Lower Cross Syndrome Treatment for Pain Relief and Better Posture

Lower Cross Syndrome Treatment for Pain Relief and Better Posture

Technology and the outsourcing of manual labor jobs have transformed the way most people work in the USA. Physically demanding jobs in manufacturing and agriculture have been replaced with sedentary tasks performed for long hours in a seated position. Excessive sitting has been cited as a primary cause of obesity, back and neck pain, and lifestyle-induced metabolic disorders.

Lower cross syndrome is a condition of muscle imbalances in the lumbopelvic region. Long hours spent sitting causes some muscles to become weak and lax, while others become stiff and tight. This negatively impacts your joint and spinal alignment along your entire kinetic chain, causing pain, poor posture and dysfunctional movement.

Certain exercises for lower cross syndrome can help to restore balanced muscle tension and dramatically improve posture. You can get lower cross syndrome treatment from a chiropractor or physical therapist who understands the condition.

What is Lower Cross Syndrome?

There is a lot going on in your hip, pelvic and lower back region. Multiple muscles and connective tissues work together to hold your joints in place, while mediating the transfer of force loads between your upper and lower body during physical activity.

Key muscles of the region include:

  • Hip flexors (rectus femoris and psoas)

  • Pelvic floor muscles

  • Hip extensors (hamstrings and gluteus)

  • Low back extensors

  • Abdominals

What is Lower Cross Syndrome?

In addition, the pelvic region houses your reproductive organs and eliminatory system whose proper function relies on good muscle tone and proper pelvic alignment. And let’s not forget the sciatic nerve, the largest nerve in your body that travels from your low back, through the pelvic region and down the length of your legs.

Good postural alignment is key to maintaining a healthy lumbopelvic region, which in turn relies on balanced muscle tension. Regular physical activity, especially walking, helps to keep the muscles and connective tissues of the pelvic region in perfect balance, so that you can enjoy pain-free fluid movement.

Lower cross syndrome is a chronic condition that worsens over time. It occurs when muscles are weakened in the lumbopelvic region and muscle tension becomes imbalanced.

What Causes Lower Cross Syndrome?

Simply put, lower cross syndrome is caused from being sedentary and out of shape. The human body is designed to move, not sit. Before the invention of the chair, ancient peoples rested in a squatting position between physically demanding tasks.

Today, many of us spend all day sitting in front of a computer for work, driving in a seated position from place to place, and unwinding at the end of the day by sitting in front of a screen. Unless offset by regular physical activity, sitting can literally kill you over time.

Lower cross syndrome is marked by:

  • Weak and lax abdominal muscles

  • Overly tight hip flexors

  • Stretched and lax gluteal muscles

  • Tight hamstrings

  • Tight low back extensors

  • Anterior pelvic tilt

  • Exaggerated lumbar curvature (lordosis)

What Causes Lower Cross Syndrome?

The postural changes brought on by lower cross syndrome can also impact:

  • Knees

  • Thoracic spine

  • Neck and shoulder region

  • Reproductive health

  • Digestive health

  • Bowel and bladder function

  • Sexual performance

How to Fix Lower Cross Syndrome

There are a number of things you can do right away to prevent or correct lower cross syndrome and its harmful side effects.

  • Take frequent breaks from sitting

  • Begin a daily walking program

  • Use a standing desk, or work at a bar-height table or countertop

  • Get physically active. Swimming, water aerobics, dancing and other activities that engage the muscles throughout your body help to promote good alignment Resistance training builds strength to hold your joints in alignment

  • Practice diaphragmatic breathing

  • Get help from a chiropractor, physical therapist or personal trainer who understands lower cross syndrome

How to Fix Lower Cross Syndrome

Exercises for Lower Cross Syndrome

Try these exercises throughout the day to offset the negative effects of sitting and restore healthy posture:

Hip flexor stretch

How to Fix Lower Cross Syndrome
  • Stand erect next to a chair or table, using your left hand for balance

  • Grasp the top of your right foot with your right hand and point your knee toward the ground until your hip is straight

  • Inhale deeply, then exhale as you gently pull upward on your foot to increase your hip extension

  • Hold for 15-30 seconds, breathing rhythmically

  • Repeat on the other side

  • Perform several times throughout the day


  • Stand erect, feet shoulder width, with a natural hip rotation (your toes may point slightly outward)

  • Cross your arms in front of you

  • Lift your chest and shift your weight to your heels

  • Inhale as you sit back slowly, keeping your heels in contact with the floor, chest lifted

  • Bring your thighs parallel to the floor

  • Exhale and contract your gluteal muscles as you return to your start position, hips fully extended

  • Repeat 15-25 times

Supine bridges

Supine bridges
  • Lie on your back, knees bent, feet flat, palms on the floor beside your hips

  • Exhale as you press your palms and heels into the floor, lifting your hips toward the ceiling

  • Hold for 3-5 seconds at the top, hips fully extended

  • Inhale as you slowly lower to your start position

  • Perform 15-25 repetitions


  • Lie face down, palms on the floor beneath your shoulders, toes curled under

  • Exhale, engage your core and extend your arms, lifting your entire body to a pushup position

  • Hold at the top with a flat back — do not arch your back or pike your hips

  • Engage your core and hold for 10-15 seconds, breathing rhythmically

  • Return to your start position

  • Repeat 3-5 times

Low back stretch

Low back strech
  • Begin in a quadruped (hands and knees) position, wrists directly under shoulders, knees under hips

  • Inhale and arch your back toward the ceiling like a cat

  • Exhale and sit back on your heels, arms extended in front of you

  • Hold for 15-30 seconds

  • Return to your start position

  • Repeat 3-5 times

Chest and shoulder stretch

Chest and shoulder stretch
  • Stand erect, feet shoulder width

  • Clasp your hands behind your back and lift your chest

  • Exhale and pull your clasped hands away from your body until you feel a stretch in your chest and shoulders

  • Hold for 15-30 seconds

  • Repeat 3-5 times

Lower Cross Syndrome Treatment in NYC

NYDNRehab clinical director Dr. Lev Kalika spent two entire years in Prague under the tutelage of Dr. Vladamir Janda, a pioneer in treating musculoskeletal pain. Janda was the first to identify upper and lower cross syndrome, and he passed a wealth of knowledge on to Dr. Kalika.

If you feel out of alignment from too much sitting, physical therapy and chiropractic care can help to restore optimal posture and eliminate pain. To get the best lower cross syndrome treatment in NYC, contact NYDNRehab today, and get the help you need to get moving again!


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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