The Pelvic Cross Syndrome
The Pelvic Cross Syndrome is defined as an abnormal adapted posture of the lower back. It is also known as lower cross syndrome. This results from muscle strength imbalances. A combination of prolonged sitting and poor posture is frequently associated with it.
Signs & Symptoms

In this condition, the following may be perceived:
- Increased curve (lordosis) of the lower back
- Forward tilt of the pelvis
- Tight hip flexor muscles (Iliopsoas)
- Weak abdominals and bottom muscles (Gluteals)
- Tight hamstrings (posterior thigh muscle)
Structures Involved In Pelvic Cross Syndrome
The Pelvic Cross Syndrome (PCS) commonly involves the Hip flexors (muscle responsible for bending the hip up), Gluteals (bottom muscles used to bring the hip back, and leg out to the side), abdominals (abdomen muscle) and the Hamstrings (muscle responsible for bringing the hip backwards).
To fully comprehend the reason why there is a muscle imbalance, we need to understand this concept. A muscle that is shortened or tightened (ie. such as in Prolonged sitting and poor postures) for long periods of time causes the weakening of muscles on the opposite side of the body. This is referred as the “automatic reflex inhibition” by the brain.
The Mechanism Of Muscle Imbalance
In Pelvic Cross Syndrome (PCS), the hip flexors become tight (due to poor posture). As a result of the automatic reflex inhibition by the brain, the abdominals and gluteals on the opposite side of the body weaken. Consequently, this muscle strength imbalance leads to an exaggerated curve in the lower spine. This in turn causes low back pain. Weak gluteals compromises its function. Other muscles such as the hamstrings and back muscles are recruited to assist them in performing daily activities. This leads to overuse and tightness of the hamstrings and back muscles. This ultimately weakens the abdominals, and further increases the curve of the lower spine.
The joints and muscles around may undergo changes progressively if these muscle differences are left untreated. Strength, flexibility and range subsequently decrease, which contributes to degenerative changes and pain in the lower back
However, physiotherapy can help to prevent these secondary degenerative changes and treatment techniques are largely aimed to stretch the tight muscles and to strengthen those that have been weakened so as to enhance optimal muscle function and to improve postural alignment of the lower back.
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