Concentric Versus Eccentric Muscle Energy Technique on Upper Cross Syndrome
Concentric Versus Eccentric Muscle Energy Technique on Upper Cross Syndrome
This project was a Randomized control trial conducted to check the effects of eccentric and
 concentric muscle energy techniques on patients with upper cross syndrome so that we can have
 best treatment option for patients with upper cross syndrome, duration was of
 6months,convenient sampling was done, subject following eligibility criteria from Mansoura
 hospital female physiotherapy department, Lahore were randomly allocated in two groups via
 lottery method, baseline assessment was done, Group A participants were given conservative
 treatment along with eccentric muscle energy technique and Group B participants were given
 conservative treatment along with concentric muscle energy technique than on 1st,3rdand 6th
 week post intervention assessment was done via neck disability index, Numeric rating scale,
 inches tape method,3 sessions per week were given, data was analyzed by using SPSS version
 26.
In Upper cross syndrome upper trapezius, pectoralis major, and levator scapulae become tight
 and rhomboids , serratus anterior, middle and lower trapezius, and deep neck flexors,
 including scalene becomes weak. The postural muscles have tendency to become tight while the
 phasic muscles have tendency to become weak and inhibited. Thus typical pattern of altered
 posture and muscular imbalance occurs whenever dysfunction of muscle start. mainly muscular
 imbalance between weak and tonic muscles leads toward this upper cross syndrome. Soft tissue
 and cervical spine disorders are found out to be the major contributor in neck pain but when
 postural abnormality becomes the reason behind neck ache than this is categorized as Upper
 cross syndrome due to this imbalance in muscles our body has to suffer from severe
 consequences.rounded shoulder posture is a result of protracted girdle of shoulder due to
 muscular imbalances between agonist and antagonist muscles resulting in extreme pain and
 exaggerated cervical curvature.Imbalanced stress on cervical vertebrae is responsible in
 creating extra pull on neck and head similarly change in normal posture is responsible in
 overloading, weakening or tightening of cervical area. Characteristics of patient presenting
 with UCS will have forward head posture, kyphosis ,hunch of thoracic spine (rounded
 shoulder),winged scapulae, protracted and elevated shoulder and reduced thoracic spine
 mobility. UCS with the passage of time can detoriate persons physical fitness and health ,it
 is not only responsible for changes in posture of upper back i.e hypokyphosis over time, but
 it is also responsible for inducing respiratory problems including asthma. It also cause neck
 back shoulder and chest wall pain, this pain can be caused by muscular imbalance leading to
 overuse and fatigue of muscle because of movement dysfunction of back and neck.when muscles
 become fatigued they start generating more amount of inflammatory chemicals resulting in
 becoming more sore and increased spasticity. With the passage of time biomechanical and
 postural changing will induce osteoarthritis in upper thoracic and lower cervical spine in
 early ages. Functional Shoulder impingement syndrome is also considered to be another
 complication of Upper cross syndrome. Therefore it is necessary to correctly diagnose and
 treat this condition before its complication starts worsening.
Inclusion Criteria:

 -  6 month chronic neck pain

 -  upper cross syndrome:

 -  Clinical picture (Postural Changes):

 -  Forward head posture

 -  Increased cervical lordosis and thoracic kyphosis

 -  Elevated and protracted shoulders (Rounded shoulders)

 -  A hunched upper back

 -  Rotation or abduction and winging of the scapula

 -  Test: Janda test: Patient supine tries to elevate the head from the couch.
 Normally the lordosis will disappear and the chin will touch the sternum.
 Otherwise pathological picture shows that the head is lifted with the very tense
 neck muscles

 Exclusion Criteria:

 -  Patients having any serious trauma on neck i.e. whiplash injury

 -  Spinal fracture

 -  Cervicogenic headache

 -  History of systemic disease RA, SLE, TUMOR

 -  psychiatric disorder

 -  Any Red flag