Frequently Asked Questions About Lower Crossed Syndrome

What is Lower Crossed Syndrome (LCS)?

Lower Crossed Syndrome is a muscular imbalance mainly affecting the lower back and pelvic region. In this pattern, some muscles become tight and shortened (tonic), while others become weak and lengthened (phasic). This can cause lower back or hip pain, poor posture (like a protruding belly and arched back), and difficulty moving, walking, or maintaining an upright posture. It was described by Czech physician Vladimir Janda, who proposed a functional model based on muscle imbalances between opposing groups.

Why does Lower Crossed Syndrome occur?

The human body has two main muscle types based on function. Tonic or postural muscles are always active to keep us upright; they tend to shorten or tighten due to overuse or lack of stretching, often becoming overactive and causing joint restrictions or pain. Examples in LCS include the iliopsoas and lumbar erector spinae. Phasic muscles activate to generate force and movement and tend to weaken with disuse, pain, or immobilization, leading to loss of motor control and stability. Examples are the gluteals and deep abdominals (transverse abdominis). In LCS, tonic muscles are tight and shortened while phasic muscles are weak and lengthened.

What changes occur in the body with LCS?

There is an increase in lumbar lordosis (excessive curvature of the lower back) and pelvic anterior tilt (forward pelvic tilt). These biomechanical changes cause abnormal muscle pulling, postural imbalance, lower back pain, stiffness, and loss of efficient motor control. Tight muscles pull on bones, while weak muscles fail to stabilize the pelvis and spine properly.

What symptoms can Lower Crossed Syndrome cause?

Lower back or hip pain, posture with a protruding abdomen and arched back, sensation of weakness or disconnection in glutes and abdominals, fatigue when standing or walking, and muscle stiffness in hips or lower back.

How to know if you have Lower Crossed Syndrome?

Common signs include recurrent lower back pain or pelvic stiffness, difficulty maintaining good posture, weakness activating glutes or abdominals, visible hyperlordosis in side profile, and inefficient or compensated gait. Professional assessment may include postural observation, flexibility tests like the Thomas test, glute and abdominal strength tests, gait analysis, and pelvic mobility evaluation.

What subtypes of LCS exist?

• Subtype A: classic and static pattern with increased lumbar curvature and marked pelvic tilt. Common in sedentary people with abdominal weakness.
• Subtype B: more complex compensations in different planes, greater disorganization of global motor control, possibly associated with cervical or dorsal alterations, part of the Upper Crossed Syndrome.

Which muscles are affected in LCS?

Tonic muscles affected (tight and shortened) include the iliopsoas, lumbar erectors, and sometimes hamstrings. Phasic muscles affected (weak and inhibited) include the gluteus maximus and medius, and deep abdominals like the transverse abdominis.

What long-term consequences can LCS have?

It can cause chronic lower back pain, degeneration of intervertebral discs and facet joints, pelvic instability with risk of knee or hip injuries, difficulties in functional activities like walking, running or bending, risk of hernias or visceral dysfunctions due to altered intra-abdominal pressure, and central sensitization processes that perpetuate pain.

How is Lower Crossed Syndrome treated?

Treatment should be individualized and comprehensive, based on three pillars: stretching tight muscles (iliopsoas, erectors, hamstrings), strengthening inhibited muscles (glutes and deep abdominals), and postural re-education. Also includes diaphragmatic breathing, ergonomic changes, and functional training.

What easy exercises can I start with?

• Iliopsoas stretch: take a big step forward, lower the back knee to the floor, feel the stretch in the front of the hip, hold for 30 seconds, switch legs.
• Glute bridge: lie on your back with knees bent, lift hips squeezing glutes, hold for 5 seconds, lower slowly, repeat 10 times.
• Deep abdominal contraction: lie on your back with knees bent, pull your belly button towards the spine without holding your breath, hold for 10 seconds, repeat 10 times.

What daily tips help control LCS?

Get up and move every 30-40 minutes if sitting, use a chair with good lumbar support, avoid high heels or unsupportive footwear, maintain regular physical activity like walking or swimming, and consult a physical therapist for a personalized program.

What advanced techniques complement treatment?

Manual therapy to release myofascial restrictions, neuromuscular exercises to restore motor control, functional training to improve force transfer in daily life, diaphragmatic breathing to stabilize the core, and in complex cases, biofeedback and neuroplasticity techniques.

Why is understanding tonic and phasic muscles important in LCS?

This classification helps identify which muscles to stretch and which to strengthen, guides therapeutic intervention, and explains the logic behind altered postural patterns. It’s essential for establishing correct and lasting treatment.

What role does diaphragmatic breathing play in LCS treatment?

It helps optimize core stability by increasing intra-abdominal pressure in a controlled way, improves the functional support of the spine and pelvis, and reduces lumbar tension.

What is the key to successful LCS treatment?

Accurate diagnosis, personalized intervention, a combination of stretching and strengthening exercises, postural education, improving functional patterns, and continuous follow-up. The goal is to restore muscle balance and prevent relapses long-term.

Make an appointment with Dr. Jordi Jiménez. He will see you in the center of Palma de Mallorca and help you regain your quality of life.