College of Massage Therapists of British Columbia (CMTBC) Practice Exam

In lower crossed syndrome a patient's abdominal muscles are assessed as weak. Which of the following muscles are likely to test weak?

1. Hip flexors

2. Gluteus maximus

3. Erector spinae group

4. Thoracolumbar extensors

The correct answer is: Gluteus maximus

In lower crossed syndrome, the body exhibits a specific pattern of muscle imbalances, where certain muscle groups become weak while others are tight. When the abdominal muscles are weak, it is often the case that the opposing muscle group, the gluteus maximus, also tests weak. The gluteus maximus plays a critical role in stabilizing the pelvis and maintaining proper hip extension. In lower crossed syndrome, the weakness in the abdominal muscles contributes to a dominance of the hip flexors and lumbar extensors, creating an anterior pelvic tilt. Because the gluteus maximus is responsible for counteracting this anterior tilt by providing hip extension and stabilization, its weakness reinforces the postural inefficiencies seen in this syndrome. Therefore, it's common to assess the gluteus maximus as weak in patients displaying characteristics of lower crossed syndrome alongside weak abdominal muscles. The other muscle groups mentioned have different roles in this syndrome. The hip flexors are often tight rather than weak, the erector spinae may exhibit increased tone or tightness, and the thoracolumbar extensors similarly tend to become overactive to counterbalance the weaknesses present in the abdominal region and glutei. Each group plays a specific role in the altered mechanics of lower crossed