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يونيو 22, 2021 4 min read

ESPORTS INJURIES: Understanding the Lower-Crossed Syndrome 

Sitting is the new smoking!!! Get that!... 

Just like its upper body counterpart, Lower-Crossed Syndrome is a chronic condition developed from prolonged sedentary sitting. Again, SEDENTARY SITTING!!! A notorious word repeatedly raised when talking about eSports injuries. Anyone couldn’t help mentioning it over and over again since it’s the major cause of most, if not all, of the gaming injuries. So what exactly is Lower-Crossed Syndrome. Just SIT and read on… 

Sedentary sitting has been blamed for various health conditions and injuries, and it’s no wonder how the prevalence of musculoskeletal injuries in gaming keeps on rising over the past years. The sport has dramatically increased in popularity since its inception into the mainstream and has become an addicting recreational and professional sport, attracting millions of young adults and the old alike. However, the worse came with it when video gaming injuries started to rise due to chronically poor posture when sitting, which produces various pain conditions and functional dysfunctions. And if you haven’t heard, sitting is the new smoking… 

Still the Culprit: The Gaming Posture 

Sitting for extended periods leads to the shortening of the hip flexor muscles over time.  If you’ve been experiencing low back pain, and your hips are slowing you down, you may be suffering from LowerCrossed Syndrome.  LowerCrossed Syndrome occurs when weak abdominal and gluteal muscles are overpowered by the tight iliopsoas and erector spinae muscles, forming a “cross” when viewed at the side. It can occur with the Upper-Crossed Syndrome, leading to a forward head posture with exaggerated buttocks and a protruding abdomen. The postural changes associated with the Lower-Crossed Syndrome include: 

  • Anterior pelvic tilt 
  • Increased lumbar lordosis 
  • Lateral lumbar shift 
  • Lateral leg rotation 
  • Knee hyperextension 

The Consequence of a Faulty Posture: The Cross 

Prolonged typical gaming posture creates a crossing pattern of the overactive and tight muscles with the counter crossing of the underactive and weak muscles – the “cross.”  In LowerCrossed Syndrome, the overactive tight muscles are the lower back muscles with tight hip flexors. This muscular dysfunction causes the pelvis to tilt forward, resulting in the exaggerated hollowing of the lower back area with an extremely protruded butt. The weakened muscles are the abdominals and gluteals, which may result in protruding abdomen and gluteals. Both muscle imbalances create a typical lordotic posture. The muscles involved in Lower-Crossed Syndrome are: 

  • Weak and Underactive Muscles: Rectus abdominis, transversus abdominis, obliques, gluteus maximus, gluteus medius, gluteus minimus, vastus lateralis, vastus medialis, tibialis anterior, tibialis posterior, peroneus longus 
  • Tight and Overactive Muscles: Iliopsoas, rectus femoris, hamstring, erector spinae, tensor fascia latae, thigh adductors, piriformis, quadratus lumborum, gastro-soleus 

Some people, especially those whose jobs or activities require long hours of sitting also exhibit Upper-Crossed Syndrome  at the same time. 

The joints' structural and functional integrity is also compromised, as well as that of the tendons and ligaments. These structures require movement to stay healthy and maintain their flexibility and will, therefore, become restricted when kept in a fixed position for prolonged periods. Tendons become stiff, which negatively affects the production of muscle force as manifested by weakness and exhaustion. Ligaments also lose their elasticity, severely restricting joint mobility. When this happens, smooth gliding of the joint surfaces will be jeopardized due to loss of movement of synovial fluid, which provides lubrication to the joints. 

How to Fix the Lower Cross?... 

The general idea in the treatment of crossed syndromes is to loosen the tight cross while strengthening the weakened cross. 

First, you must loosen the tight and overactive iliopsoas and erector spinae muscles, and then strengthen the weak and underactive abdominals and gluteals.  

CORRECTIVE STRATEGY FOR LOWER CROSSED SYNDROME: Suggested Treatment Order 

STEP 1: Self-Myofascial Release 

Perform self-myofascial release manually or use a Recovapro massage gun for quick results. This can decrease the activity of the overactive muscle groups through the mechanical vibration's inhibitory effect, relaxing the tight or contracted muscles and making it easier to activate the weakened muscle groups. The focus should be given on tight iliopsoas, quadriceps, and lower back erector spinae to address the tight cross. For general workup on these areas, visit Recovapro. 

STEP 2: Loosen the Tight Cross 

Lengthening the tight part of the cross through stretching alleviates the pain and discomfort associated with the LowerCrossed Syndrome.  Second, it allows the body to be receptive to strengthening the weak part of the cross.  If you were to jump into strengthening exercises, you are more likely to exacerbate your injury, rather than treat it.  A physical therapist will recommend foam rolling exercises for the iliopsoas muscles, floor exercises designed to stretch the lumbar spine, pelvis, and hip joint, and standing stretches for the upper spine if there is a forward head position. 

STEP 3: Strengthen the Weak Cross 

Strengthening the weak abdominals and gluteals is often not as simple as planking and performing squats, although these exercises may play a role in your recovery.  Instead, the deep stabilization muscles need attention if LCS is going to be treated effectively.  One exercise that can strengthen both the glutes and the deep abdominals is the hip raise.  Lay on your back with your feet flat on the ground.  Raise your toes slightly, making sure the majority of the pressure is in the heels.  Raise your hips until your knees, hips, and mid-back form a straight line, taking care to not hyper-extend the hips.  Hold for 2-3 seconds and lower the hips, repeating for 12-15 reps. 

STEP 4: Keep a Good Posture 

Once you have addressed both parts of the cross, you'll have to check your posture for any more possible deviations and addressed that accordingly. Maintaining a good posture is key to preventing the occurrence of LowerCrossed Syndrome and reducing low back pain that comes along with it. Good posture means that the muscles around your spine are balanced and at their optimum health to support your body and maintain an upright posture. Use Recovapro to fix both sides of the cross and effectively reduce the pain from being doublecrossed! 

For more information on Recovapro, click here…