Lower crossed syndrome

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26 Jul 2016 - General

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Lower Cross Syndrome


Most of us are glued in our chairs for hours during consultation period. Prolonged sitting is a problem because it creates muscular imbalances. Imbalance between the core and lower extremity muscles is often referred to as the lower cross syndrome.

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What is lower cross syndrome?


The trunk, thigh, and gluteal muscles all work together to maintain the natural lumbar lordotic curve and neutral pelvic orientation. When sitting down becomes a habit for a lengthy period daily, disharmony between muscle contractions occurs.

The hip flexors and back extensors are fixed in a shortened state for an extended period; consequently, it results in muscle tightness. The gluteal and abdominal muscles are inhibited from activity. Thus, these muscles turn weak. This results in a faulty posture that tilts the pelvis anteriorly. Anterior pelvic tilt exaggerates lumbar lordosis (think of a pregnant woman’s posture) that causes excessive shear forces on the low back muscles and vertebrae with resulting back pain.

The Fix for lower cross syndrome

Stretching of tight and strengthening of weak muscles is the key to correct muscle imbalances. The section below will guide you in correcting lower cross syndrome. As a general rule, always stretch before strengthening in case of lower cross syndrome to improve range of motion.


Pain is not a component of stretching. A stretch is felt as a non-painful tension of the muscle. Hold each stretch for at least 30 seconds to get the benefits of improved range of motion.

Hip flexor stretching

The hip flexors run from the lumbar vertebrae down to the proximal femur. Stretching this group will promote a better posture, as it is commonly tight in most individuals.

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1.     Take a huge step with right foot while standing. This puts you in a staggered position with the right leg forward and the left leg backward. Both feet must point in the same direction. Keep your torso straight at all times.

2.     Bend the right knee until it is over the right foot and place your hands over the right thigh.

3.     The back foot’s heel may or may not come in contact with the floor.

4.     Slowly lower your hips forward and downward until you feel a stretch. This stretches the left hip flexor.

5.     Hold this for 30 seconds and switch with other foot.



Iliotibial band stretching

The iliotibial band (ITB) originates from the gluteus muscles and tensor fascia lata and runs along the lateral thigh. It is imperative to stretch this muscle to improve hip flexibility.

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1.     Cross over your right foot over your left foot while standing.

2.     Slowly bend at your hips by pretending to close a door behind you using your gluteal muscles and reach for your toes. The arch of the lower back is maintained if you do it right. Rounding of the back means you are not bending at your hips and beyond your range of motion.

3.     You should feel a stretch over the lateral aspect of the left thigh. This stretches your left ITB. Hold the stretch for 30 seconds.

4.     Switch foot and repeat.


Hamstring stretching

Hamstring muscles are bi-articular meaning they cross two joints, namely the hip and knee joints. Bi-articular muscles are prone to tightness due to the pull of two joints they cover. Hamstring muscles also influence tilting of the pelvis. Hence, stretching of this muscle group is vital.

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1.     Assume a long sitting position. Bend your left knee so that the sole of your left foot presses against the inner aspect of the right knee.

2.     Slowly reach for the toes of your right foot by bending at the waist. Keep your back straight while doing so.  This stretches the right hamstring.

3.     Maintain the stretch for 30 seconds. Repeat with other leg.


Low back stretching

The low back muscles become inflexible due to countless hours of sitting. Keeping the back muscles limber maintains the natural curve of the lumbar spine.

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1.     Assume a long sitting position. Bend your knees at a 30 to 50 degree ankle with knees pointing out and feet about hip width apart.

2.     Slowly reach for your toes by bending at the waist. Keep your back straight while doing so.

3.     Maintain the stretch for 30 seconds.



Core and gluteal muscle strengthening maintain the lumbar lordotic curve and pelvis orientation, respectively. Perform the set of exercises without holding your breath. This can be done daily to maintain proper posture.



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1.     Lie prone in a yoga or cushioned mat. Prop yourself using your forearms and forefoot to support the body. The elbows should be directly under the shoulders.

2.     Brace your gut as if you were to be punched in the abdomen without rounding your back. Hold this position for 10 seconds while breathing normally.

3.     Work your way up to a minute of plank exercise. Do 3 sets.


Side Plank


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1.     Lie in a left side-lying position in a cushioned mat with the body forming a straight line (i.e. as if you were standing tall.). Prop yourself using the left forearm and lateral aspect of left foot to support the body.

2.     Keep the left hip elevated with the body maintaining a straight line for at least 10 seconds. This strengthens the left oblique muscle group.

3.     Work your way up to a full minute. Switch sides and repeat. Do 3 sets.



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1.     Lie supine in a cushioned mat with arms prone at your side. Bend your knees at 90 degrees with feet hip-width apart.

2.     Raise your hips off the floor using your gluteal muscles. The shoulders, hips, and knees must form a straight line.

3.     Maintain this position for 10 seconds without holding your breath. This strengthens the gluteal muscles.

4.     Work your way up to a minute of bridge exercise. Do 3 sets.