Lower Cross Syndrome

Written by Dr. Jason Ngan, DC

What is Lower Cross Syndrome?

Lower cross syndrome (LCS) is a condition where the muscles in the lower back and legs are imbalanced. If untreated, LCS can lead to osteoarthritis (wear-and-tear on the joints), low back pain, knee pain, sciatica, facet syndrome, and even lumbar disc issues.

What Causes Lower Cross Syndrome?

LCS is caused by an imbalance of the lower back and leg muscles. Poor posture of the lower back and legs over-stress certain muscles while the opposing muscles are under-stressed and weakened.

  • Muscles that are over-stressed(tight, hyperactive) include iliopsoas, rectus femoris, TFL, adductor, erector spinae, gastrocnemius, and soleus.

  • Muscles that are under-stressed (weak) include rectus abdominus, obliques, gluteus maximus/medius, and hamstrings.

Some common activities that cause LCS include:

  • Sedentary lifestyle (no exercise)

  • Prolonged sitting

  • Poor posture

These activities causes the abdominal and buttock muscles to weaken since they are not being used. The opposing muscles of the lower back and hip flexors will tightened from overuse.

What are the Signs and Symptoms?

  • Anterior pelvic tilt: pelvis rotated forward, buttocks sticks out, and causes lumbar spine to arch more (hyperlordosis).

  • Low back pain.

  • Knee pain.

  • Hamstring strains.

  • Pain, numbness, tingling down the legs.

How is Lower Cross Syndrome Diagnosed?

LCS is diagnosed with a thorough medical history, physical examination, and orthopedic testing.

  • Muscle tightness

  • Trigger points (muscle knots)

  • Pain, numbness, tingling, weakness if it compresses on the nerves

  • Decreased range of motion due to tight muscles

What are the Treatment Options?

Patients with lower cross syndrome find that chiropractic care helps a lot.

  • Chiropractic manipulation and mobilization

  • Flexion-distraction

  • Spinal traction

  • Soft tissue therapies

  • Gua-sha

  • Cupping

  • E-stim

  • Ultrasound

  • Ergonomic/postural counseling

  • Rehabilitative exercises and stretches

Other treatments that patients may seek (not provided at Ngan Chiropractic) include acupuncture, and pain relief medication.

References

  1. Das S, Sarkar B, Sharma R, Mondal M, Kumar P, Sahay P. Prevalence of lower crossed syndrome in young adults: A cross sectional study. Int. J. Adv. Res.2017 Jun;5(6):2217-2228

  2. Kale SS, Gijare S. Prevalence of lower crossed syndrome in school going children of age 11 to 15 years. IJPOT 2019 Apr-Jun; 13(2): 176-179

  3. Key J. The Pelvic Crossed Syndromes: A reflection of imbalanced function in the myofascial envelope; a further exploration of Janda’s work. Edgecliff Physiotheraphy Sports and Spinal Centre, 2010; Pp. 299-301.

  4. Page P., Frank C., Lardner R. Assessment and Treatment of Muscle Imbalance: The Janda Approach. Human Kinetics, 2010; Pp. 94-97.