Lower Cross Syndrome

Lower cross syndrome was first described by Dr. Vladimir Janda as a pattern of alternating tightness and weakness involving core and pelvic muscles. (1) This pattern often contributes to back pain and is associated with diagnoses throughout the lower body. This pattern emerges as certain muscles are overused and become shorter and tighter.  This makes the muscles that work in opposition become longer and weaker (stretch weakness). (2) This muscle imbalance leads to dysfunctional and inappropriate movement patterns both in that area and through the entire body. It has a direct impact on joint surfaces and can lead to a self perpetuating cycle of joint dysfunction. (3-5) Long term dysfunction can cause joint degeneration and change how the brain controls the body. (5)


Individuals with lower cross syndrome typically complain of low back pain, as well as pain in the hips and pelvis. (6) The dysfunction associated with lower cross syndrome contributes to many issues of the lower body including IT band syndrome, patellofemoral pain syndrome and plantar fasciitis. (7,8)


Treatment of lower cross syndrome involves eliminating abnormal input through joint mobilization and soft tissue release. Rehabilitation then follows through stretching, strengthening and facilitation of proper movement patterns. 


If you have an issue that you would like some guidance with, give us a call at (616) 301-1702.


  1. Frank C, Page P, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach. Human kinetics; 2009.

  2. Kendall FP, McCreary EK, Provance PG. Muscles: testing and function with posture and pain. Lippincott Williams & Wilkins; 2005.

  3. Lewit K. The functional approach. J Orthopedic Medicine 1994; 15:73–74.

  4. Key, J., Clift, A., Condie, F., Et.al. Journal of Bodywork and Movement Therapies. 2008;12,113.

  5.  Tunnell PW. Protocol for visual assessment. Journal of Bodywork & Movement Therapies. 1996;1(1):21-7.

  6. Liebenson C. Rehabilitation of the Spine: A Practitioner’s Manual. Baltimore: Williams and Wilkins, 1996; 97–112,196

  7. Hammer WI, editor. Functional soft-tissue examination and treatment by manual methods. Jones & Bartlett Learning; 2007.

  8. Perry Nickelston Lower Crossed Syndrome and Knee Pain Dynamic Chiropractic – May 21, 2007, Vol. 25, Issue 11