Lower Cross Syndrome
A common imbalance that occurs in a high percentage of the population is lower cross syndrome. The imbalance can develop due to maintaining a seated position for long periods of time, whether career or lifestyle choices are at play, or from training imbalances.
Vladamir Janda was first to note the term in 1979. (About Dr. Janda 2010) Lower cross syndrome refers to tightness in the thoracolumbar extensors which then crosses with tightness of the iliopsoas and rectus femoris. Weakness of the deep abdominal muscles cross with weakness of the gluteus maximus and medius. This pattern of imbalance creates joint dysfunction, particularly at L4-L5 and L5-S1 segments, SI joint and hip. The most noted postural changes seen in lower cross syndrome include an anterior pelvic tilt, increased lumbar lordosis, lateral leg rotation and knee hyperextension. (Frank, Lardner & Page 2010)
Hip flexors with poor length and tension are known to create reciprocal inhibition of the gluteals. Basically what this means is, the neural pathways for the gluteals may become compromised due to tension in the lumbar region. Gluteal inhibition then follows and can have numerous consequences throughout the lower extremities.
The biggest flaw I see in training and injury rehabilitation is individuals that display imbalances related to lower cross syndrome, fail to address the length imbalances and lead their strength training with muscle groups already in a shortened position.
To address the imbalances associated with lower cross syndrome, firstly address the length imbalances of the iliopsoas and rectus femoris or the hip flexor group in general. Address the length of the thoracolumbar extensors, both I suggest to do before training. You’ll find a great stretch for the hip flexors in a previous article Awaken Your Glutes.
Secondly increase the strength of the deep abdominal muscles. I mentioned in a previous article Abs in Time for Summer, a phenomenal abdominal program by Ian King that is ideal to use for rehabilitation, injury prevention and performance. Find it, implement it. By addressing the length imbalances of the hip flexors and addressing the weakness of the abdominals, you’ll then decrease tension in the thoracolumbar extensors which will allow the gluteals to fire optimally. Maintaining above average length, tension and joint stability of this area is crucial for this very reason.
Lastly, address the weakness in the gluteals using hip extension exercises. Again, refer to the previous article Awaken Your Glutes. Three key exercises which I include are hip thigh extensions, quadruped hip extensions and side lying abduction. These 3 variations target different areas of the gluteals and are great for increasing strength.
Note, these are very basic steps in correcting lower cross syndrome. Ideally you would want to take into account current lifestyle influences or lines of movement imbalances within your training and reverse the cause.
The key is to treat the cause rather than the symptom.
Jandaapproach . 2010. About Dr. Janda . [ONLINE] Available at: http://www.jandaapproach.com/about/. [Accessed 28 December 15].
Frank, Lardner, Page, CF, RL, PP, 2010. Assessment and Treatment of Muscle Imbalance The Janda Approach . 1st ed. United States of America : Benchmark Physical Therapy Inc.
Written by – Dan Marshall