Effect of Diaphragmatic Release on Upper Crossed Syndrome

Poor posture typically causes upper cross syndrome, resulting in neck pain. Neck pain is the most common reason for patients to visit healthcare professionals. This syndrome can cause dysfunctional tone in posture and muscular disparity of the head, neck, and shoulder region . Evidence suggests that 6-48% of the upper crossed syndrome population complain of pain in the shoulder girdle and cervicothoracic region. Many disorders are linked with the upper crossed syndrome, including migraine headaches; chronic headaches; Subacromial impingement; biceps tendinitis; thoracic outlet syndrome; degeneration of the cervical spine; and joint dysfunction at the C1-C2 segment, C4-C5 segment, cervicothoracic joint, and T4-T5 segment. Upon the available research studies, there is no study conducted to investigate the effect of diaphragmatic release on upper crossed syndrome patients.

Group A: diaphragmatic release +conventional The patients will be positioned in the supine position. The therapist stood at the head of the patient contact thoracic cage and ask the patient to take inspiration and move laterally then ask the patient to expire. conventional Subjects will form the letter 'Y' with their arms then they will flex their elbows and move into a position of shoulder extension so that their arms will form the letter 'w L to Y Exercise: Subjects will begin with arms abducted to 90° and elbows flexed to 90° Chin tucks: Subjects will length the neck by pushing the chin into the table in an entirely posterior motion stretch the pectoral area from the supine lying position

Group B: conventional posture correction exercises Subjects will form the letter 'Y' with their arms then they will flex their elbows and move into a position of shoulder extension, so that their arms will form the letter 'w L to Y Exercise: Subjects will begin with arms abducted to 90° and elbows flexed to 90° Chin tucks : Subjects will length the neck by pushing the chin into the table in an entirely posterior motion stretch pectoral area from supine lying position

The patients will be positioned in the supine position. The therapist stood at the head of the patient.therapist make manual contact of ribs and ask patient to inspire the move ribs laterally and then expire conventional exercise Subjects will form the letter 'Y' with their arms then they will flex their elbows and move into a position of shoulder extension, so that their arms will form the letter 'w L to Y Exercise: Subjects will begin with arms abducted to 90° and elbows flexed to 90° Chin tucks : Subjects will length the neck by pushing the chin into the table in an entirely posterior motion stretch pectoral area from supine lying position

using tape to measure chest expansion during inspiration and expiration at axillary level and at the level of T10

The subject was instructed to place a vertical mark on the line to indicate his/her pain which zero is no pain and ten being severe pain.

Inclusion Criteria: Age ranged from 17 to 22 years . Body Mass Index from 20 to 25 kg/m². All participants have an intensity of neck pain on VAS (4-8) (moderate cases). The subjects were chosen from both sexes. All participants have kyphosis angle ≥42° All participants have mechanical neck pain and FHP (craniovertebral angle CVA < 49). Exclusion Criteria: Malignancy Fractures of the cervical spine Cervical radiculopathy or myelopathy Vascular syndromes such as vertebrobasilar insufficiency Rheumatoid arthritis Neck or upper back surgery Taking anticoagulants Local infection Whiplash injury