Consultant – Orthopaedic Surgeon
Speciality interests include:
Lower extremity: trauma, sports surgery, knee, patella dislocation, tendon problems, foot and ankle surgery, and the management of degenerative joint disease in younger patients.
Visiting on Sep 21-22, 2019Request an Appointment
A few years ago, I was afforded the opportunity to work with British Columbia (BC) Wheelchair Basketball as they hosted a Canada West tournament. This tournament was in preparation for the upcoming Canada winter games taking place in Prince George. I could go on for ages to speak about just how amazing these athletes are; how they’ve been able to overcome adversity, both physical and mental, to become the best at what they do. Not only is the sport itself fun to watch, but the whole community is surrounded and supported by other former wheelchair athletes, fathers, mothers, husbands, wives, brothers, sisters and children who aim to give back to their respective community. It is apparent, more so than in any other sport I’ve ever seen, that the sport is just the surface, and that there is a greater impact on a holistic level to the lives of all involved.
If you haven’t seen a game, you’re missing out. You should check out this major tournament happening this week from May 4-11 in Dubai. The 10thFAZZA Wheelchair Basketball Championships. Check out the event website: https://iwbf.org/event/10th-fazza-wheelchair-basketball-championships
Ok, let’s get back to some MSK talk. The human movement pattern fascinates me. However, with individuals who are wheelchair bound, the typical bipedal motions of movement are, most surely, affected. When looking at wheelchair-bound individuals, each individual pattern of movement is different from the next. Whether an individual is hemiparetic, paralyzed from the T5 vertebrae and down, or has unilateral lower limb dystonia, they must propel themselves forward in their chair, pick up or shoot a basketball, in a different manner.
I want to relate this article to an issue that I saw this weekend. Given the hunched over body position for wheelchair propulsion, multiple athletes approached me asking about their chronic upper back and neck pain.
Upper crossed syndrome (a.k.a proximal or shoulder girdle crossed-syndrome)is defined as tightness within the upper trapezius, levator scapulae, pectoralis major, pectoralis minor, and suboccipital muscles (the headache muscles); combined with weakness of the deep neck flexors, middle and lower trapezius, rhomboids and serratus anterior. These muscles are found in the neck, chest, upper back and shoulders (Jung-Ho, Rae-Young, Su-Jin, et al., 2012).
This pattern of muscle imbalance creates dysfunction within the joint of our neck, upper back and shoulders. Jung-Ho, et al (2012), noted the transitional zones where the vertebrae of our spine change morphology:
According to Muscolino (2015), an individual who has these muscle imbalances typically displays:
These postural changes in our spine cause a secondary effect on our shoulders. Our glenoid fossa becomes more vertical due to serratus anterior weakness. This then leads to rotation and winging of our shoulder blades. This, in turn, affects the stability within our shoulder. The cascade effect then calls upon our levator scapulae and upper trapezius muscles to compensate for the lack of shoulder stability.
As you can see, these muscle imbalances can cause quite a cascading effect. It’s no wonder that individuals with this stooped forward posture complain about headaches, neck, shoulder, arm and upper back pain.
So, this then leads us to the ultimate question: if this is me, what on earth can I do about it?
If you have any questions about upper crossed syndrome or are dealing with any upper back or neck related injuries, stop by Emirates Integra or give us a call and have a checkup with one of our amazing team members.
Dr Kristian Frantzen
Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The Effect of The Forward Head Posture on Postural Balance in Long Time Computer Based Worker. Ann Rehabil Med. 2012 Feb;36(1):98-104. https://doi.org/10.5535/arm.2012.36.1.98
Muscolino, Joe. Upper crossed syndrome. Journal of the Australian Traditional-Medicine Society. Winter 2015;21(2):80, 82-85 https://search.informit.com.au/documentSummary;dn=268356182476327;res=IELHEA> ISSN: 1326-3390.