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Janda's Upper Cross Syndrome and Lower Cross Syndrome

Janda’s Cross Syndromes are a way of understanding your body, balance, and alignment. Janda outlines three central patterns: Upper Cross Syndrome (forward head posture and round shoulders), Lower Cross Syndrome (pelvis tilts forward), and Layered (both syndromes combined)- as they relate to postural abnormalities.

Janda’s approach aims to find the cause of pain rather than focus on where it manifests to alleviate symptoms. With this understanding, a clinician (practitioner) can use these patterns to help you better understand how your posture may impact your overall wellbeing.

Janda's upper and lower cross syndromes

Janda's Cross Syndromes are a way of understanding your body, balance, and alignment.

Structure vs. Function

The two arms of a musculoskeletal medicine approach.

Structure Approach:

The structural approach is when you focus on specific parts of the body. Then, you can use special tests to find out what is wrong with them.

For example, the typical orthopedic approach looks for pain in a specific part of the body. It then uses special tests to find out what else might be going on.

Function Approach:

The functional approach looks at the way your body is working. It doesn’t just focus on a single site for the problem. For example, this approach can be better when you have chronic long-term musculoskeletal (in your muscles, bones, and joints) pain.

Tonic and Phasic Muscle Systems

Man curling into himself. Contracting flexors.

Dr. Janda identified two categories of muscles: TONIC and PHASIC.

Tonic Muscle System

The tonic muscle system is made up of the flexor muscles. These same muscles contract during pregnancy in an unborn baby, keeping the baby curled into the ‘fetal’ position.

Phasic Muscle System

The phasic muscle system is made up of extensors. These muscles work against gravity and are the first muscles to develop after birth. Thus, giving the newborn baby the ability to extend head and shoulders upwards and forwards while on their front.

Why is this important to cross Syndromes?


The importance of the distinction of creating the two groups is how they function both together (synergistically) and independently. For example, Janda found that the “tonic flexors” were prone to tightness (shortness). At the same time, the “phasic extensors” were prone to weakness (inhibition).

His studies and observations identified the central nervous system (CNS) as a critical element in understanding and addressing musculoskeletal patterns through the nervous system’s role in influencing muscle activity.

As with all things, there are no hard and fast rules that govern change. Nevertheless, Janda’s theory is an essential addition to understanding balance and imbalance. This is because variables can affect how muscles respond to stimulus and localized changes beyond a straightforward analysis of pattern recognition.

Janda's Cross Syndromes

Change can be seen over a continuum of time. These patterns can be categorized as:

  • Upper Cross Syndrome
  • Lower Cross Syndrome
  • Layer Cross Syndrome
Both Janda’s Upper Cross Syndrome and Lower Cross Syndrome are related to postural abnormalities.

According to Janda, movement dysfunction occurs due to variations in muscular tone, creating significantly poor posture and movement patterns.

Consequently, an accredited health care provider can use Janda’s categorization to start predicting patterns of tightened and weakened muscles to assist in returning the body to a state of balance and equilibrium.

Part of Janda’s approach is that specific tight muscles require little stimulus to ‘tighten’ again.
Part of Janda’s approach is that specific tight muscles require little stimulus to ‘tighten’ again.

As an example, ongoing tensioning of your neck and shoulders is constantly going through a tight-relaxed-tight cycle.

Every time you get some relief (whether from a treatment or relaxation), it doesn’t take a lot for things to tighten up again.

“In some cases, joint degeneration may be a direct source of pain, but the actual cause of pain is often secondary to muscle imbalance. Therefore, clinicians should find and treat the cause of the pain rather than focus on the source of the pain.”

(“Janda Syndromes – The Janda Approach”) (http://www.jandaapproach.com/the-janda-approach/jandas-syndromes/)

Upper Cross Syndrome

A forward head posture and rounded shoulders are hallmarks of this condition. Unfortunately, many people have fallen into this pattern due to the ongoing trend toward more prolonged computer and smartphone usage.

Upper crossed syndrome is a disorder that affects people who suffer from neck pain, shoulder discomfort, and headaches.

It can be seen when there is a weakness of the ‘upper’ muscles of the posterior chain.

Janda Upper Cross Syndrome

Which are the TIGHT muscles?

  • Upper Trapezius
  • Levator Scapula
  • Sternocleidomastoid (SCM)
  • Pectoralis Muscles

Which are the WEAK muscles?

What kind of issues could occur with Upper Cross Syndrome?

lower Cross Syndrome

One of the most frequent compensatory postures is Lower Crossed Syndrome. It is characterized by a pelvis that tilts (tips) forward.

An excessive anterior tilted pelvis can lead to an increased curve in the lower back (Lumbar Lordosis) and protruding stomach.

Lower Cross Syndrome

Which are the TIGHT muscles?

  • Thoraco-Lumbar Extensors
  • Rectus Femoris (hip flexor)
  • Iliopsoas (hip flexor)

Which are the WEAK muscles?

  • Abdominal Muscles (in particular
  • Transversus Abdominus)
    Gluteal Muscles

What kind of issues could occur with Lower Cross Syndrome?

  • Anterior pelvic tilt (forward movement of the pelvis along its axis) 
  • An increased curve of the lower back (lumbar lordosis)
  • Locked Knee Joint, similar to hyper-extension of the knee.

Layer Syndrome

Jandas Layer Cross Syndrome reflects elements of both upper and lower cross syndromes

This is a combination of both Upper Cross Syndrome and Lower Cross Syndrome. An example of this can be seen in Kyphosis Lordosis Posture Pattern. Here you will find some key characteristics of both Cross Syndromes.

While there may be a tendency to develop one pattern more than the other, the influence of them combined will have an impact on overall postural balance and movement.

Finally

Janda’s Cross Syndromes are a way of understanding your body, its balance, and alignment. Janda outlines the three central patterns: upper cross syndrome (forward head posture and round shoulders), lower cross syndrome (pelvis tilts forward), and layered (both syndromes combined) as they relate to postural abnormalities.

With Janda’s approach, clinicians should find the cause of pain rather than focus on where it manifests to alleviate symptoms. In addition, many accredited health care providers can use these patterns to help you better understand how your posture may impact your overall wellbeing.

PLEASE NOTE

PostureGeek.com does not provide medical advice. This information is for educational purposes only and is not intended to be a substitute for professional medical attention. The information provided should not replace the advice and expertise of an accredited health care provider. Any inquiry into your care and any potential impact on your health and wellbeing should be directed to your health care provider. All information is for educational purposes only and is not intended to be a substitute for professional medical care or treatment.

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