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Straighten Your Back: Correct Lower Crossed Syndrome

    What is Lower Crossed Syndrome?

    Lower crossed syndrome (LCS) is a muscular imbalance syndrome that is characterized by an excessive low back arch and a forward tilted pelvis. In most cases, it is caused by a sedentary lifestyle. When you think about sitting for prolonged periods of time, certain muscles, such as your hips flexors, are in a shortened position while your other muscles, such as your glutes and hamstrings, are in a lengthened position. Over time, these shortened muscles become tight and overactive. At the same time, the lengthened muscles grow weaker and underactive. As a result, the tightened muscles tilt the pelvis forward and the weaker muscles are unable to counteract the overactive muscles, leading to an excessive arch in the lower back. 

    In comparison to other postural dysfunctions, such as a rounded upper back or forward head displacement, the excessive low back arch can be easier to overlook. Maybe since the back already has a natural arch, we tend to overlook an even greater arch. Nonetheless, an excessive low back arch can put undue stress on your muscles that support the spine, and can lead to pain in the lower back, hips, and knees.  Not to mention, it can also lead to more injuries or problems down the road such as increased risk of injury, reduced mobility, and chronic pain.

    Exercise Correction Plan

    While pain management strategies are a temporary way to find relief, you need to address the underlying muscular issue to combat poor posture. To rebalance the muscular imbalances that leads to lower crossed syndrome, here is a gist of your correction plan:

    1. Foam rolls the tight muscles. The main target muscles are hip flexors, latissimus dorsi, and erector spinae (group of muscles in the back). 

    2. Static stretch the tight muscles (same muscles as above).

    3. Strengthen the lengthened muscles. The prime target muscles are glutes, medial hamstrings, and abdominals.

    Alright, let’s get into detail for each of the above points.

    Foam roll the tight muscles

    Foam rolling is an effective form of self-myofascial release. When you roll across the tight muscles, it applies compression to the underlying connective tissue and muscles. This compression helps break up any adhesions or knots in the muscle, and restores mobility to the tissue overtime. Ultimately, we are trying to inhibit the overactive, tightened muscles to increase flexibility and aid the activation of the opposing muscle.

    Remember to go slowly; it helps to hold pressure when you come across a particularly tight area. In all honesty, foam rolling may hurt a little. It should be the “good pain” though – much like the discomfort associated with stretching stiff muscle, not sharp, sudden pain.

    Foam roll each area for 30 seconds, three times through:

    • Hip Flexors: place the foam roller on the ground, lay on top of the roller so that it is under the top of your hip and the front of the body parallel to the floor. If you start with the left side of the hip, move slowly from top of left hip to left quadricep, and keep rolling back and forth. Then repeat on the right side.
    • Latissimus Dorsi: With the foam roller on the ground, start with one side of the body. Lay sideways on top of the roll with your arms extended above your head so that the roller is under your armpit. You can either extend or bend your legs, whichever feels more comfortable. Use your legs and non-rolling arm for support and to move back and forth. Repeat on the other side.
    • Erector Spinae: Place your back to the roller, with your arms folded behind your head. Move up and down from mid to low back.

    Static Stretch the tight muscles

    Static stretching after foam rolling is more efficient as its easier to achieve a greater range of motion. The purpose of stretching is to lengthen the tight muscles and increase flexibility. There are many great stretches when it comes to targeting a specific muscle; I have listed five options for each muscle/muscle group below. You don’t necessarily have to do all the suggested stretches below. Pick one or two stretches for each muscle and hold for 60 seconds:

    • Hip Flexors: Kneeling hip flexor stretch, static lunge hold, butterfly, side-lying hip flexor stretch, and pigeon pose.
    • Latissimus Dorsi: Kneeling lat stretch, wall lat stretch, standing lateral stretch, extended child’s pose, and elbow pull stretch.
    • Erector Spinae: Standing forward fold, seated forward bend, knees to chest hold, kneeling back rotation, and cat pose.

    Strengthen the lengthened muscles

    Lower crossed syndrome can involve many weak, lengthened muscles. Predominately the underactive muscles are glute muscles (mainly the gluteus maximus and gluteus medius), medial hamstrings, and abdominal muscles. Just as stretching the overactive muscles is important, its equally important to strengthen the underactive muscles in order to rebalance the muscles around the pelvis and back.

    Most of the recommended exercises below can be categorized as lower body pull exercises – which are more hip focused, and particularly target the glutes and hamstrings. This doesn’t mean you should exclude lower body push exercises, which are quad focused; it just means that you should include more lower body pull exercises than lower body push exercises. A good rule of thumb is to do two lower body pull exercises for every one lower body push exercise.

    • Glute Muscles: lateral band walks, reverse lunges, fire hydrants, romanian deadlifts, bent knee kickback.
    • Medial Hamstrings: deadlifts, bridges, hamstring curl, pilates double leg, pilates hamstring curl.
    • Abdominals: Toe touches, crunches, plank knee-to-nose, bicycle crunches, and bird dog.

    Prevention & Pain Management 

    Prevention is better than cure. To prevent excessive low back arching and lower crossed syndrome, it’s essential to maintain good postural alignment and strengthen the core. You should also be mindful of activities that involve excessive sitting, which can weaken the core muscles and cause low back pain. If sitting is necessary, make sure to get up and move around every hour. Incorporating a regular stretching and strengthening routine, as outlined above, can help prevent lower crossed syndrome from occurring in the first place. 

    If you already have an excessive lower back arch, put the above exercises into practice. In conjunction with the exercises, consider pain management strategies such as warm compressions,  TENS devices, and ice packs to manage pain. With that being said, exercise is still the best solution and should not be replaced with passive pain management strategies. I encourage you to seek out professional advice. While lower crossed syndrome is a common problem, it is treatable with the right approach!