Facebook Pixel
Brookbush Institute Logo
Continuing Education4 Credits

Lumbopelvic Hip Complex Dysfunction (LPHCD)

Predictive Model of Lumbopelvic Hip Complex Dysfunction (LPHCD): Signs of lumbopelvic hip complex dysfunction, muscle, joint, fascia, nervous system, neuromuscular recruitment, subsystem, and core muscle contribution. Exercise selection related to lower cross syndrome, anterior pelvic tilt, posterior pelvic tilt, knee bow in, knee bow out, and forward lean.

Course Description: Lumbopelvic Hip Complex Dysfunction (LPHCd)

“Lumbopelvic Hip Complex Dysfunction (LPHCd)" is an edit and update of previous postural dysfunction models (e.g. lower body posture, lower-crossed syndrome, sway back posture, anterior pelvic tilt, etc.). It is important to recognize that in these models the term "posture" is being used as an analogy for "ideal alignment". Similarly, when movement professionals refer to pelvic posture, low back posture, good posture, poor posture, better posture, etc. they are referring to this analogy of ideal alignment; not the rigid positioning implied by the colloquial use of the term "posture."

Postural dysfunction and movement impairment syndromes are likely the beginning of "modeling". Modeling has significant potential to aid in refining clinical decision-making, intervention selection, and program design, and improve the reliability and effect size of outcomes. Models are especially conducive for assisting in interpreting multi-variant problems, which is how all clients and patients present. The Brookbush Institute recommends that all sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) consider these models as an aid in refining decision-making in practice.

Additional Models:


  • Posture: Arthro- and osteo-kinematics alignment maintained by optimal myofascial activity and length, as a result of sensation, integration, and activation by the nervous system - both statically and dynamically.
  • Postural Dysfunction: The absence of ideal posture as a result of maladaptation by one or multiple tissues within the human movement system.
    • Brookbush Institute Modern Definition: Modeling patterns of movement impairment correlated with orthopedic dysfunction, based on all available evidence, with the intent of predicting best-practice assessments and techniques, to optimize measured outcomes.


Short/Over-active (Release and Lengthen)

Recommended Assessments:

Recommended Techniques:

Short/Under-active (Prime Mover Inhibition - Integrate)

  • Lumbar Stabilizers
Recommended Assessment:
  • Palpation

Recommended Techniques:

Long/Under-active (Activate)

Recommended Assessments

Recommended Techniques

Long/Over-active (Synergistically Dominant – Release Only) Recommended Assessments:

Recommended Techniques (Release Only)

Fascia (Reduction in Extensibility)

Restricted Mobility (Thickening, histochemical changes, decrease in tensile strength, addition of disordered collagen fibers)
  • Abdominal Fascia
  • Thoracolumbar Fascia
  • Sacrotuberous ligament
  • Iliotibial Band
Recommended Techniques

Additional manual techniques:

  • Instrument Assisted Soft Tissue Mobilization
  • Pin and Stretch

Myofascial Synergies (Altered Recruitment)

Under-active (Integrate)

Over-active (Release and Avoid)




  • Leg Raises
  • Hyperextensions
  • Hamstring Curls
  • Potentially Planks and Crunches


  • Knee: Inadequate anterior glide of the tibia on the femur (the lateral compartment may be more restricted)
  • Hip: Inadequate posterior/inferior glide of the femur in the acetabulum
  • Lumbar Spine: Combination of Hypermobile and Hypomobile segments
  • Sacroiliac Joint: Asymmetric laxity/stiffness
Recommended Assessments:
  • Passive Accessory Motion Assessment

Recommended Techniques:

Signs of Dysfunction

Overhead Squat Assessment :

Goniometric Assessment

Muscle Length Tests

Manual Muscle Tests

Correlated Injuries, Pathologies, and Pain

The Lumbo Pelvic Hip Complex Dysfunction (LPHCD) model is constructed based on research demonstrating the maladaptive alterations of tissues and motion associated with common impairments of the human movement system. If we create a list of these impairments, this adds to the definition of the LPHCD model, as the model itself could be defined as the expected maladaptive changes to arise from those impairments.

  • Low Back Pain (24, 26-27, 30-31, 33-35, 37, 39-58, 65, 71, 95, 97-100, 110, 116, 131-132, 134, 144, 147-160, 166-170, 172, 203-206, 208-210, 212, 214, 218-219, 221-222, 224-225, 228, 229-231, 249-250, 256, 264, 276-277, 280, 290-293, 298-302, 314-315, 339-353, 357, 360, 388, 392-393, 418, 421, 422, 437, 438, 440-441, 445-446, 455-456, 458, 460, 465-466, 475-477, 485-487, 494, 499, 500-505)
    • Disk Herniation (133, 136-143, 444)
    • Spondylolisthesis (29, 32, 428)
    • Instability/Hypermobility (146, 175, 426, 429-435, 462, 478)
    • Sacroiliac Joint Pain (36, 38, 74, 174, 194, 275, 368-369, 389, 488-493, 500, 507, 515, 525-527, 529-530, 535, 544-546, 549)
    • Sciatica (94, 96, 135)
    • Peripartum Pelvic Pain (496-497, 511, 513-514, 532-534, 537-542)
  • Knee Pain and Medial Knee Displacement (59-64, 66-70, 82, 303, 305-308, 310-312, 381-385, 396-408, 518-520)
  • Hamstring Strain (521)
  • Hip Pathology (180, 410-411)
    • Snapping Iliopsoas Tendon (102-109)
    • Adductor and Groin (77, 78, 211)
    • Piriformis Trigger-point (182)
    • Chronic Pelvic Pain (284)


Summary of Model

Why Do We Need a Better Model?

Signs of Lumbo Pelvic-Hip Complex Dysfunction

Muscle Dysfunction

Short/Overactive Muscles

Long/Overactive (Overactive Synergists)


Introduction to the Muscular and Fascial System

Myofascial Synergy a.k.a Subsystems

Arthrokinematic Dysfunction

Symptoms, Injuries and Diagnoses Associated with Lumbo Pelvic Hip Complex Dysfunction (LPHCD)

Thank You


© 2024 Brookbush Institute. All rights reserved.




1. Introduction

00:00 00:00