What is Lower Crossed Syndrome?
June 29, 2009 by Spencer
Filed under Chiropractic 101
Just like in upper crossed syndrome, lower crossed syndrome is a muscular abnormalities of the body brought on by one’s posture. Common patterns of lower crossed syndrome include tight lower back muscles, potentially with lower back pain. The individual might also have sore knees due to tight leg adductor muscles (muscles that move your legs towards the center of your body.
Lower crossed syndrome can develop from someone who sits for long periods of time, leaning in a slightly flexed position. This causes the lower back muscles or erector spinae to continually contract to hold the body’s weight upright while the constantly flexed position shortens the muscle length of the iliopsoas and rectus femoris muscles. Through continued concentric contraction or in a shortened position, the muscles adapt and shorten in length leading to muscle tightness.
However, since the body acts like a series of pulleys and levers, when one muscle gets shortened, it usually means that another muscle gets lengthened. This phenomenon is known as reciprocal inhibition. How it works is that when a muscle is contracting, the muscle opposite of its function, or antagonist muscle, is turned off so that they aren’t both contracting at once. Your brain can of course override this, but the purpose of reciprocal inhibition is to make the body more efficient and to avoid injury. While inhibited though, the antagonist muscle is not only prevented from contracting, but in many cases is actually stretched or lengthened. If you think of your quads (front thigh muscles) versus your hamstrings (back thigh muscles), if you flex one, you’ll usually feel the other stretch when you maximally stretch (I really feel this if I’m sitting down). In the end, the shortened tight muscles cause the stretching and lengthening of their antagonist muscles. This ultimately leads to the weakening of those muscles.
Due to the tightened and lengthened muscles, one with lower crossed syndrome will typically present with anterior pelvic tilt. This could look like someone is hunching over forward since their feet are more than likely planted on the ground. They might also have an increased lumbar lordotic curve, or increased lower back arch, which contributes to the anterior pelvic tilt. Both of these conditions help to further enforce the lower crossed syndrome, resulting in one of the many reasons for lower back pain.
You can see the anterior pelvic tilt in this example
Muscles commonly tight or shortened in lower crossed syndrome include:
- Iliopsoas
- Rectus femoris
- Erector spinae
- Piriformis
- Tensor fascia latae (TFL)
- Leg adductors
The weakened or lengthened muscles include:
- Abdominal group
- Gluteal group
How to treat lower crossed syndrome
What is upper crossed syndrome?
Hi,
I have this syndrome. What can be done about it? I have tried basic hip flexor stretches but still have residual problems.
Thanks
Hi Shaun, stretching can be an important treatment, it is important to remember that strengthening the weak muscles is just as important to regain balance of your lower structure. Common muscles that need to be strengthened are the gluteal or butt muscles, the hamstring or posterior thigh muscles, and your abdominal or stomach muscles. You can also stretch your quads out and your lower back if you know how to.
Finally even more importantly, since this is a postural syndrome, go and have your posture analyzed and fixed. You can stretch and strengthen for the rest of your life, but if you keep the bad habits, this will never fully go away! Most people don’t realize it, but many people have a slight anterior lean when they stand. This activates the lower back muscles to maintain balance and is a common reason why people get lower back pain. You can try it out for yourself, feel your lower back muscles, just right above where your belt would be. If you lean back slightly, and you feel your muscles relax, then chances are great that your back muscles are always firing when you’re standing! Tight lower back muscles are a hallmark finding of lower cross syndrome, not just tight hip flexors.
Posture can help relieve your symptoms for many musculoskeletal conditions. If you don’t know anyone, most chiropractors are well trained in analyzing one’s posture and can give your a focused exercise regimine to fit your needs.
Good luck!
I am doing research for a paper in school, a massage student. Do you know where I can find more information about this and upper crossed syndrum? Also, Lower crossed syndrum broken down, is is antior tilt and hyper lordosis? Thank you for your help
I am a personal trainer with clients with lower crossed syndrome and also having pronated feet. What exercises in the gym do you suggest I use to help those clients?
Laura – the great majority of my information came from the experience and teachings of my professors at school. I know that upper/lower crossed syndrome is not a chiropractic specific diagnosis, but for some reason, much of the information can be found from chiropractic doctors and their websites.
Smith Frank – The best way to help those with lower crossed syndrome is to find out where they are functionally weak and hypertonic. This will vary on an individual basis, but generally speaking, they will have weak glutes and abs plus hypertonic/spasmotic low back extensors, hamstrings, and psoas muscles. Look up Dr. Stuart McGill’s protocol on back, ab, and core functional testing as this is a good place to start to see where your clients need to work on first.
For pronotated feet, an exercise that I really like is called the peanut butter exercise (coined by me, heh heh). Imagine that the lateral aspect of your foot is covered in peanut butter and it’s your job to coat the floor with it. By inverting the foot and sweeping in towards your body, you can really work out your tibialis posterior muscles, which help to hold up the arch in your foot. While this won’t stop they hyper pronation anytime soon, you might also want to consider orthotics. Just don’t forget to tell your client to get their foot properly adjusted before fitting the orthotics. You wouldn’t want their feet to get shaped incorrectly! Try this out and let me know what you think.
I have this condition and i’m a basketball player. I cannot recruit my glutes. I work on my abs all the time, they are strong. I can’t feel my glutes, when i squat, deadlift, lunges. I tense them but i don’t feel that burn for confirmation. It might be that i am abnormally fast and i use my hip flexors to run, i can’t find a glute exercise to counter my powerful hip flexors. I’ve had lower cross syndrome for a couple years, my glutes protrude.. can you recommend an intense glute exercise that i can do in repetition?
thx.
hai….thanks alot for the info….after read this info only i really understand what does lower cross syndrome means…..really thanks alot man….
hi , your information is very useful for me . i need a full text article for lower cross syndrome with evidence for the purpose of my project am greatful 2 u if u post it
Lower (and Upper) Cross Syndrome was originally the work of Vladimir Janda, MD, DSc. If you want to go to the source look him up. There is a paper that is especially helpful to summarize him and his work. Google
“Janda Approach to Chronic Musculoskeletal Pain”
Reno –
Sorry for the very late response. If you really want to do a great exercise to recruit your glutes, you can buy a Theraband or resistance band. Tie it to make a large rubberband so that it’s about 1 food in length. Next, put it around your knees. Next, when you do a squat, really focus on pushing your knees against the rubber band when you’re standing up from the squatting position. You should really feel the burn after several reps.
In addition, you can do a half squat and then proceed to walk sideways, like how a crab walks. I think this one is even harder! These exercises really focus on your gluteus medius muscles.
Hi spencer,
did you ever see a patient who also showed neurological symptoms + a lower crossed syndrome? Can a lower crossed syndrome cause nerve root impingement?
thx,
Hi Sebas,
Lower Cross Syndrome can definately cause neurological symptoms such as numbness, tingling, muscle weakness, or shooting, electrical pain (also called referred pain) down your legs. One reason this occurs is that lower cross syndrome generally causes or is caused by a flexed foward posture in an individual. When you lean forward using your lower back, it causes the vertebral discs between your vertebrae to bulge backwards towards your nerve roots. If the bulge is too great, it can cause pressure and or irritation to those nerves, causing those symptoms.
Sciatica is a common diagnosis for someone with these symptoms. People with sciatica usually notice that when they bend forward, such as to tie their shoes, they may get these shocking symptoms. Not only is this because of a potential disc problem, but when you flex forward, it stretches out those nerves, cause irritation if they are already inflamed. To better understand this, you can get a piece of string and tuck it into your pants behind one of your buttocks. Then bring the string taut against the backside of your leg and foot, and then grab the end of the string with your toes. Now bend over and try to touch your toes, keeping your legs straight. You’ll feel the string get taut, maybe it will even get untucked from your pants. When this happens with your sciatic nerves, it will cause neurological symptoms, which might be due to lower cruss syndrome!
Hi Spencer,
Great article. Ive been suffering from LCS for over a year now, but was only recently diagnosed by a chiro. I am 21 yr old student, I used to play a lot of soccer till i pulled my left hamstring. My hamstring has mostly healed, but I am left with LCS. I feel that I have strong abdominal muscles, as I work on them regularly at the gym. My question is should I be concentrating on strengthening my obliques as well?
I also overpronate in my feet, orthotics have been recommended but they cost 500$ and I am only a student. So can overpronating hinder or inhibit me from fixing my posture back to normal??
Thanks!
hi thanks for alot of information i need more information for purpose of my seminar realy thanks
hi this article is good how can i test whethae a person is having LCS or not? any special testing? n rehabilitation techniques?
Before anyone tries to correct this problem, you need to realize it’s going to be a gradual process. We’re talking at least a few months. The problem didn’t start overnight and it won’t be remedied overnight.
Since there is usually pain associated with this syndrome, you have to deal with a secondary problem of possibly having pain even as you are doing the correct exercises to correct it. This is why you need to start out easily: very light strengthening of the weak muscles, and very light stretching of the tight ones. Otherwise you may cause further injury. If all goes well and no significant pains results, you may continue to progress. I am in the process of correcting my own LCS and I can tell you that some days I will have a flare-up of pain, afterwhich I need to rest completely for a few days (aside from aerobic exercise).
I am a Clinical Exercise Physiologist.
Rashi,
Lower cross syndrome is determined through a patient’s history, symptoms, and posture. There is no specific test to determine it. Typically, a patient will have low back pain and will demonstrate a forward posture, and sits a lot whether from work or something else.
Best you could change the post subject title What is Lower Crossed Syndrome? | Back Into It to more better for your content you make. I loved the the writing nevertheless.
Hi: It has been suggested that I have lower crossed syndrome because after bilateral hip replacement surgery, I have lingering hip flexor pain when I try to do some of my normal stretching (ie. full splits front and back). I don’t know – I have always had excellent posture and excellent strength. I can dance in pointe shoes with ease again, and I jump very, very well. I have strong abs and no low back pain. I don not have an anterior pelvic tilt, nor do I have tight quads or adductors. I just have trouble with sustained forward flexion. I regularly supplement dancing with Pilates reformer work. Any thoughts?
I was diagnosed with parkinsons disease about 10 years ago by a neurologist.
I have a different doctor now (another neurologist) who says he doesn’t think
that i have PD. he thinks i have lower body syndrome. how do you tell the difference? I have no pain. It’s just my legs are getting weaker and they don’t want to work. I have very bad balance. I was a crane operater for several years. could that be the reason? from reading your article it sounds possible. thank you for any help you can give. mainly I need to know the symptoms of LBS.
Hi Merle, I’m not familiar with lower body syndrome. After doing a quick search online, I could not find out a good explanation of what it is. Is there another name for this condition?
Parkinson’s disease will mainly give you muscle tremors at rest. It can lead to weakness and bad balance if you can’t control your muscles. Several conditions that pop into my head based off of your symptoms include:
– myelopathy
– neuropathy
– muscular dystrophy
I’m assuming that since you’re working with a neurologist, he would have been able to recognize this though. While lower crossed syndrome may have played a role in this, it has progressed much further and sounds much more serious.
Good luck
Hi Carol, when I think of hip replacements, I usually think of severe arthritis affecting the joint. I am glad that you are not in pain, but I feel that the lingering affects of the surgery migtht be the cause. It is possible that lower crossed syndrome contributed to your hip arthritis, but I am not sure if your surgery was necessary. I would recommend some sort of rehab through a PT or chiropractor so that your hips don’t degenerate again. Many surgeries do not have a positive lasting effect because the patients that get them stop their healing journey after the surgery leading to the same pain and problems 5-10 years down the line.
Good luck!
I’ve been seeing a lot of great articles stating that kettlebell exercises can definately help with correcting the lower cross syndrome. Kettlebells in general are a great way to correct a lot of posture, strength and balance issues. I’m walking proof of this. I used to spend a lot of time at my PT and chiropractor for muscle imbalance, core strength related issues would be more like it. I only visit a couple of times a year now!
Do a Google search on kettlebells and lower cross syndrome. You’ll be amazed at what you will find. I don’t want to list any websites as you may not want to endorse them in this forum. However, the one at the top of the google search has the most interesting information of them all.
Cheers!
In lower cross there are two scenarios: anterior pelvic tilt (hyperlordosis) and posterior pelvic tilt (hypo(less)lordosis). You want to go to the gym and use resistance machines targeting/address the following. (1)lengthened/inhibited muscle group, and (2) hypertonic muscles.
The hypertonic muscles with anterior pelvic tilt are: psoas, quads and erector spinae. The hypertonic muscles with posterior pelvic tilt are: hamstrings, gluteals and abdominals. The lengthened/inhibited with anterior pelvic tilt are: hamstrings, gluteals and abdominals. The lengthened/inhibited with posterior pelvic tilt are: psoas, quads and erector spinae.
good luck
Thanks for the useful info. I recently was hired to teach a course at a massage school on ortho/sports injury massage and the course syllabus included the topics of upper crossed and lower crossed syndrome. I’ve been a chiropractor for 30 years and I’d never heard this terminology! (Though I understand the concepts, of course.)
Thanks!
Ron Lavine
I am a competitive kayaker/long distance surf ski paddler where I spend a great deal of time sitting, legs bent and lower torso muscles tensed due to unstable water. i have found my hip flexors are constantly tight – no amount of massage or stretching can alleviate this. I am constantly getting adjusted at the chiro in the T4, SI and L2 & 5 regions.
I usually have either a chiro or massage session a week, sometimes both! I’m 37 and have been doing this for years!!
One other thing I would like to know is: could this syndrome affect the lower leg so much as to cause recurring calf injuries – not complete tears, but just tightness that gets tighter when running, and feels like its “pops” a little when pushed too far??
For over 2 years I haven’t been able to run because of this – and for the same period of time my paddling has gotten a lot more serious!!
Keen for your thoughts.
Cheers