Lower Cross Syndrome

Last time I addressed the posture pattern Upper Cross Syndrome (UCS). This article will focus on what happens with the lumbo-pelvic region, the lower back and hip area. Let me preface this discussion by saying while these syndromes are talked about independently, there are instances when there can, in fact, be a combination of the two, namely, Layer Syndrome (LS). This occurs with long standing muscle imbalances. But, I will for simplicity sake, stick with LCS so as to not cause confusion.

We have, in each of us, two types of postural muscles, those that are prone to tightness, or HYPER-tonicity and those that are prone to weakness, or inhibition. The following lists are not to bore you with the technical, but hopefully give you a better picture of the tissues involved. The symptom presentations are part of what may be experienced, and not complete. There can be significant overlapping of involved tissues because of fascial connections and pain may just be what you initially notice; there may be issues that one has compensated for that are easily ignored i.e. lower back range of motion decrease with a golf swing leading to eventual shoulder pain. The clinical manifestations or consequences of these muscle imbalances can lead to; painful and or restricted motions, dysfunctional, weak or absent motions, painful, abnormal or absent sensations, as well as swelling in the involved tissues.

UCS AND LCS MUSCLES PRONE TO TIGHTNESS/HYPERTONICITY:

• suboccipitalis (attaches to back of skull)…neck pain and headaches
• sternocleidomastoid (attaches from skull behind ear to the collar bone)…neck pain and stiffness
• scalenes (attach deep to side of neck)…neck and arm pain as well as tingling and numbness
• upper trapezius (attaches to side and back of neck to skull)…neck pain and headache
• levator scapulae (attaches from tip of shoulder blade to neck)…neck and shoulder blade pain
• pectoralis major and minor (chest muscles)…neck, shoulder and mid back pain
• temporalis (sides of skull around ears)…temporo-mandibular joint syndrome
• masseter (cheek muscles)… temporo-mandibular joint syndrome
• biceps (muscle in front of arms)…shoulder and arm pain
• erector spinae (deep muscles in back along spine)…back pain
• quadratus lumborum (between hip and lower rib)…back pain
• hip adductors (inner thigh muscles)…hip and back pain
• iliopsoas (attaches deep abdominally to sides of spine to top of thigh bone)…back pain
• rectus femoris (top center quadriceps muscle in front of thigh)…back pain
• tensor fascia latae (top side of thigh muscle that ties into ilio-tibial band)…hip and knee pain
• hamstrings (muscles in back of thighs)…hip, knee and back pain
• piriformis (muscle deep in buttock)…can spasm, along with surrounding muscles on sciatic nerve
• gastrocnemius and soleus (calf muscles)…knee pain and plantar fascitis

UCS AND LCS MUSCLES PRONE TO WEAKNESS/INHIBITION:

• serratus anterior (along side of ribs to shoulder blade)…shoulder and rib pain
• middle and lower trapezius (mid back from spine to shoulder blade)…mid back and neck pain
• gluteus muscles (hip and buttock area)…lower back and pelvis pain
• abdominals (belly area)…back pain
• rhomboids (between shoulder blade and spine)…mid back pain
• triceps (large muscle behind upper arm..shoulder pain
• deltoids (muscle that drapes over shoulder)…shoulder pain
• tibialis anterior (muscle along outside shin)…shin splints and ankle sprains
• peroneus muscles (muscles along outside lower leg)…ankle sprains and outer knee pain

The lists above name common symptoms associated with the named muscle and are not necessarily complete.
The most common pattern of muscle imbalance that the discoverer of these syndromes, (Vladimir Janda) in this discussion regarding LCS is the combination of tight hip flexors (rectus femoris and iliopsoas) and lower back (erectors), paired with weak abdominals and gluteal muscles. This scenario leads to an excessive lower back arch, a flabby tummy and a flat buttock area. What we do as far as treatment is to determine which muscles are tight and break down the adhesions. Also, the muscles that are weak or inhibited need to be strengthened. Inflammation may be treated by instrument assisted soft tissue mobilization or cold laser. Any spinal issues that may be contributory to pain, burning, tingling, etc. are addressed via manual or instrument adjusting. Ultimately, the goal is to help the individual achieve a better lifestyle, whether to be able to perform activities of daily living, or work, or re-engage in a sport activity.

I hope this has not proved to be too technical an article and that hopefully has, in fact, been helpful in understanding your physical ailment or weakness or sub-par performance at work or in your sport. Please call us at (770) 922-1212 if you have issues in this area.

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