Updated: Oct 16
Low back pain: we've all been there. It's often seen as the ominous sign that your youthful days are fading, and you're on the fast track to becoming that neighborhood curmudgeon who yells at kids to stay off their lawn. But hold on a second – is it really a sneak peek into old age, or is there more to this pain puzzle that can be fixed with some know-how and a touch of effort? Surprise, surprise! That nagging ache you've been living with might not be solely because you're aging (phew, one less worry). Instead, it's likely tied to other issues that have snuck up on you over time. So, congrats! You're not old just yet. But about that pesky pain – there's still some sleuthing to do. Enter stage left: muscular imbalances.
Before we dive into the nitty-gritty, let's demystify this term – "muscular imbalances." It's like a tug-of-war between the muscles around your joints, but not the fun kind you played as a kid. Picture one of your bones as a spaceship floating in the vast galaxy of your body. Now, attach a string to one side of that bone and give it a gentle yank. What happens? The bone obediently sways toward the string, following the force. Now, imagine you do the same on the other side, with an equal amount of oomph. What occurs this time? Well, ideally, your bone would just stay put, not pulling in either direction. That's the cosmic balance we'd love to see in all our joints – equal muscle pull on both sides of the bone.
But here's the plot twist: reality isn't always a perfect world. In real life, sometimes one muscle decides to flex a little harder than its counterpart, leading to a bit of an imbalance. Now, I know you're probably wondering, "What on earth did I do to have my joint pulled to one side?" Don't worry; I'm here to unravel the mystery.
Adapting to a World of Imbalances
Your body is a marvel of adaptability. Think about those quirky habits of your neighbors or mysterious odors that once irked you but now barely register – that's sensory adaptation for you. Well, your muscles have a similar knack for adapting, and it's all part of a fascinating phenomenon called motor behavior (Fahmy, 2023).
While noise or scent might not change your muscles, they're particularly responsive to differences in proprioception – that's a fancy word for the awareness of your body's position in space. You see, every time you pick up a pen or haul all those groceries in one heroic trip (because who needs two?), your brain gets a sneak peek at your body's position. Your brain then sends signals to your muscles, dictating how much tension they need to apply to your bones. These signals aren't one-size-fits-all; they vary in intensity. For instance, picking up a pencil won't trigger the same muscle frenzy as lugging in a mountain of groceries. Over time, your muscles become savvy to these tasks, adapting to perform more efficiently in their respective roles. It's like getting free gains!
Now, here's where it gets interesting – and potentially troublesome. If certain muscles start flexing their metaphorical muscles more often than others, it can throw your body off balance. Picture a group of muscles that never skips leg day – they'll pull your helpless bones towards them. Left unchecked, this imbalance can lead to altered posture and a skewed force-couple relationship (Fahmy, 2023). So, what's the game plan?
You've got two choices: either groan every time you stand up for the rest of your life or dive into this simple guide. Since you're still with me, I'm guessing you're keen on the latter. Let me be clear: there's no one-size-fits-all solution. The causes of joint pain are as unique as you are. But let's start by revisiting those hypothetical scenarios about your back and shoulder.
In the first case, low back pain is often linked to anterior pelvic tilt (APT), also known as "lower crossed syndrome." This postural quirk occurs when certain muscles become overactive while others slack off, causing your pelvis to tilt forward (Fahmy, 2023; Kosinska, 2020). Picture your pelvis as a bone in space, suspended by strings from the top and bottom. Lower crossed syndrome gets its name from the X-shaped pattern of muscle activity on your pelvis when viewed from the side. Overactive muscles include the hip flexors and low back muscles, while the lower abdomen and glutes/hamstrings become the underachievers (Fahmy, 2023; Kosinska, 2020). The tight muscles give your pelvis a seesaw effect, tilting it and making your lower back muscles work overtime instead of relying on the larger, more powerful glutes.
As for the shoulder saga, when you favored your left arm for carrying groceries, your shoulder naturally shrugged upward to protect your neck from straining. With repetition, your body learned to keep your shoulder in that position, recruiting the upper trapezius muscle to stay shortened. As this muscle became the go-to in the area, other activities that involved the entire trapezius began relying heavily on these fibers, neglecting the less-used lower trapezius. As the upper trapezius remains engaged (even at rest), it pulls the shoulder blade from its natural position, stretching the muscles below and causing discomfort.
Taking Action: Four Steps to Balance
Now that we've identified the culprits causing those aches and pains, it's time to roll up our sleeves and tackle these imbalances head-on. According to the NASM model, there are four essential steps to correct these issues: inhibit, lengthen, activate, and integrate (Fahmy, 2023). Let's break them down, shall we?
Step 1: Inhibit (Myofascial Rolling)
Okay, I get it, the thought of rolling out your muscles might not sound like a spa day treat. But hang in there – it doesn't have to be a torture session. You've got options, my friend! There are some fantastic massage tools out there, including handheld devices like rollers and massage guns. The beauty of these gadgets is that you're the boss of the intensity. Keep it at a comfortable 2/10 on the Wong-Baker Pain Rating Scale (Fahmy, 2023). Give each side a good 30-60 seconds of TLC while you take slow, deep breaths. For that anterior pelvic tilt, focus on the psoas major and lower back. And don't forget your upper trap if it's giving you grief. Once you're done, bask in the sweet relief.
Step 2: Lengthen
Now, we're not talking about adding inches to your height, but rather reducing muscle activity to release their iron grip on your joints. The magic trick here is stretching – again, stick to a 2/10 on the pain scale for 30-60 seconds on each side (Fahmy, 2023). Want to level up? Try some muscle contractions during your stretch. Hold the stretch for 10 seconds, then follow it up with a 6-10 second muscle squeeze (Fahmy, 2023). After that, ease back into the stretch for another 30-60 seconds (Fahmy, 2023). You'll notice some extra flexibility. For APT, consider the psoas major foam roller stretch and various low back stretches. To tame that upper trapezius, go for an upper trap stretch. The goal here is to make those muscles relax and let your joints return to their happy place.
Step 3: Activate
Let's flip the script. Remember all the fuss we made about reducing overactive muscle activation? Well, it's time to crank it up on the other side. We want to give those underactive muscles a little workout to get them accustomed to their new roles. Think of it as boot camp for your muscles. Incorporate resistance exercises targeting the lower fibers of the trapezius, lower abdomen, and glutes. I'm talking scapular pull-ups, scapular pull-downs, leg raises, and any flavor of the Romanian deadlift that makes those glutes work. Aim for 3-5 days a week, 1-2 sets, 10-15 reps, with moderate weights (RPE ~7), and follow a slow tempo (4 seconds down, 2 seconds hold, 1 second up) (Fahmy, 2023). Your muscles will get used to these new positions and start pushing back against the bullies.
Step 4: Integrate
Last but not least, it's time to bring it all together. Integration means gradually reintroducing the affected area into your exercise routine. You'll use that newfound range of motion and strength to tackle more complex movements. Think medicine ball throw variations and lower leg plyometrics for the rotator cuff and hip. Perform these exercises 3-5 days a week, 1-3 sets, 10-15 reps, keeping it controlled (Fahmy, 2023). By easing the affected area back into your routine, you're helping it adjust to everyday activities and hopefully preventing any unwelcome comebacks.
Muscular imbalances disrupt the equilibrium between opposing muscles around joints, quietly infiltrating our daily routines and subtly altering our posture. The solution? A systematic four-step approach: we ease overactive muscles through myofascial rolling and stretching, awaken dormant muscles with tailored resistance exercises, and seamlessly integrate them into daily routines. However, identifying the precise imbalances can be as complex as solving a puzzle, as muscles adapt to various factors. While I've provided you with a compass to navigate this terrain, remember that each case is unique and filled with subtleties. Attached below is a list of some common imbalances with potential causes. With this knowledge, you're not just embarking on a fitness journey; you're on a quest to restore balance, posture, and your body's innate harmony, one step at a time.
Fahmy, R. (2023). NASM Essentials of Corrective Exercise Training. Langara College.
Kosinska, A. (2020, September 5). What is Anterior Pelvic Tilt?. Physiopoint. https://www.physiopoint.ie/post/what-is-anterior-pelvic-tilt
National Academy of Sports Medicine. (n.d.). https://www.nasm.org/docs/pdf/cpt7-static-dynamic-posture-assessment-template.pdf?sfvrsn=42bcd01f_8