LOWER CROSSED SYNDROME
If you look at the pics at the top of the page (particularly the kneeling skeleton), you'll notice that the pattern of Lower Crossed Syndrome takes the shape of an "X" --- overly-tight HIP FLEXORS and THORACOLUMBAR MUSCULATURE, with weak BUTTOCKS and ABDOMINAL MUSCLES. What does this do? It creates massive amounts of mechanical stress in the low back that can be clearly seen in these side-by-side TEN SECOND VIDEOS of Adhesed Thoracolumbar Fascia as well as in the DEGENERATIVE CHANGES that follow. It also sets people up for CHRONIC SACROILLIAC PROBLEMS or even issues of the hip rotator cuff (particularly the PIRIFORMIS MUSCLE). Beyond that, it contributes to a weak core (remember that the core is not simply your superficial abdominal muscles). While this is all great to know, the real questions are what does it look like clinically, what caused it in the first place, and what can you do to address it? Let's look at these questions one at a time.
WHAT CAUSES LOWER CROSSED SYNDROME?
- YOU ARE INACTIVE: Unfortunately, in our modern electronic society, this problem is not getting better. As you'll see shortly, not only is activity critical for preventing or reversing Lower Crossed Syndrome, but it needs to be the proper sort of activity. Repeating the wrong sorts of movements over and over again can sometimes be as bad as inactivity. Sort of like repeatedly trying to drive a bent nail --- you straighten it out but every time you hit it, it bends again.
- YOU HAVE BAD POSTURE: While sometimes this is a chicken and egg sort of thing (for instance, some people have genetic predispositions toward things like 'sway back' or horrendously pronated / supinated ankles) mostly it's laziness and lack of effort. I spend a lot of time telling young people that their POOR POSTURE will end up haunting them as they get older. Are they listening? Some do and some don't.
- YOU SIT TOO MUCH: This is not surprising considering the insane amount of research that's come out in the past decades on the detriments of sitting. Sick around and I'll show you some simple remedies for this that you can do throughout the day (for instance, 'The Founder'). Sitting is another reason that EXTENSION THERAPY can be such a huge benefit.
- SPORTS AND TRAINING: I already see the indignation on some people's faces and hear it in their voices. How in the world can sports (lots and lots of activity) cause problems if too little activity is one of the reasons people get Lower Crossed Syndrome? By their very nature, most sports tend to be very repetitive, as are their training regimens. GET INTO A RUT and you essentially spend all your time straightening and re-driving the bent nail I talked about in the first bullet --- over and over and over again. This is why poor technique and imbalanced training (for instance, neglecting core strength or doing THE WRONG KIND of training) bends the nail even further, making it impossible to ever drive it into the board. It may look OK on the surface, but for all intents and purposes, it's not functional.
- OTHERS: There are certainly others so just remember that this list is not exhaustive.
WHAT DOES LOWER CROSSED SYNDROME LOOK LIKE?
WHAT IS THE CLINICAL PRESENTATION OF LOWER CROSSED SYNDROME?
- POOCHED BELLY: While in this day and age it's not uncommon to see a pooched belly because of BELLY FAT, I am not talking about belly fat here. Not that OBESITY can't make this and other issues more difficult to see.
- SWAY BACK (LORDOSIS): This is having the extra amount of front-to-back curvature of the lumbar spine as seen in the lateral / profile view. The September 2011 issue of the European Spine Journal (Sagittal Spino-Pelvic Alignment in Chronic Low Back Pain) said, "Sagittal spino-pelvic alignment was different between patients with chronic low back pain and controls, suggesting the relationship between this specific pattern and the presence of chronic low back pain." Exactly three years to the month prior to that, the journal Spine (Classification of Sagittal Thoraco-Lumbo-Pelvic Alignment of the Adolescent Spine in Standing and its Relationship to Low Back Pain) compared lateral photographs of children to lateral X-rays of adults, concluding that, "Those adolescents classified as having non-neutral postures when compared with those classified as having a neutral posture demonstrated higher odds for all measures of back pain." In other words, POSTURE really is a big deal when it comes to chronic low back pain (or CHRONIC PAIN in general).
- AN ANTERIORLY TILTED PELVIS: With overly tight hip flexors pulling down, and the overly tight low back pulling largely in an upward direction, the pelvis will typically tilt as seen by the curved arrow in the pelvis of the pic above left. Sometimes this will cause hyperextended knees as well, as seen by the second pic from the right.
- LOW BACK PAIN: Just be aware that this problem is so common in our society that Lower Crossed Syndrome is not the only cause here, but one of many potentials.
HOW CAN YOU GO ABOUT SOLVING LOWER CROSSED SYNDROME ON YOUR OWN?
- TREAT LOWER CROSSED SYNDROME AS A SYSTEMIC PROBLEM: Honestly, this is good advice for whatever ails you. If you will treat this problem as though it has a significant INFLAMMATORY COMPONENT (which it very well might), your odds of solving it --- along with any number of OTHER ISSUES as an added bonus --- skyrockets.
- LIFTING WEIGHTS IS AWESOME IF YOU DO IT CORRECTLY: I've been fascinated by big muscles and feats of strength since I was a skinny, ripped, Kansas farm boy. I'm a huge fan of squats, dead lifts (since I don't compete, I prefer a hex or diamond-shaped bar), power cleans, and the like. I must admit, however, that several years ago I fell in love with KETTLEBELL SWINGS. The thing about lifting weights is that if you are going to do it (and I think you should), you need to do it properly and with good form. This is waaaaaay more important than simply worrying about how much weight you are pushing. In the immortal words of David Carradine's Kung Fu character, "Learn balance young grasshopper".
- MAKE SURE YOU ADD FUNCTIONAL STRENGTH TRAINING TO YOUR POWER REGIMEN: As you just saw, I'm a huge fan of lifting weights. While POWERLIFTING is great fun, make sure that you are doing some FUNCTIONAL STRENGTH TRAINING AS WELL. There are so many videos on Functional Strength Training on YouTube I'm not even sure where to start. Another post for another day.
- TAKE CARE OF YOUR CORE: While this sort of goes hand in hand with the previous bullet, I have plenty of information specifically on TAKING CARE OF THE CORE, as well as including some basic stretches / yoga poses in a slide show below. I also included a neat little exercise I have been doing for about five years now called "The Founder".
- REALIZE THAT IT IS POSSIBLE TO HAVE OTHER ABERRANT PATTERNS OF MUSCLE IMBALANCE: If you have crazy high arches like mine, you may very well tend toward tight glutes instead of flabby or weak glutes. The thing to remember about the body is that while you want to be aware of the most common patterns, also realize that it can get messed up in any number of ways for any number of reasons
- STUDY AND LEARN: Back in the dark ages (prior to the internet), finding quality information was tough. Now it's easy. The cool thing is that there are a ton of YouTube Videos and websites full of exercise and stretching protocols. In all honesty, most of it really isn't hard --- it's just a matter of CREATING A PLAN, starting small, and sticking with it. Having been to a number of seminars on Lower Crossed Syndrome (I was just at one a couple months ago), I can tell you that you can't learn it all in a day. Read, watch videos, and learn. It's just one more tool in your box for solving CHRONIC LOW BACK PAIN.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).
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