Efficacy of Post-Isometric Relaxation vs. Sustained Stretching for Improving Cervical Spine Mobility in Upper Cross Syndrome-A Randomized Controlled Trial

Background: Upper Crossed Syndrome (UCS) is a common musculoskeletal disorder characterized by muscle imbalance in the head and shoulder areas, often exacerbated by poor posture. Muscle Energy Technique (MET), including Post-Isometric Relaxation (PIR) and sustained stretching, is commonly used to alleviate symptoms associated with UCS. Methodology: This randomized controlled trial compared the efficacy of PIR versus sustained stretching in reducing muscle tightness of the upper trapezius and levator scapulae muscles among 30 participants at Al-Sehat Rehabilitation Centre, Karachi, Pakistan. Pain intensity was assessed using the Numeric Pain Rating Scale (NRS), and cervical range of motion (ROM) was measured with an inclinometer. Results: PIR and sustained stretching significantly reduced pain and improved cervical ROM. PIR showed superior pain reduction, while sustained stretching enhanced ROM, particularly in left rotation and lateral flexion. Conclusion: PIR and sustained stretching are effective treatments for managing UCS-related symptoms. PIR excels in pain management, whereas sustained stretching enhances cervical ROM. Clinicians should consider these findings when designing treatment protocols for UCS.