The body pattern of lower crossed syndrome
Students rarely arrive at yoga class perfectly balanced in their body. In fact I’d say that I’ve never met anyone perfectly balanced in their body. We all have patterns. We inherit genetics that make certain patterns more likely and we acquire our unique set of patterns through our habits, activities, sports, work, injuries, and accidents. There are also patterns common to many of us simply because we live and work in similar ways. One of the patterns common to westerners that you might see showing up in yoga students is called lower crossed syndrome. In this article we’ll take a look at what constitutes that pattern, where it might come from, and how to work with it.
What are the “crossed syndromes”?
The “crossed syndromes” are patterns in the body that were originally described by a doctor named Vladimir Janda in 1979. The crossed syndromes describe situations of muscle activity imbalance. Certain sets of muscles are tight and short. Other muscles, often antagonists to the tight, short muscles, are weak and long. The arrangement of the sets of tight, short muscles with the weak, long muscles can be seen visually as a cross pattern in the body around a major joint. Janda primarily described two crossed syndromes, an upper crossed syndrome around the thorax and shoulder girdle, and a lower, or pelvic crossed syndrome, around the pelvis. These patterns of muscular activity imbalance can create dysfunction of individual joints and dysfunction in movement as a whole.
What is lower crossed syndrome?
Lower crossed syndrome, also called pelvic crossed syndrome, was initially described by Janda as a potential source of back pain. Although there is some variability in how this pattern expresses in different bodies, the compensations that occur as a result of these patterns of muscular imbalance can influence tension around the low back, among other effects.
Specifically, the short, tight muscles in lower crossed syndrome usually include some or all of the following:
- Rectus femoris
- Erector spinae
- Tensor fascia latae
- Quadratus lumborum
The long, weak muscles in lower crossed syndrome usually include some or all of the following:
- Rectus abdominis
- Transverse abdominis
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- Vastus lateralis
- Vastus medialis
- Tibialis anterior
- Tibialis posterior
- Fibularis longus
Compensations and patterns in lower crossed syndrome
Depending on exactly which sets of muscles are short and tight and which muscles are long and weak, lower crossed syndrome can create different visual expressions in the body. There are considered to be two main “types” or ways that lower crossed syndrome is expressed, but there is certainly variability within and among these two general types.
1) In type A, or posterior pelvic crossed syndrome, the common aspects of the pattern include:
- Hip flexors are short
- Anterior pelvic tilt
- Knees and hips are slightly flexed at rest
- Extensors of the thoracic spine are over-active
- Hyperlordosis of the lumbar spine
- Hyperkyphosis of the area where the spine transitions from lumbar to thoracic
2) In type B, or anterior pelvic crossed syndrome, the common aspects of the pattern include:
- Abdominal muscles are short and weak
- Hypolordosis of the lumbar spine
- Hyperkyphosis of the thoracic spine
- Forward head posture
- Knees are hyperextended at rest
Why might someone acquire lower crossed syndrome?
So how might someone acquire lower crossed syndrome? Sitting, sitting, and more sitting is one big reason. Typical western habits include lots of sitting, at a desk, in the car, on the couch, etc. Other activities, like repetitive motions or posture for work, or in specific sports, can contribute to this pattern as well. When we ask our body to hold a particular shape for hours of the day, it becomes harder for it to let that shape go when we’re not trying to hold it. Tensional patterns can form, with some muscles being held in a chronically shortened state, and their antagonists (opposites) in an active, but lengthened state because they are constantly resisting being pulled too far. When we sit for long hours of the day, we’re shortening the hip flexors, which can lead to an anteriorly tilted pelvic pattern. Other muscles above or below then need to compensate for this change in the body.
What dysfunctions can be associated with lower crossed syndrome?
Lower crossed syndrome can affect the function of all the joints it crosses and it can contribute to dysfunction either up or down the kinetic chain of movement. It can affect function at the sacroiliac (SI) joint, L4-L5, L5-S1, and the hip joints, which the pattern crosses. It can also be related to low back pain, contribute to iliotibial band syndrome, knee pain, even ankle dysfunction, and plantar fasciitis.
What to do if you think you have lower crossed syndrome?
First, see a physical therapist or bodyworker to confirm that the pattern you’re experiencing really is lower crossed syndrome. Then, start by identifying the activities that might be contributing to this pattern in your life. Especially take a look at all the time you spend sitting: sitting at home, sitting at work, sitting in the car, etc. Consider whether you can reduce the time spent sitting and potentially change how you sit. A physical therapist or qualified bodyworker can help you identify specifically how to change habits to have the most impact on your particular pattern.
Also consider other repetitive actions or postures at work, repetitive actions in sports, or other leisure activities. Are any of these activities contributing to the pattern of lower crossed syndrome? Once you’ve identified habits and activities that you might want to modify to reduce the time spent reinforcing the pattern of lower crossed syndrome, get some help from a bodyworker to start unwinding the pattern. A bodyworker can help you release trigger points, lengthen the shortened muscles, and then give you suggestions for rehabilitating movement patterns to teach previously long and weak muscles to fire actively again.
How might we work with lower crossed syndrome in yoga?
Yoga can help rebalance the body by lengthening shortened areas and reeducating previously long, weak areas to activate again. When working with lower crossed syndrome in yoga, I would particularly emphasize lengthening the hip flexors and hamstrings to rebalance the tension around the pelvis in the forward – backward direction.
Once these muscles are lengthened, yoga can help reeducate previously long muscles to activate, stabilize, and support again. Notice I didn’t say strengthen. Activating a muscle is not the same thing as strengthening, at least not in the way that word is usually used. If we just add more strength, meaning more short, tight muscles, on top of a pattern where there is already an imbalance, we are just adding more complexity to the overall imbalance. Lengthen short muscles first. Then use functional movement activities like yoga to help reeducate previously long muscles to actively support a range of movement in the body.