Lower cross syndrome is named for the crossing tightness and weakness that occurs in the lower back, core, and hip muscles. In LCS, tightness of the low back muscles crosses with tightness of the iliopsoas (hip flexors) and rectus femoris (main quad muscle). Weakness of the deep abdominal muscles crosses with weakness of the gluteus maximus and medius.
This pattern of imbalance creates joint dysfunction, particularly in the lumbar spine, pelvis, hips, and knees. Specific postural changes seen in LCS include anterior pelvic tilt, increased lumbar curve, and knee straightening. Stress is increased on the low back and hips due to tight muscles and can cause pain in the low back when running, walking, and standing for long periods of time.
LCS is common in females, individuals that sit for most of the day and individuals that perform repetitive activities such as running and jumping. Many common injuries that plaques the active person can stem from LCS. Treatments for lower cross syndrome consist of postural training, Active Release/Graston on overactive muscles, and rehab exercises for underactive muscles. Additional home treatments for Lower Cross are foam rolling the quad and anterior hip muscles, Nature Made High Potency Magnesium 400 mg – 150 Liquid Softgels
for overactive and sore muscles, and anti-inflammatory nutrition for proper healing. Anti-inflammtory book.
In Lower Cross Syndrome the anterior hip is chronically tight and lacks motion due to muscle overactivity and posture. If one can not move through the anterior hip, the low back has to become hypermobile or have too much motion. This can lead to low back pain and inhibition or weak core muscles.
The anterior hip consists of the large muscle of the quadriceps, Rectus Femoris, and the large hip flexor, Psoas. When these muscles become chronically tight, the anterior hip capsule or ligaments begin to shorten. Now the hip can not translate or move through its proper range of motion and the gluts are put into a weakened, elongated state. The lumbar spine compensates by increasing its curve which causes the core muscles to weaken and shut off.
This process leads to overuse of the low back and pain, glut and core weakness, and hip impingements. If you have hip or low back pain, and/or Lower Cross Syndrome the click here to see this weeks exercises.
Yours in health
Dr. Justin Hildebrand
The low back consist of five lumbar vertebrae and the sacrum or “tail” bone. Between these vertebrae are discs that act as ligaments and allow the spine to be flexible. A disc is a little like a jelly donut, with a softer center encased within a tougher exterior. When the discs become irritate they can begin to migrate posterior or backwards and cause pain. When the disc migrates it can become a bulge or herniation.
Many factors play a role in disc herniation. The most common are flat-back posture (plumber’s crack), prolonged sitting, working in a slumped position, and incorrect lifting/bending posture. All of these factors place increased pressure on the disc and can lead to irritation and possible herniation.
The symptoms of disc irritation or herniation are pain in the low back, buttock or hip (most common) and radiating pain down one leg. Pain is generally worse in the morning and subsides with movement, increases with sitting or driving, and is irritated with changing of position such as sitting to a standing and rolling over in bed.
According to the Mayo Clinic “Conservative treatment… relieves symptoms in nine out of 10 people with a herniated disk. Many people get better in a mo
nth or two with conservative treatment.” Treatments consist of correcting seated posture, adjusting activities of daily living, corrective exercise, and treating dysfunctions with manipulation, Active Release, and anti-inflammatory nutrition.
The classic disc presents with the symptoms: pain in the low back and/or buttocks area that may or may not travel down one leg. The pain is generally in the SI joint or back of the hip. It will increase with sitting or being slumped over.
The disc patient generally has a flat low back and tight posterior muscles. The hamstrings are tight so the patient can not generally bend down and touch their toes easily and the “piriformis” muscles are tight so sitting in a cross legged position is not comfortable. This presentation generally looks as if the back is rounded and the buttocks is clinched while standing.
Most disc presentations state “I just bent over to pick something up and had pain in my back.” Repetitive flexion (bending) or rotation movements set up the low back for injury.
So if you are dealing with disc-like symptoms click here to see rehab exercises.
Yours in health,
Dr. Justin Hildebrand
In this weeks post we are going to discuss the importance of the posterior hip and what the lack of movement in the hips does to the body.
Being able to move through the hips is very important in any athletic movement but also in day to day activities. Every time one goes to sit down, squat, or bend over proper posterior hip movement is crucial and necessary for injury prevention. Without proper posterior hip movement the lower back and knees are put under tremendous stress and have to work much harder than they should.
The posterior hip is made up of primarily six muscles, a fibrous joint capsule and the hip joint. These muscles help rotate the leg and control pelvic stability. When they have to over-work to control the pelvis they become tight and restrict hip motion. Once motion has become restricted, the hip capsule then begins to shrink further limiting motion. Treatment of the posterior hip is a combination of mobilization, soft tissue techniques such as Active Release Techniques and/or Graston, and home rehab exercises.
Individuals that lack posterior hip mobility and have tight hip external rotators commonly have a posture that is termed “Butt Gripper”. This is due to the appearance that one is squeezing the buttocks muscles together and the flattening of the low back.
The “Butt Gripper” appears to not have a well-defined back side and is aware that they are not very flexible, especially in the hamstrings and hips. Their lower back will be very flat if not rounded and may have trouble finding pants that fit or stay up on their waist. This individual may be guilty of showing off his “plumber’s crack” when bending over or stumping down.
“Butt Grippers” appear to have very strong back, hip and core muscles, but they actually have very weak core and glut stabilizing muscles. This posture and weakness places them at higher risk for lumbar disc injuries and low back pain. If you or someone you know is a “Butt Gripper” check out the posterior hip exercises by clicking here.
Yours in health,
Dr. Justin Hildebrand