Lower Crossed Syndrome and sedentary lifestyle

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We discussed a similar condition in previous blog article, Upper Crossed Syndrome. In this session, we look at Lower Crossed Syndrome.


Lower Crossed Syndrome is also known as Pelvic Crossed Syndrome, Distal Crossed Syndrome, or ‘Unterkreuz Syndrome’. It is the result of postural imbalances that involve lower back, pelvis, and hip joints, usually with prolonged sitting or standing (sedentary) together with poor posture.


Causes of Lower Crossed Syndrome

Lower crossed syndrome occurs when you are inactive in a sitting or standing position with a relax and slouching posture. This posture creates tightness in hips and lower back muscles and weakness in buttock and abdominal muscles. The postural imbalance can lead to unnecessary strain on lower back muscles, hips, and joints. Over time, it can decrease load tolerance and cause disabilities.

The common causes include:
  • Incorrect posture or lack of ergonomic awareness.
  • Improper training on muscle groups.
  • Stresses on one side of the body.
  • High tension in the lumber area.
  • Poor physical condition.
The sitting anatomy of Lower Crossed Syndrome

Postures and Symptoms

2 common observations on your posture would be:

  1. Forward rotation of pelvic (anterior pelvic tilt)
    Your pelvic tilts forward when the abdominal muscles are weak and upper body weight is pressing on your lower body. It usually causes chronic lower back pain and muscle spasms.
  2. Backward curve of lumbar spine
    Together with anterior pelvic tilt, your lumbar will curve inward excessively. This can lead to severe lower back pain.
Negative impacts of Lower Crossed Syndrome

Because of the imbalance of muscles, you may experience the following symptoms:

  1. Feeling pain at lower back, buttock muscles, hip, groin, and pelvic joints.
  2. Reduced mobility of the hips, pelvis, and lower back region.
  3. Tightness and discomfort with hip movements.
  4. Externally rotated hip bones.
  5. Protruding tummy.

How to Prevent Lower Crossed Syndrome?

Similar to Upper Crossed Syndrome, there are several preventive measures to reduce your risk of developing Lower Crossed Syndrome.


  • Be mindful of your lower body posture whenever you walk, eat, sit, stand, rest, and sleep.
  • Avoid sedentary lifestyle, especially keeping your position in a poor posture for long hours. Take breaks in between the activities.
  • Use ergonomic chair with adjustable lumbar support.
  • Stretch your body and lower back and improve blood circulation.
  • Do cardiovascular exercise for 30 minutes a day at your comfort level.
  • Do core training such as planking, squats, hip raise to strengthen the muscles in the abdominal, lower back, buttocks, and hamstrings.
  • Engage in exercises such as Yoga, Pilates, Tai Chi, swimming, jogging to loosen the tight muscles and strengthen the weak muscles.

Treatments for Lower Crossed Syndrome

As Lower Crossed Syndrome is a neuromuscular dysfunction, chiropractor manipulation is a preferred choice for the alignment of dysfunctional joints.


To fully regain the normal range of motion, you would probably need to seek treatment from a physiotherapist. The treatment for Lower Crossed Syndrome involves a 2-stage treatment:

  • First stage, to loosen the tight hip flexors and lumbar erector spinae muscles. 
  • Second stage, to strengthen the abdominal and gluteal muscles.

It is important to note that you must loosen the tight muscles first before engaging any strengthening exercises. Otherwise, you will be more likely to exacerbate the injury at your lower back.


To prevent further injury to your lower back and help you maintain the correct posture, the physiotherapist may advise you to wear lumbar support brace especially when your daily activities require you to carry loads or remain in a prolonged and fixed position.



You should always be mindful of your lower body posture. Lifting of heavy objects in wrong ergonomic position, a jerking movement, and exercising without warming up can strain your back muscles and weaken the spinal ligaments. Constant strain and injury on your back along with poor posture can cause muscle spasms and develop into chronic back injury. 


You may not feel too much of the impact when you are still young and active. As you age, your recovery mechanism slows down, muscles and bones get weaker, any injury or poor posture can take months or years to recover.

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