Cross Syndrome-A possible cause of lower back, hip and leg pain?

Have you observed or noticed any changes in your body posture lately, specifically along your lower back area? And also, have you been experiencing lower back pain, buttocks or even hip pain?

There are a lot of factors that causes lower back, buttocks or hip pain but one of the most clinically relevant patterns of joint dysfunction and muscle imbalance is the lower cross syndrome. Lower cross syndrome (LCS) or also referred to as distal or pelvic cross syndrome, wherein a group of weak muscles are combined with overactive, tight or facilitated muscles; that creates a movement pattern in the lower back area that leads to joint dysfunction and muscle imbalance then eventually injury. People develop this distinct pattern due to prolonged static postures, such as sitting in front of their desk all day or long flights.


Studies has proven that when a muscle has been in a shortened or contracted state for an extended period of time it causes weakening of the muscles opposite side of the body, which we call reciprocal inhibition. Examples of it are office workers, wherein they sit for about eight hours a day. The hip flexors, muscles anteriorly, tend to be shortened for a span of time; therefore the brain will automatically send signals to your gluteal muscles, muscles posteriorly, to shut down or inhibit. So in this case the body will normally just compensate on what is left, that it will synergistically approve the functioning of other muscles which in this case are the hamstring and lower back muscles to assist in performing hip extension. In other terms, you start to use muscles that are not really intended for that specific activity such as walking. That is also why it is advisable to walk for a couple of minutes from time to time rather than sit nonstop for 8-9 hours.


Basically, the combination of tight thoracolumbar extensors and hip flexors paired with weak abdominal and gluteal muscles causes’ chronic low back pain, buttocks or even hip pain. Typical Symptoms are as follows:

  • Arching of the lower back or rounding or increased lumbar lordosis
  • Protruding abdomen or anterior pelvic tilt
  • Flat butt due to weakness of the gluteal muscles
  • Lateral lumbar shift
  • Lateral leg rotation
  • Knee hyperextension

This could be managed by exercises, such as stretching, manual and or physical therapy. Perhaps, the most common given management for this, is strengthening of the core muscles which includes the pelvic floor muscles, transversus abdominis, multifidus, internal and external obliques, rectus abdominis, erector spinae (sacrospinalis), longissimus thoracis, diaphragm, latissimus dorsi, gluteus maximus, and as well as the trapezius muscles.

But before doing such strengthening exercises it is advisable to seek a professional help before executing to avoid further development of injuries.

Monica Laine DG. Gonzales, PTRP