Lower Cross Syndrome

Office worker suffering from back pain due to lower cross syndrome

Joint movement is achieved by muscle contraction. However, what happens when this well-orchestrated biomechanical machine lacks synchronisation? The answer? Lower cross syndrome.

What Is Lower Cross Syndrome?

Lower cross syndrome describes an imbalance of muscles that can occur in the lower back, legs and pelvis. Common presentations include lower back pain, SIJ pain, leg length differences, hip pain and muscular strains.

How Does This Relate to Lower Back Pain?

Around your hips and pelvis, there are many different pulley systems. Muscle groups including hip flexors (top and front of the hip), hip extensors (glutes and hamstrings), back extensors, quadriceps (front of the thigh), abdominal muscles, inner thigh muscles (adductors) and outer thigh muscles (abductors).   

The main ones we focus on in lower cross syndrome are the abdominals, glutes, back extensors and quadriceps/hip flexors.  

When we overwork one group of muscles, they will respond by shortening to protect themselves. The opposing pulley muscles will stretch and compensate. However, over time without enough strength or endurance, the opposing muscles can tighten which can result in a restricted range of motion, joint dysfunction and pain. The body will try to compensate for this, however, if the muscle imbalance not addressed in a timely manner, there is a risk of injury (Laker, Putukian, Saint-Phard, & Meron, 2018). 

An example of this would be tight hip flexor muscles. A complaint commonly seen in desk workers is lower back pain, this can be due to the hip flexors working during prolonged sitting. Without adequate hip extensor strength to offset the pull of the hip flexors, this can place more stress on the joints and muscles surrounding the lower back and can increase the risk of muscle strains.

What Can We Do?

Through assessment, your practitioner can test each of these muscle groups and may help explain to you why your lower back is sore. Our practitioners are able to diagnose a range of conditions and will also be able to rule in or out other common conditions that may be present and create a personalised treatment plan to manage your presentation. Through hands-on manual therapy and rehab, we can address joint and muscle compensations which can assist the body’s ability to heal.

If you are experiencing pain or discomfort, contact us today and begin your road to recovery.


Laker, S. R., Putukian, M., Saint-Phard, D., & Meron, A. J. (2018). Track and Field. In C. C. Madden, M. Putukian, E. C. McCarty, & C. C. Young (Eds.), Netter's Sports Medicine (2nd ed., pp. 700-712). Saunders Elsevier. 

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