Upper/Lower Cross Syndrome

One of the most clinically relevant patterns of muscle dysfunction is the Lower Crossed Syndrome.

An understanding of the imbalances is important for low back and pelvic conditions related to abnormal sitting, standing posture, gait, bending and twisting activities.

Lower Crossed Syndrome is typified by the following pairs of tight and weak muscles:

• Weak Gluteus Maximus and Short Hip Flexors
• Weak Abdominals and Short Lumbar Erector Spinae
• Weak Gluteus Medius and Short TFL and QL

An understanding of these patterns is important:

• Lumbar Hyperlordosis - Shortened Erector Spinae
• Anterior Pelvic Tilt - Weak Gluteus Maximus
• Protruding Abdomen - Weak Abdominals
• Foot Turned Out - Shortened Piriformis
• Hypertrophy of TL Region - Hypermobile Lumboscaral Joint
• Groove in IT Band - Shortened TFL

The combined effect of the above postural abnormalities is that the lumbosacral, thoraculumbar, sacroiliac, hip, and knee joints are all overstressed.

Joint dysfunction and trigger points will naturally result from these muscle imbalances and will be accompanied by low back pain, buttock pain, pseudo-sciatica, and knee disorders.

Evaluation of Lower Crossed Syndrome:

Each of the three muscular imbalances that contribute to Lower Crossed Syndrome is evaluated based on the key movement pattern that is affected. The movement patterns are:

1. Hip Extension
2. Hip Abduction
3. Trunk Flexion

Upper Crossed Syndrome:

Upper Crossed Syndrome is typified by the following pairs of tight and weak muscles:

1. Weak lower and Middle Trapezius and Short Upper Trapezius and Lavatory Scapulae
2. Weak deep Neck Flexors and Short Suboccipitals and Sternocleidomastoid
3. Weak Serratus Santerior and Short Pectoralis Major

An understanding of this pattern is important for neck, shoulder, or upper back conditions that are related to: abnormal sitting, respiration, mastication, and apprehension activities. The common postural signs of Upper Crossed Syndrome and their corresponding muscle dysfunction include:

1. Rounding Shoulders/Slumping - Shortened Pectorals
2. Forward Drawn Head- Kyphotic Upper Thoracic Spine
3. C0-C1 Hyperextension- Shortened Suboccipitals
4. Elevation of Shoulders- Shortened Upper Trapezius and Levator Scapulae and weak Lower and Middle Trapezius
5. Winging of Scapulae- Weak Serratus Anterior

The combined effect of the above postural abnormalities is that the Cervicocranial, Cervicothoracic, Glenohumeraland, and Temperomandibular joints are all over stressed. Joint dysfunction and trigger points naturally result from these muscle imbalances which are often accompanied by headaches, neck pain, shoulder blade pain, TMJ, and shoulder disorders.

Evaluation of Upper Crossed Syndrome:

Each of the three muscle imbalances that contribute to Upper Crossed Syndrome is evaluated based on the key movement pattern that is affected. The movement patterns are:

1. Scapulohumeral Rhythm
2. Neck Flexion
3. Push-Up