The Exercise Guide for Desk-Worker’s Neck and Back Pain (Cross Syndrome)


Sitting at a desk for long periods of time during the work week leads to a predictable pain pattern and structural misalignments in the spine.  This is known as “Cross Syndrome”.

Cross Syndrome was first described by Vladimir Janda in 1979 as a predictable pattern of alternating tightness and weakness in the neck and shoulder area, as well as the lumbar spine and pelvic areas.  These are also referred to as upper/cervical/neck Cross Syndrome and lower/lumbar/pelvic Cross Syndrome.


How Do I Know If I Have Cross Syndrome?

Upper Cross Syndrome is marked by tightness and tenderness across the top of the shoulder blades, tightness and tenderness in the muscles at the skull/neck junction, tight chest muscles, forward-drawn head posture and forward-drawn shoulders.  This causes the head to feel heavy at the end of the day.

Lower Cross Syndrome involves tightness and tenderness in the lower back and hip flexor area.  The hips may either rock forward (flatter gluteal area) or backward but they usually rock forward (rounded gluteal area).

There are areas of weakness in the shoulder and pelvic areas as well, which we will soon discuss.

It is possible to have ONLY upper or lower Cross Syndrome but having one is generally a risk factor for eventually having the other because each of them is considered a progressive and degenerative condition.  The main risk factor for developing either of these conditions is sitting for long periods of time month after month.

The reason one Cross Syndrome predictably spills into the next is because the human body is a self-correcting mechanism.  When the sail on a sailboat begins to compress, it will keep compressing until it capsizes since it doesn’t know how to compensate for the shift in weight.  Our bodies will do everything they can to keep the head over our body’s center of gravity.  If it doesn’t, then certain muscles get “turned on” which attempt to lessen the uneven load of how the head is sitting on top of the neck.


Adaptive Normal or “Normal” Normal?

Your body works efficiently and will automatically slouch when you need to in order to take pressure off certain joints.  However, when the body is constantly subjected to “adaptive” loads instead of “normal” loads (according to gravity) there will be a constant tug-of-war between the muscles of the shoulders, spine and pelvis to keep you on center.

When one muscle gets “turned on” the equal and opposite (“cross”) muscle gets shut off.  Keep in mind, muscles have no mind of their own.  They’re under the direct control of the brain and spinal cord and they only know how to squeeze or relax.  Below is a chart showing the muscles that get weak, along with the ones that get tight in Cross Syndrome.

cross syndrome diagram

Notice how the title of this E-Book does not involve “curing” or “solving the cause of” Cross Syndrome.  The only way that would be possible were if you gave up your desk job and became a full-time astronaut, skydiver or snorkeler.  Gravity is always at work and desk-workers must have an effective and efficient way to deal with the ever-present gravitational cause of Cross Syndrome. 

This E-Book will attempt to help you in four areas: 1) decrease your back pain throughout the day; 2) help you be more productive; 3) help ensure that you have more “left in the tank” at the end of your day; 4) help you sleep better; and 5) help you to wake up feeling taller, lighter and looser.


How to Win the Tug-of-War

Upper and Lower Cross Syndrome, in its most general sense, is an over-facilitation of certain muscles and an inhibition of other muscles.  For our purposes, muscles that are over-facilitated can also be described as “tight”, “too strong”, “tense” or “switched on”.  Inhibited muscles can be described as “loose”, “weak”, “switched off” or “low tone”. 

The idea is to help you be more productive, avoid neck and back pain as much as possible, and help you to have more left in tank at end of day and sleep better since this will also help you avoid sleeping in the fetal position.

Let’s define a couple more terms…


Integrate – involves the neurologic component of proper posture, such as teaching the body to do new and unusual movements while integrating the balance mechanism so that acquiring this new skill makes easier tasks such as sitting properly appear to be easier or more “second nature”.  For example, a person who is a very good dancer should easily be able to skip or hop on one foot.

Isometric Exercise – Involves sustained or held positions against gravity and/or one’s own body weight.    The emphasis is not in strengthening certain muscles but rather strengthening certain muscle groups in order to improve a postural skill.


Let’s now discover how an isometric exercise helps improve our posture and why it works…

To give you a better understanding of how this works, do this.  Stand next to a wall and keep your arm straight.  Move your arm to the side, away from your hip.  At the point it touches the wall, it should be about 6” away from the side of your hip.  Try to make only the lower half of your forearm and entire back of your hand touch the wall.  Now, press up against the wall at a 90% effort and do this for 10 seconds.  IMMEDIATELY after this, bring both arms down to your sides so they’re touching the side of your hips and slowly move your arms straight out to the sides as if making a snow angel. 

  isometric arm exercise                                        

Did you notice how the arm you pressed up against the wall feels much lighter compared to the other arm, especially once it about 1 ½ feet away from your hip?  You should also notice is that this was an unconscious thing.  You did the work of pushing your arm against the wall, but when you were elevating your arm, you didn’t think about making it lighter. 

This is the type of effect we must have on your upper and lower spine regions in order to decrease your pain while you’re at your workstation.  We must “go around” the conscious barrier and figure out a way to make your body prefer to sit (and stand) taller as part of your default mode setting.  This is how to create a new and better “normal” and this is how we prevent gravity from taking a toll on your energy levels at the end of the day.

The reason isometric exercise works so well for both upper and lower Cross Syndrome is that it is safe, it’s efficient because it lets your body figure out (as opposed to having an examiner reach a complicated diagnosis and prescribe a series of reps and sets with weights and machines) which muscles to turn on, and it’s easy to integrate the neck and shoulder areas with the lower back and pelvic areas at the same time. 

Here is an example of isometric exercise of the neck and shoulders:

isometric exercise neck and shoulders

In this position, you are lying on your back.  Your head is elevated slightly, while the shoulders are pushing down towards the floor.  This position is held for 5 seconds and is performed ten times per day.  This strengthens the deep neck flexors.

isometric exercise for deep neck flexors

Here is a modification of the same exercise with the help of a wedge support.  Both exercises are good for strengthening the front neck muscles, but you can see with the postural support piece the head-to-spine alignment is more optimal.


Here is an example of isometric exercise of the lower back and pelvis:

isometric exercise for lower back and pelvis

Lifting the legs slightly off the floor and holding them for five seconds at a time strengthens the lower abs.  This is done ten times per day as well.


Here is an example of using integration, which enhances coordination of the upper with lower spine regions.

integration isometric exercise

Notice it is ONLY the head that is touching the wall.  It may look like it’s only a “neck” workout, but after a minute or so, the main challenge is in keeping the pelvis from sagging forward.  This is a full spine workout, also including the lower abs.  When you walk away from the wall after holding this position for 5 minutes, normal posture now feels normal and it would feel strange and like you’re working against the grain if you now brought your head and neck into a forward-drawn position. 

Not only does this simple exercise reinforce a good posture, it also helps you become more aware of when you’re slipping into bad posture – especially moving your head and shoulders too far forward.

If limited on time, most people would choose to do this exercise instead the previous two. 

This is an example of an isometric exercise which uses integration.  I call this the London Guard because I had a patient from the UK that I asked to do this and her nephew was a Queens’ Guard and stood in front of the palace all day, wearing the red jacket and black bear fur helmet.  He told her that they do this exact same exercise to give them a better sense of postural awareness and strengthen the areas in the spine and cord that need it most.

A word of caution though.  You should first stretch and get proper blood flow to the areas of your spine that need it most before doing any of these isometric strengthening exercises, or else you could be setting yourself up for injury.  If not injury, then certainly limited positive effect.  Just like baking a cake, these steps should be done in a certain order.  Our complete system, when done in the correct order, should help you feel taller first thing in the morning.

Notice how we’re basically stretching the muscles that are tight from the Cross Syndrome diagram and we’re strengthening the weakened ones.

The next exercise is an integration-type exercise, coordinating upper body movements with lower body movements and assisting with strengthening the glutes.

integration exercise for glutes

Alternate arms and legs, holding this position each time for two seconds.  Do both sides a total of ten times.  This should be done every day.


log carrier integration exercise                                              

This exercise is called The Log Carrier and breaks the pattern of having the shoulders rolled forward with hands facing down, as is the common posture of sitting at a desk.  In position 1, the elbows come all the way back to the wall and the arms are touching the flanks.  Hands and forearms are perpendicular to the wall, as if carrying a stack of logs.  In position 2, the shoulders stay back against the wall even though the arms are out in front of you.  Make a triangle with your hands while bringing them back to parallel with the wall by extending the wrist.  Make sure to keep your shoulders, buttocks and head back against the wall.  Do this 15 times a day at your own speed.

integration exercise ymca

This exercise is called “Y”MCA.  Your shoulders, buttocks and head remain touching the wall.  Try to keep your elbows and backs of your fingers touching the wall at all times.  You’re essentially making the field goal sign down low and then up high, making sure to keep these body parts touching the wall.


The Log Carrier and “Y”MCA are considered “integration” exercises because they’re essentially training you to make certain movements that break habitual patterns associated with desk posture.  The trick to improving posture, whether in the seated or standing position, is to access the neurological balance mechanism, thereby bypassing the conscious barrier.  Good posture is a subconscious phenomenon.

*The YMCA and Log Carrier Exercises can be combined with doing the London Guard at the same time.  Not only does it save time, there is more “muscle confusion” involved so there is even more integration.

london guard exercise with head cushion

We have available a postural support piece that assists in cushioning the head and providing clearance for the shoulders and buttocks along the wall.  It is a non-slip surface and is contoured for the head for additional comfort.

The next several exercises involve stretching the muscle groups that are over-active in upper and lower Cross Syndrome.  All of them should be held for a minimum of 30 seconds to 2 minutes.

chest stretch

Above, we are focusing on opening the chest area and stretching the pectoralis muscles.  Simply find a corner, bend your elbows and align your forearms so they are vertical against the wall and lean forward.

sustained dog stretch

In this one, we are stretching the erector spinae muscles in the mid and lower back.  The erector spinae muscles are also called the “postural” muscles and the “anti-gravity” muscles.  Start on all 4’s, shoulders above the wrists and hip sockets above the knees.  Then walk forward 6 inches with your hands.   Next, glide forward so your shoulders are above the wrists.  The end position is having your hip sockets 6” in front of the knees.  Let your shoulder blades wing upward and relax your head downward.  Focus on breathing from your belly so you’re getting as much oxygen to the spinal tissues as possible.

child's pose

This is often called the Child’s Pose in Yoga.  It has a similar effect as the above exercise and is generally better if you have a history of shoulder, elbow or wrist injury.  We recommend not letting your buttocks touch your heals so that you have space to move as you’re slowly sliding your upper body backward.


the sky dive effortless stretch

Our 7-piece posture and decompression support set allows you to combine against-the-wall pec stretch with the erector spinae stretches featured above.  Advantages include: 1) it allows you to fully relax since it is effortless; 2) it allows you to hold the stretch longer; 3) because of these two, it allows you to focus on your breathing so that proper oxygen flow is getting to the areas in the spine that need it most; 4) it is easier on the shoulder and wrist joints than the one featured two examples above; and 5) it places you into the exact opposite position (opposite “C”) of the compressed mid-back posture that is so common among desk workers.

Our secret to exponential results is leverage plus time plus oxygen.


hip flexor stretch

In this position the left leg is brought up and held toward the chest.  The leg/hip area that we’re focusing on is the right side here.  Do this on both sides.  It is the down leg’s iliopsoas/hip flexor muscle that we’re releasing here.  Hold this position for 30 seconds – 2 minutes.


Hopefully, you now have a better sense of what is causing desk-worker’s posture and why it causes pain.  You also have learned to target the weaker and tighter areas through isometric exercise, stretching and integrating your anti-gravity mechanism.


multi use seat wedge

Our posture and decompression support set also comes with a seat wedge, which helps to maintain good alignment during the workday.  Our seat wedge is designed to either sit on or lean back against.  Most prefer to change the position of the wedge during the workday. 



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