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Lower Crossed Syndrome


by Dr. Chandler Turnipseed, DC

I frequently see patients that complain of tight hamstrings, hip flexors and low back muscles which they cannot seem to stretch out enough. However, in some cases stretching may not be the right answer. In a condition called Lower Crossed Syndrome, there is a muscle imbalance which pulls the hips into an anterior pelvic tilt and also increases the backwards curve in the low back. As shown above, it looks as if the person is pushing their stomach out and their butt back which tightens the hamstrings up. Also there is often a weakness in the glute and abdominal muscles.

sitting One of the most common causes of Lower Crossed Syndrome is excessive SITTING. After you sit all day at work and sit on your couch at home, your hip flexors begin to shorten up over time. When you stand up they pull your pelvis forward like the picture above. Now your body doesn’t want you looking down because your hips are too tight so it begins to compensate a little higher up the chain. Muscles on the opposite side – the glutes and abdominals – begin to relax and weaken and the issue worsens.

imbalanceImbalance in your workout is another big cause of this condition, for example emphasizing on the hip flexors and low back and ignoring your glutes and abs. I see this mostly when patients avoid a particular exercise or perform an exercise incorrectly. Usually this happens with sit-ups when instead of using your abs to bring your torso up, you use your hip flexors instead. In most cases, this can be avoided by having correct form and balanced programs that work both the front and back of your body.

SFMA ART At our office, we use a series of movements called the Selective Functional Movement Assessment (SFMA) so we can discover where the true imbalance in your body is and develop a better plan for treatment. Initially, we would use Active Release Technique (ART) which helps the muscle function properly by breaking down any scar tissue or adhesions. If there is an increased amount of inflammation or swelling from overuse of the muscles, passive therapies such as Ultrasound and Cold-Laser may be used to help speed up the healing process and decrease the pain and irritation further.

As the muscles begin to recover and relax with treatments, it is important to gradually introduce corrective exercises so the muscle imbalance does not worsen or return. Initially, some exercises could include single and double leg Glute Bridges, X-Band Walks, and Clamshells. Eventually, adding in some heavier conditioning and resistive work like a Romanian Dead-Lift (RDL) will help build the weaker muscles, eliminate any imbalance and keep it from returning.


Written by Dr. Chandler Turnipseed – Johns Creek Chiropractor

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