Lower crossed syndrome is a postural condition that develops over time in the region of the hips and lower back, and the muscular imbalance creates potential risk to other structures throughout this region.
Lower crossed syndrome is a postural imbalance that occurs in the muscles of lower back, pelvis, and hip joints. This condition is a result of prolonged sitting and will be exacerbated by poor posture.
While sitting, some muscles are stuck in a shortened position—a position which begins to take hold. At the same time, other muscles are stuck in a lengthened position, and these muscles become weak or inhibited.
It’s important to know some basic anatomy of the lower back, pelvis, and hips to understand lower crossed syndrome. First, you need to understand some of the bony anatomy (which includes the joints). Then, you can learn the muscles involved and how they are affected.
To begin, the bones of the lower back are the lumbar spine, which is comprised of 5 bones.
The lowest of these 5 bones attaches to the sacrum—the last bone in the spinal column that bears the weight of your body. One more bone attaches below the sacrum, called the coccyx. The coccyx is often called the tailbone.
The sacrum sits between the left and right pelvic bones. Each half of your pelvis has three parts:
Lastly, the femur bones are the thigh bones. On each side, the femur attaches to the pelvis, and these are your hip joints.
Muscles that are affected in lower crossed syndrome include muscles that attach from the lumbar spine to the pelvis, muscles that attach from the pelvis to the femur, and one muscle that has attachments from the lumbar spine to the femur.
The abdominal muscles—namely the rectus abdominis (the 6-pack muscles)—are also involved, attaching from the lower portion of the ribs and sternum to the upper portion of the pubic bone.
Lower crossed syndrome occurs when prolonged sitting creates tightness in some muscles and inhibition of others.
While sitting, the hip flexor muscles described above are shortened from the flexed position of the hips. Over time, the muscles begin to hold in this shortened position.
This response to shortening is described as chronic hypertonicity. A hypertonic muscle is one that has an unconscious, partial contraction. A hypertonic muscle will also have resistance to stretching due to this low-grade contraction.
The tight or hypertonic muscles in lower crossed syndrome include:
These tight muscles will pull on the bones to which they attach, even when you’re no longer sitting.
While sitting, the gluteal muscles described above are lengthened and both the gluteal muscles and the abdominal muscles inactive.
Over time, this prolonged inactivity combined with the antagonist muscle tightness (hip flexors and lumbar erector spinae) creates weakness or inhibition of these muscle groups.
Tightness of the hip flexors and lumbar erector spinae along with weakness/inhibition of the gluteal and abdominal muscles creates a postural imbalance in the lower back and hips.
The postural imbalance noted in lower crossed syndrome is a forward rotation of the pelvis and an excessive extension in the lumbar spine, known as hyperlordosis.
This excessive backwards curve of the lumbar spine may lead to back pain, commonly known as facet syndrome, mechanical or postural back pain.
As a postural imbalance, lower crossed syndrome does not necessarily present with pain or other symptoms. The signs of lower crossed syndrome are the same details as described in Pathophysiology.
Other symptoms may include:
The mechanism for the onset of lower crossed syndrome is simple and straight forward. Prolonged sitting will lead to the muscular imbalance, and this imbalance is exacerbated by poor posture.
However, there are other preventative measures to reduce your risk of developing lower crossed syndrome if you are stuck in a seated position for many hours per day.
Sometimes, a simple reminder can help to keep your body in a better position. However, prolonged sitting—especially in a poor position—will create the muscular imbalances described earlier.
When this happens, simply thinking about sitting more appropriately may still be ineffective. So, we developed Power-Up Posture with 21 exercise and stretches to help improve your posture!
Power-Up Posture is an exercise and stretch program designed to counter the ill-effects of prolonged sitting. The program is effective for both prevention and rehabilitation of lower crossed syndrome.
Power-Up Posture is a comprehensive program to stretch and relax the hypertonic muscles and to stimulate activation and strengthening of the inhibited muscles affected in lower crossed syndrome.
Through participation of this program, you can effectively prevent these muscular imbalances and reduce pain associated with prolonged sitting and poor posture.
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