Forward head, rounded shoulders indicate which syndrome?

• A. Lower crossed syndrome
• B. Upper crossed syndrome
• C. Thoracic outlet syndrome
• D. Scoliosis

Answer: (B)

Forward head and rounded shoulders are classic signs of upper crossed syndrome. This pattern happens when the muscles in the chest and the back of the neck become tight and overactive, while the muscles of the upper back and deep neck become weak. The tight front-of-the-body muscles pull the shoulders forward and push the head forward, and the weak stabilizers fail to pull the shoulder blades back and down. The result is the characteristic posture: the head juts forward and the shoulders round.

Understanding the imbalance helps explain why the posture occurs: tight pectoralis major/minor, upper trapezius, and levator scapulae pair with weak deep cervical flexors, lower trapezius, and serratus anterior. This is different from lower crossed syndrome, which involves the pelvis and lower back; thoracic outlet syndrome, which involves nerve or blood vessel compression, and scoliosis, which is a sideways spine curvature.