Lower Cross Syndrome

Range of Motion Physical Therapy Newsletter December 13

Lower-cross syndrome is the term for a pattern of muscular imbalance around the lower back and hips. There are two types A & B with the more common type, Type A depicted above.

LCS is tightness of the thoraco-lumbar extensors (Erector Spinea) in the lower back, rectus femoris (Quad) and the iliopsoas (Hip Flexor). The hip flexor attaches from the lower lumbar vertebrae and passes to the front of the hip.

This pattern of tightness is contrasted by weakness of the abdominal muscles in particular the transversus abdominus and the gluteal muscles of the bum.

This muscle imbalance can create joint dysfunction at points within the spine and it also create postural changes. Areas affected in the spine are the lower lumbar joints such as L4-L5, L5-S1 segments and SI joints of the pelvis and the hip joint.

Some of the symptoms can be poor postural pattern, low back pain, hip joint dysfunction and restricted hamstrings, to name a few. It is important to look at a clients history, people who sit for long periods of time can suffer from shorten hip flexors and weak abdominal muscles, similarly those that cycle a lot may also suffer from tight hip flexors due to overuse and lack of stretching.

The most common result of LCS are postural changes such as anterior pelvic tilt, where the pelvis tilts forward, increased lumbar lordosis (the spinal curve of your low back), lateral lumbar shift, lateral leg rotation (outwards rotation), and knee hyperextension.

Once a group of muscles become tight and short, the opposite muscle groups become weakened. This starts a negative feedback cycle that with no intervention can compound the muscle imbalance. Treatment will focus on releasing out the tight muscle groups and strengthening the weaker muscles, this is done through hands on treatment techniques and corrective strengthening exercises to restore the muscle imbalance and postural issues.

If you think you are suffering from Lower Cross Syndrome contact Range of Motion Physical Therapy for an assessment.

gift voucher
Treat someone special to a Christmas Gift Voucher from Range of Motion Physical Therapy. A great Christmas present idea for someone in your life that does a lot of training or enjoys a good deep tissue or sports massage.

Gift Vouchers are available for Christmas and other special occasions, contact me should you wish to place an order!!


Gait Cycle

Can Fallen Arches Cause Knee Pain?

Can fallen Arches cause Knee Pain?….in short, Yes, fallen arches can cause knee pain, along with hip, pelvis and low back pain. To understand how this occurs we first need to look at how we walk or the gait cycle.

During the gait cycle our legs pass through the “stance phase”, this is where our foot strikes the ground and stabilises the stance foot, leg and hip to allow the other leg pass through the “swing phase” and so on.

Gait Cycle

During the stance phase the foot plants itself on the ground creating a stable surface, this is done by using the small intrinsic muscles of the foot, lower leg muscles and other elements of the ankle, foot and hip.

One of the dysfunctions that can effect the stability of the foot is Fallen Arches or a weakness in the small intrinsic muscles of the foot thus allowing the foot to over- pronate during the gait cycle .

knee painWhen the arch of your foot weakens and collapses (over-pronates) as the foot strikes the ground the lower part of your leg (tibia or shin bone) rotates inwards. As the lower limb rotates inwards this puts additional pressure on the knee structure, thus causing misalignment of the knee during the gait cycle. If you multiple this movement pattern by a few thousands steps a day or load the knee further by running on this pattern…yes you will have knee pain…sooner or later. As mentioned, in addition to knee pain, the hip, pelvis and lower back can also be affected by fallen arches causing pain in these areas.

As a Physical Therapist there are a couple of options I make available to clients to help resolve this issue. One factor to consider with Fallen Arches is that they can be heredity and as result of this an exercise program may not be as effective on the weakned muscles. For these clients I stock a custom designed off the shelf Orthotic to help support the arches and correct their movement pattern, the Orthotic is to be used in conjunction with foot strengthening exercises.

For other clients I will always look to work with them to strengthen their intrinsic foot muscles to ensure they can create the stability need to prevent over-pronation. This is done through a series of soft tissue and foot mobilisations techniques, which are support by foot straightening exercises, such as picking up a pen with your toes.

I also explain the tripod position of the foot to ensure clients understand what biomechanics are taking place and how they can help themselves to correct over-pronantion on a more permanent basis without the use of expensive ortothics.

Tripod Ex:

If you have foot, knee, hip or low back pain or fallen arches please contact Range of Motion Physical Therapy for an appointment.