Lower Crossed Back Syndrome
Due to the sedentary nature of life today, most people have some degree of
contracture or tightening in the front of their hips. This continuous tight area
produces a weak and elongated gluteal (backside) region. A series of further
reactive contractures and inhibitions result in a cascade of muscle imbalances
that lead to the posture typically described as both Lower and Upper Cross
Syndrome.
Lower Cross Syndrome was first described by Czech physician Vladimir
Janda. He noticed that the front of the hip (hip flexor muscles) was very tight
in many of his patients, and that their antagonist muscles (the hip extensors)
were elongated and weak. This was the result of a neurological phenomenon
known as reciprocal inhibition (where activation of one muscle reflexly causes
inhibition of its opposition muscles), and was to play a major role in his future
research and therapy design. Many people suffer from the chronic effects of
Lower Cross syndrome, which can be present in any age group, fitness level
or occupation.
In the diagram to the left, observe how the head is positioned way forward,
with the centre of gravity line significantly behind the ear (rather than straight
through it). This will cause a great deal of activity in the upper back muscles,
which try to maintain neutrality of head position. Observe how the chest is
sunken, which will eventually influence respiratory function. Notice further that
the shoulders will have rolled forward due to tight chest muscles, exposing the
lower back to increased strain. The Pelvis has rolled forward in response to
tight hip flexor muscles, which results in a protruding and weak abdomen as
well as a weakened backside and hamstring region. The front of the thigh is
tight, as are the calf muscles, resulting in knee joint strain; while the shin
muscles are weak with the feet allowed to roll inward (pronation) resulting in
flat footedness and possibly knocked-knees. The colour shaded areas above
right represent typical weak (blue) and opposing hyperactive-contracted (red)
muscle groups, and you will notice how they establish the illustrated "Cross"
syndromes in both the lower and upper back regions. In fact there are several
more possible "Cross" syndromes involving the lower leg, upper neck, jaw
and arm regions, all related to the effects of a sedentary civilisation and the
effects of reflexive inhibition of particular groups of muscles.
Below are some of the common health problems that can arise from chronic
Upper and Lower Cross syndromes:

Trigger Points and fibromyalgia

Ache or burning in the shoulders

pins and needles, or other referred symptoms into the arms and hands

Rotator cuff strains and other shoulder problems

Breathing disturbances including Asthma

Emotional and psychological conditions such as depression

Migraines and tension headaches

digestive disturbances, bowel problems, kidney and menstrual
dysfunction due to circulation failures

Allergies and weak immune function, such as Candida infections etc.
It might seem peculiar to a reader how postural faults might
relate to functions such as immunity and digestion. Bear in mind that the
abdominal organs are not fixed in place but rather move and roll rhythmically
based on the rise and descent of the diaphragm during breathing. This
movement of organs promotes circulation within the body, movement of the
bowel and digestive organs, as well as assisting in the secretion and
distribution of hormones, enzymes, immune cells and other substances.
Similarly, elimination of toxins and excess fluid can be impaired when there is
stasis of organs and internal circulation. If the ribcage is put under mechanical
strain from poor posture, slouching or prolonged sitting, this strain will be
reflected in the function of all organ systems in the body.
As you might imagine, one of the aims of treating such conditions would be to
try and balance some of the opposing muscle groups. In other words, stretch
the "red" muscle groups and strengthen the "blue" muscle groups. However,
as most people exhibit some degree of weakness and contracture in many
muscle groups, it is important to stretch all your muscles for the purpose of
stimulating good sensory and circulatory flow, which is why our exercise
section has activities that will work both extremes. Nevertheless, from a
clinical perspective it is most important to focus on the following activities:
Upper Cross Syndrome

Stretch the pectoral muscles

Stretch the upper back muscles

Strengthen the middle back

Strengthen the rear shoulder muscles
Lower Cross Syndrome

Strengthen the gluteal muscles

Strengthen the abdominal muscles

Strengthen the hamstrings

Stretch the hip flexor muscles

Stretch the quadriceps muscles (front of the thigh

Stretch the calf muscles

Stretch the low back muscles
What Causes Lower Crossed Syndrome?
The culprit is generally a sedentary lifestyle or repetitive hip flexion that keeps the
iliopsoas muscle shortened. It can effect everyone from sedentary 9-5ers to weekend
warriors and professional athletes. Once the iliopsoas is in a chronically shortened
state, compensatory adjustments pass through the kinetic chain causing a bevy of
other muscular imbalances that create pain and joint dysfunction. (In the case of the
client above, it’s probably a combo of sitting at his desk, travel and spinning.)
According to Sherrington’s Law of Reciprocal Innervation, the antagonist to the
iliopsoas, the gluteus maximus, becomes weak. Without the balance of hip flexion
(iliopsoas) and hip extension (gluteus maximus), the pelvis becomes unstable and
pulled anteriorly. In a desperate attempt to keep the spine from tipping forward with
the pelvis, the lumbar erectors and quadratus lumborum work overtime to pull us
upright. This creates the sway back a.k.a hyperlordosis. The chronic hyper-extension
of the lumbar spine creates compensatory weakness in the abdominal group and the
imbalances continue down the kinetic chain; potentially creating pain in the low back,
knees and ankles.
TIGHT/FACILITATED
Iliopsoas
Rectus Femoris
Hamstrings
Lumbar Erectors
Tensor Fascia Latae
Thigh Adductors
Piriformis
Quadratus Lumborum
Tibialis Anterior
Gastrocnemius/Soleus
WEAK/INHIBITED
Transversus Abdominis
Rectus Abdominis
Obliques
Gluteals
Vastus Medialis
Vastus Lateralis