After low back pain, neck pain is the most common reason for a visit to a chiropractic office. There are many risk factors for neck pain including postural faults in the neck and upper torso. Let’s look at how common poor posture is among youths and what can be done to reduce the risk for neck pain in children and teens both inside and outside of the doctor’s office.

Upper crossed syndrome (UCS) is a postural fault characterized by a weakness of the deep neck flexors and interscapular (middle and lower trapezius) muscles and over-tightness/shortness of the upper back and neck and pectoralis (chest) musculature forming an “X” when looking at the body from the side and connecting the weak muscles and tight muscles with imaginary lines. This can cause the head and shoulders to rest forward of their normal position, straining the soft tissues of the neck and upper back, which can manifest as neck pain.

In a January 2023 study, researchers examined secondary school students and observed that 37.8% exhibited UCS, 38.9% had forward head posture, and 80% had forward shoulder posture. Further analysis revealed that students who were overweight, physically inactive, wore a heavy backpack, and spent too much time on electronic devices were at greater risk for poor posture. Additionally, the data show that UCS is associated with worse academic performance!

The good news is that a randomized controlled study that included adolescents from two schools found that those who participated in a 16-week resistance and stretching program incorporated into their standard gym class led to measurable improvements in neck and shoulder posture. The program in the study included chin and scapular retractions; stretching of the pectoralis, levator scapulae, and anterior scalenes muscles; and strengthening of the shoulder external rotator muscles. Replacing screen time and other sedentary behaviors with physical activity (such as after school sports), as well as proper backpack use (using both straps, keeping the weight of the back higher on the back, and restricting the bag’s weight to less than 10-20% of the child’s bodyweight) are also strategies for avoiding poor posture.

If a teenager with neck pain and faulty posture presents for chiropractic care, treatment will include hands-on care in the office, which can include manual therapies and physiotherapy modalities. Between visits, the patient may be asked to perform exercises to restore muscle balance in the neck and upper torso to help correct their posture. Not only can this approach help relieve their neck pain, but it can also lower their risk for neck pain in the future!