in order to figure out the best treatment plan. At our office, East Cobb Upper Cervical Spine Clinics, we figure out specific vectors for correction from the x-ray, as well as, which specific traction set-up that will be best for said person. Each person is unique and therefore, requires a unique set-up. Over time, we the combination of PT, massage, specific Chiropractic care, and most importantly — patient commitment to care, Upper Cross Syndrome is correctable and has good outcome.

Take Home

Your first step is to find a specifically trained Chiropractor who is looking at the entire picture — not just chasing your symptoms. Often times, this will happen via word of mouth or reading an abundance of reviews on Google. You can read our reviews here. Next, you will want to see whether or not they take pre and post x-rays to measure the amount of correction done. It is important your Chiropractor can prove to you the structural change that has happened. Lastly, you want to make sure that the Chiropractor is actually listening to you and your concerns. Just with any profession and professionals, there are great doctors and not-so-great ones.

In conclusion, it may be that your shoulders (trapezius) actually aren’t tight and need to be kneaded (see what we did there?) out over and over again. It may be that your spinal structure has shifted away from normal due to your postural habits, irregular sleeping position, minor/major accidents, injuries, or traumas, etc over time.

To learn more about our practice, you can e-mail us at or give us a call at (770) 353–9339. Our website is


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