Tired of sitting all day? Forgotten what it feels like to spring out of bed? Are you suffering with lower back pain?

Nowadays so many of us are condemned to our desk for 10 hours a day, before we are allowed the chance to squeeze back into a sweaty seat on the train home. All this time spent sedentary is topped off by a desperate attempt to do a day’s-worth exercise in 40 minutes before collapsing into bed and starting the routine again.

So why, if so many of us are doing the same thing, do I wake up every morning stiff as a board, aimlessly flicking my sock towards my foot to avoid bending forwards? The answer could be “lower cross syndrome”.

So, what do we mean when we say, “Lower Cross Syndrome”?

Lower cross syndrome (LCS) is a term used to describe a muscular imbalance at the lower back and hip girdle. It is most commonly seen in individuals who have a sedentary desk-based job. Hours in front of the screen often leads to certain muscle groups  becoming “shortened and tight”, whilst others will become “long and weak”. This is as a result of imbalance in use between the different muscle groups.

Short and Tight: Lower back musculature (lumbar erector spinae) and hip flexors (psoas, iliacus, quadriceps, Tensor Fascia latae).

Long and Weak: Abdominals, gluteals and hamstrings.

How does it cause pain?

The muscular imbalance developed from excessive sitting causes a shift in weight-bearing posture. The anterior tightness of the hips and creates a kypholordotic posture in which the lower back curve is accentuated. This shifts our centre of gravity line backwards from the structures designed for weight-bearing (vertebral bodies) onto the facet joints which are designed to control movement. This alteration in function leads to increased stress on the muscular and ligamentous structures around the spine which often manifests itself as a dull ache across the lower back. The facet loading posture often leads to acute or sharp pains within the lower back which are commonly aggravated by; rolling over in bed, getting up from sitting, bending forwards and standing up straight.

Other causes of pain tend to be as a result of neurological compromise, often predisposed by dysfunction to the joints or discal portions of the spine. These may manifest themselves as leg pain, numbness or pins and needles.

How can Osteopathy help?

As Osteopaths, we see Lower Cross Syndrome many times a day and treatment will vary depending on symptoms and causality. However, the common principle remains the same, increase the movement in areas of stiffness to reduce the load on the areas under strain and improve muscular health to further support and maintain the changes that are made.

A wide variety of treatment approaches are likely to be used including manipulation and articulation of joints, soft tissue massage and stretching to improve muscular health. Further management will include exercises and most importantly education. Lower cross syndrome is most commonly a result of habitual dysfunction and will require daily alterations to maintain long-term health.

Here are some great home remedies to help battle Lower Cross Syndrome:

Knee hugs – Lie on your back and bring your knees in towards your chest, using your arms. The aim is to lengthen your back as much as possible so think about tilting your pelvis underneath as you do so. Lifting your knees to your chest may be uncomfortable in an acute spasm so use your hands to assist the motion as best able.

Lunge stretch – Begin kneeling on a cushioned surface. Lunge your left foot forwards so to create a 90 degree angle at your left knee and hip joints. To maximise the function of the stretch, tilt your pelvis underneath (pull your pubis bone up towards your breastbone) by contracting your abdominals. Whilst maintaining this pelvic tilt, gently lean forwards so as to create a stretch on the front of your right hip. You can advance this stretch by raising your right arm up over your head and side-bending your trunk to the left. Hold for at least 20 seconds and repeat on the other side.

Gluteal Bridges – Lie on your back with your knees bent, feet shoulder-width apart on the floor and hands palm down by your hips. Keeping your shoulders and feet pressed hard into the floor, slowly raise your pelvis up towards the ceiling. You should concentrate on squeezing your glutei (buttocks) tight as you do this and aim to make your body a straight line from neck to knee. Hold this position briefly before slowly returning to flat, feeling each individual vertebra regain contact with the floor.

Back flatteners – Lie flat on your back with your arms by your side. Note the gap between your lower back and the floor. Without moving your legs, attempt to flatten this space underneath your back by pushing your spine down towards the floor. Please note: this exercise is about control, the flatter your back, the better control. You should still be able to breathe freely throughout this process!!

To increase the difficulty of this exercise you can begin to add movements with your leg. Throughout all variations, the aim is to maintain complete contact of your lower back with the floor. In ascending level of difficulty;

  1. With both legs bent and feet on the floor, gently raise one foot off the floor and lift that knee towards your chest.
  2. With one leg bent and foot on the floor, lift a straight leg to just 10cm off the floor.
  3. With both legs bent, aim to lift them off the floor bringing your knees to your chest.
  4. With both legs straight, lift your feet to 10cm off the floor.


Gym time exercises, (please ask your personal trainer for advice during these activities if unsure):

Plank, Hamstring curls and lower abdominal crunches.