Lower Cross Body Syndrome: Understanding Muscle Imbalance
What is Lower Crossed Syndrome?
“Lower Crossed Body Syndrome” was first described by Vladimir Janda in 1979 as a predictable pattern of alternating tightness and weakness involving core & pelvic musculature. The condition frequently contributes to back pain and is associated with diagnoses throughout the lower body. Muscular balance is required for normal function, and muscular imbalance leads to dysfunctional and inappropriate movement patterns- both locally and globally. This has a direct impact on joint surfaces and often leads to a self-perpetuating cycle of recurrent joint dysfunction. Longstanding postural dysfunction may cause joint degeneration and changes in movement patterns that can result in pain. Lower crossed body syndrome is caused by poor posture that can also negatively affect balance, walking gait, and functional performance.
Lower quadrant muscular dysfunction does not occur at random, but rather, in a predictable pattern of altered posture as the body attempts to reach an equilibrium. The process typically begins when a muscle or muscle group is overused in a certain direction and becomes shorter and tighter (adaptive shortening). The Lower Crossed Syndrome Symptoms, a common manifestation of this phenomenon, can lead to a range of discomforts in the lower back, pelvis, and legs. Muscles opposing this action are subject to prolonged stretch and tend to become longer and weaker, also known as “stretch weakness”. The term “lower crossed body syndrome” was coined because a line drawn to connect the tight muscles forms a cross with a second line drawn between the weak muscles.
What Will Lower Crossed Syndrome Look and Feel Like?
The ideal standing posture, when viewed from the side, is a line passing through the ear, shoulder, hip and ankle, therefore oftentimes visual inspection of a person’s posture can indicate the presence of lower crossed syndrome. Lower crossed body syndrome is usually based around one of two things and is dependent on whether the dominant postural imbalance is from tightness or weakness. Some people demonstrate predominantly tight hip flexors, resulting in excessive hip and knee flexion with a compensatory arching positioning of the low back. Patients with weakness exhibit primarily weak abdominal and gluteal muscles, therefore lacking adequate force to counteract the relatively stronger hip flexors and muscles that run the length of the spine. As a result, Lower Crossed Syndrome Symptoms can be seen, such as synergistic hyperactivity in the hamstrings and piriformis, leading to further weakness. Gluteal weakness typically causes synergistic hyperactivity in the hamstrings and piriformis. Additional sites of hypertonicity commonly include muscles of the low back, hip and calves. Palpation will often demonstrate tenderness or trigger point activity in the previously mentioned muscles as well as the concurrently weak abdominal and gluteal muscles.
How Do We Treat Lower Crossed Syndrome?
Management of lower crossed body syndrome should first attempt to eliminate abnormal tightness in muscles causing joint restriction or abnormal movement patterns. Rehab then progresses sequentially through stretching, strengthening, and finally, facilitation of normal movement patterns. Core stability and hip flexibility exercises have been shown to improve function in low back pain patients.
There is literature to suggest that when one muscle is tight, its antagonist relaxes. This law necessitates that tight muscles must be lengthened before embarking on the process of strength training. Therefore, self-massage and trigger point release will likely be a part of a home program for lower crossed body syndrome in addition to strengthening in order to maximize the treatment effect. Manipulation of Lower Crossed Syndrome Symptoms may be necessary for restrictions in the lumbopelvic joints that don’t respond to manual soft tissue work.
Strengthening exercises will focus on the abdominal and gluteal muscles as well as exercises to improve activation of muscles that have not consistently been functioning normally.
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