Do you live a sedentary lifestyle? In today’s world, that’s not a surprise at all. However, if your career or living situation requires prolonged sitting, it is important to properly take care of your body and avoid painful health complications such as lower crossed syndrome. Even if you work a lovely desk job or enjoy your comfy couch time, be sure to spend some time exercising and moving your body. Humans are not designed to stay cooped up, so continue reading to learn more about lower crossed syndrome and exercises designed to avoid or alleviate its symptoms!
What is Lower Crossed Syndrome?
Unterkreuz syndrome, more commonly known as Lower Crossed Syndrome, is caused by large muscle strength imbalances in the abdominal muscles and the gluteus maximus. According to the National Academy of Sports Medicine, the lower crossed syndrome is one of the most common compensatory body patterns. It differs from the upper cross syndrome as it does not occur in the shoulders and neck but in the lower lumbopelvic region.
When muscles become lengthened or shortened over time, the lower muscular imbalance results in postural changes of the neutral spine, lower back pain, and overactive muscles. Postural changes are most commonly viewed as an increased forward bend of the pelvis coupled with an excessive lower back arch. The uneven pull on your muscles forces the back muscles and hamstrings to work harder, leading to injuries. Because the lower crossed syndrome causes overactivity in certain muscle groups, there is intense tightness of hip flexors and lumbar erector spinae.
The Two Types of Lower Crossed Syndrome
There are two different types of lower crossed syndrome. While they are very similar and involve the same main muscle imbalances and common compensatory patterns, one mainly affects the hip flexors, while the other affects the lower back. Unlike upper cross syndrome, which affects the upper trapezius, both lower crossed syndrome subgroups are differentiated by how they alter the gluteal musculature’s postural alignment and change the myofascial activation patterns of the pelvic region, although they both result in tight muscles and a painful lower back. Often, physical therapy is the best option to resolve this painful condition and muscle weakness.
Posterior Pelvic Crossed Syndrome
The first subgroup is called posterior pelvic crossed syndrome and dominates the axial extensor. In this type of lower crossed syndrome, the pelvis has an anterior tilt while the knees and hip region are put into a slightly flexed position with unnaturally lengthened muscles. Often associated with a compensatory hyperlordosis of the lumbar spine and hyperkyphosis between the thoracic and lumbar spine, the condition leads to a decreased ability to breathe and control one’s posture. The tightened hip flexors and lumbar spine may become painful as they take on more strain to compensate for the weak muscles.
Furthermore, due to the lack of stabilization within the abdominals and internal oblique, the thorax will move up to over 90 degrees, and the postero-inferior thorax will be hyper-stabilized. This means that exhalation becomes difficult as the rectus abdominis activation cannot lower the thorax into its neutral position. In short, the expiratory phase becomes shortened, and problems arise when the coordination between the transverses and the diaphragm is insufficient.
Anterior Pelvic Crossed Syndrome
The second type of lower crossed syndrome is called the anterior pelvic crossed syndrome and occurs when the abdominal muscles are too weak or too short. In this condition, the muscles compensate with minimal hypolordosis of the lumbar spine, hyperkyphosis of the thoracic spine, and head protraction. Thus, the anterior pelvic tilt forces the knees into a hyperextension.
What Causes the Lower Crossed Syndrome?
The lower crossed syndrome is caused by either the shortening or lengthening of muscles within the pelvic or lumbosacral regions of the body. Often related to or caused by poor posture or prolonged sitting, the lower crossed syndrome results from changing muscular length and increased stress on certain muscles and hip joints. When you maintain improper posture, training, or ability to perform daily tasks, the affected muscles bear the burden of one-sided stress or high tension. Although the lower crossed syndrome is most often linked to poor posture, it can also be caused by general poor health or physical condition.
Another common cause of the lower crossed syndrome is prolonged sitting. You can cause an imbalance between the muscles as weakness occurs due to reduced mobility or prolonged sitting.
What are the Symptoms of Lower Crossed Syndrome?
The most common symptoms of the lower crossed syndrome are lower back pain or pain within a pelvic or hip joint. Other symptoms include:
- Difficulty moving or stiffness in the lumbar spine, hip, hamstring, or pelvic region
- Pain in the hip flexors, groin, spine, or gluteal muscles
- Protruding stomach due to an overly arched lower back
- Tension in the lower back or gluteal muscles
Lower Crossed Syndrome Exercises
One of the best treatment techniques for the lower crossed syndrome is through an exercise program. Especially if you sit for prolonged periods, it is important to take time to exercise your body and loosen your sitting muscles or gluteus maximus. The first step toward treating this condition is to loosen your hip flexor muscles and joints and strengthen the weakened abdominal and gluteal muscles, particularly the gluteus medius. The goal is to loosen any possibly tight muscles and strengthen weak muscles. Certain floor exercises and stretches can work wonders at reducing pain in the lower body. However, if these exercises fail to reduce tension and pain, you should seek help from a physical therapist.
Everyone should learn how to relax their overactive muscles. One way to do this is by using a foam roller to slowly roll parts of the body. Take the roller and use it on tight muscles such as the quads and inner thighs. If you find a tender spot, hold the position for 30 seconds.
After you have relaxed your overactive muscles, it is time to begin strengthening and lengthening your weak muscles. The iliopsoas stretch or single-leg squat uses static stretching to do just that. You can even increase the severity of the stretch with the rectus femoris.
To perform this hip flexor stretch and rectus femoris:
- Assume a kneeling position with your back in line with the buttocks and knees.
- Put one leg in front of you with the knee bent, the foot resting flat on the ground, and the toes facing forward.
- Lean forward into a lunge position until you feel a gentle stretch in the hip flexors and the front and back of the thigh muscles.
- Hold the hip flexor stretch for 15-30 seconds, then repeat using the other leg. You can increase this stretch with the rectus femoris by bending the knee more than 90 degrees during the iliopsoas stretch.
Erector Spinae Stretch
A similar gentle stretch is called the erector spinae stretch. In this stretch, you begin by lying in a supine position or an upright fetal position with your knees tucked into your chest and your arms wrapped around your knees. Exhale and stretch while staying balanced on your back. Hold the position for 15 seconds before releasing.
Muscle Strengthening Exercises
The last step is strengthening the muscles and hip flexor with little to no external resistance.
One exercise you can use is called the bridge:
- First, lay flat on your back with your knees bent and your feet flat on the floor.
- Lift your pelvis into the air with your heels a few inches from your buttocks and your arms extended towards your feet. You should form a straight line with the knees, pelvis, and shoulders by keeping your shoulders on the floor.
- Hold the position for a couple of seconds before gently lowering the body. Repeat the exercise 10 to 15 times.
Another useful exercise is called hip extension:
- Start on all fours with your hands directly under your shoulders, your knees under your hips, and your neck in line with your spine.
- Stretch the right arm and left leg, keeping your hand and foot against the ground.
- Once you feel balanced, raise the outstretched right arm and left leg until they are parallel to your back.
- Hold the position for a few seconds and then slowly return to the starting position.
- Again, repeat the exercise 10 to 15 times.
Once you have begun exercising and stretching your tight cross semi-regularly, you should begin integrating movement patterns to help your brain understand how to move the muscles. Follow the exercises your physical therapist advises you to complete to reach the ultimate goal of integration and resolving muscular imbalances.
Dr. Doerr is the Best Chiropractor in New Jersey for Treating the Lower Crossed Syndrome!
At Bergen Chiropractic and Sports Rehabilitation Center, our chiropractic team, under the leadership of Dr. Gregory Doerr, adheres to the highest and most professional medical standards to provide superior chiropractic help. Our mission is to provide unparalleled patient care in a comfortable, healing atmosphere.
Access our contact form or call us at (201) 945-4075 to learn more about our chiropractic care services! Our offices at 532 Anderson Avenue, Cliffside Park, NJ 07010, and 62 Summit Ave, Hackensack, NJ 07601, are ready to welcome you as we proudly serve the areas of New York, New Jersey, Philadelphia, PA, and Baltimore, MD. Also, feel free to access our blog, Facebook, and Instagram pages for more information on chiropractic adjustments!
- “Lower Crossed Syndrome.” Physiopedia, www.physio-pedia.com/Lower_Crossed_Syndrome. Accessed 24 Aug. 2022.
- Miller, Ken. “Lower Crossed Syndrome: Starting from the Center.” NASM, blog.nasm.org/lower-crossed-syndrome. Accessed 24 Aug. 2022.