It is a common misconception among the general public that core stability and postural integrity simply involve strength and flexibility of the abdominal wall and low back musculature. In actuality, postural integrity involves the strength and flexibility of much more structurally. Core stability involves the strength and flexibility of the entire lumbo-pelvic-hip complex.
A great example of this is the occurrence of lower crossed syndrome. Lower crossed syndrome is a common postural distortion pattern that is a result of muscular imbalances. It is characterized by an excessive anterior pelvic tilt, as well as an excessively arched lumbar spine (lumbar lordosis). In lower crossed syndrome typically the gluteals, quadriceps, tibialis anterior, rectus abdominis, transverse abdominis, and internal & external obliques are weak. In addition, hip flexors, erector spinae, hamstrings, and gastrocnemius are typically overactive (tight) when an individual has an excessive lumbar arch ¹.
Lower Crossed Syndrome
As a Certified Personal Trainer (CPT), one can design an exercise program for those with postural deviations such as lower crossed syndrome for the purpose of strengthening muscles that are likely to be weak and stretching muscles that are likely to be tight. Here are some examples of such exercises:
Side Plank: Lie on your right side, in a straight line from head to feet, resting on your forearm. Your elbow should be directly under your shoulder. With your abdominals gently contracted, lift your hips off the floor, maintaining the line. Keep your hips square and your neck in line with your spine.
Ball Crunch: Lie supine on stability ball (ball under low back), with knees bent at 90 degrees. Place feet on floor with feet hip distance and parallel. Cross arms. Crunch upper body forward, lift scapulae off the ball. Lower upper body over the ball, returning to the start position.
Lower Body Russian Twist: In a supine position with arms at in a “t-square” position, knees bent, with thigh-torso angle at a 90 degree angle, and knees at a 90 degree angle. Lower knees to the right side, lift back above hips, and lower bent knees to the left side.
Reverse Crunch: Lie in a supine position on bench with hips and knees bent. Lift hips off the bench while bringing the knees toward the chest. Slowly lower the hips back to the start position.
Cable Rotation: Stand with feet shoulder width apart, knees slightly flexed, and toes pointing straight ahead. Hold a cable with both hands directly in front of the chest, with arms extended and shoulder blades retracted and depressed. Rotate body away from the weight stack using abdominals and gluteal muscles. Allow back foot to pivot to achieve triple extension (plantar flexion, knee extension, hip extension).
Pilates Single Knee Stretch: Lying in a supine position, lift head, tuck chin, draw in at the core. Draw one knee in to the chest and touch it with hands. Opposite leg is extended. Switch legs.
As part of a well-designed exercise program for someone who suffers from a postural deviation like the lower crossed syndrome, it is just as important to include flexibility exercises that help address the overactive and tight areas.
Cat stretch: Start on hands and knees with both shoulder width apart. Engage abdominals and maintain a neutral spine. As you continue to engage the abdominals, round your back towards the ceiling and allow your head and neck to fall naturally between the arms.
Knees to chest: Lying in a supine position, bring one knee up towards your chest so that you can grasp your lower leg with both hands. Gently pull your knee towards your chest while trying to relax your legs, pelvis and low back.
Supine hamstring: Lie in a supine position on the floor with hips and knees bent. Take a step or belt loop, and loop it around the ball of one foot and straighten the leg so that it is inline with your bent knee. Gently pull back on the strap so that your leg points towards the ceiling. Keep your thigh engaged, your toes relaxed and your hip on the floor. Your upper body should also be relaxed on the floor.
Kneeling hip flexor: From a kneeling position, place right knee down on the floor, directly under your hip with toes under. Place your left foot on the floor in front of you with the knee directly over the ankle to form a 90º angle at the knee joint. Place both hands on the left leg, engage through the abdominals and gently lean forward into your left hip.
Do you want to learn more about how to help clients with common postural deviation? Check out our home study course Assessment and Treatment of Muscle Imbalances (#9254). Follow the link for details!
¹ National Exercise Trainers Association (2018). The Fitness Professional's Manual, 5th edition Minneapolis, MN: National Exercise Trainers Association.
Colleen O’Neil is PhD student in Health and Human Performance at Concordia University, Chicago, where she also earned her M.S. in Exercise Science. She has worked as a Personal Trainer and Group Fitness Instructor for over 20 years. She holds accredited Personal Training certifications through ACSM, and NASM, and Group Fitness Instructor and specialty certifications for Yoga and Pilates through NETA, YogaFit, and the YMCA. She worked in corporate fitness for 12 years, and now runs a personal training business, and is a Presenter for NETA. Her goal is to help clients enhance their health through exercise and education, and by incorporating a variety of exercise formats in personal training and group exercise.