& REHAB
LOWER CROSSED SYNDROME
If your client’s buttocks and stomach constantly protrude, they probably have a
postural distortion syndrome that is affecting the lower kinetic chain.
WORDS: MERRIN MARTIN
ower crossed syndrome (LCS) is a postural distortion
syndrome affecting the lower kinetic chain (lumbopelvic
hip complex, knee and ankle). It is characterised by
people demonstrating a lordotic postural stance in which the
buttocks and stomach protrude. Common causes include wearing
high-heeled shoes over a prolonged period of time, pregnancy, or
the classic ‘beer gut’ posture.
Tight hip flexors and lower back muscles characterise this
syndrome, while neurological inhibition (weakness) with constant
stretching of the lower abdominals and gluteal muscles promotes
this easily identifiable posture. Weak, lengthened and inhibited lower
abdominal muscles subject the joints of the lower back to greatly
increased loads and increased risk of facet joint injury.
The imbalance of muscles that occurs in lower crossed syndrome
results in anterior tilt of the pelvis, increased hip flexion and a
compensatory hyperlordosis in the lumbar spine. This imbalance
tends to over-stress both hip joints and leads to complaints such as
lower back pain and sacroiliac joint dysfunction. The functionality of
the gluteal muscles (particularly gluteus maximus) has been linked to
sacroiliac/pelvic joint dysfunction.
The effects of the lower crossed syndrome are exacerbated by
performing exercises involving double leg lifting and lowering. The
increased load on the hip flexors, particularly in individuals with weak
core stabilising muscles, increases the risk of compressing and
loading of lumbar spine facet joints (photo 1).
L
Table 1: Features of lower crossed syndrome
Anteriorly
Tight
Weak
iliopsoas
adductor group
rectus femoris
obliques
TFL ( ѕ