Muscle Imbalances.

Muscle imbalances can cause or contribute to skeletal misalignment by pulling the bones out of place. If a pair of muscles that operate a joint are not balanced strength and length wise the joint will be pulled towards the tighter, stronger muscle. For example the Tensor Fascia Latae (TFL) and the Gluteus Medius should be balanced to allow the hip to move correctly, be stabilized in its socket and to ensure the pelvis is neutral. The TFL frequently dominates the Gluteus Medius and pulls the pelvis and hip medially (towards the midline) and is not prevented from doing so by a weak gluteus medius. The problems from this destabilize the hip joint, allowing the hip to move in an incorrect way, pull the pelvis towards the midline causing seperation of the sacroiliac (SI) joint on that side. This in turn can lead to many problems involving both sides of the pelvis because if one side becomes distorted and weak the other side must compensate in whatever way it can, often in a dysfunctional manner which compounds the problem.

The most important thing to remember when dealing with exercise programmes for muscle imbalances is to test the muscles. This cannot be stressed enough and any therapist who doesn't test for strength and length and just assumes the muscle needs stretching is not worth attending. A common example of this is the iliopsoas. Because this muscle is prone to tightening most therapists will not even test it. They just give you a standard stretching program which can make matters worse if this muscle has become lengthened, as is often the case with sacroiliac problems, the iliopsoas loses dominance as the main hip flexor and the rectus femoris and TFL become overactive. Never let anyone assume they know what is happening with your muscles. Always insist they test them.

One side of the body can become stronger than the other. This is especially true if your back pain started in one side of the back first, regardless of whether it is now on both sides. Always get this checked too. If one side of the body is stronger than the other it can lead to rotational problems of the pelvis, spine and thorax. Sometimes assymetrical exercises are necessary with stretching on one side and strengthening on the other. The piriformis is another muscle therapists commonly make assumptions about. If your piriformis hurts you will most likely be given standard stretches for it, however, it can hurt because it has become lengthened, or because it has become tight but weak and stretching will make these problems worse. If your SI joints are unstable and not being supported by the correct muscles it stands to reason another muscle will try and take over, usually not very successfully, but it will try all the same in order to keep you upright. If the piriformis is hanging onto the pelvis attempting to provide stability where the other muscles are failing it will be sore from working too hard at the wrong job, sometimes tight but essentially weak and sometimes lengthened and strained from failing at this task. Always test!

Sometimes a manipulation can help reset the muscles as well as the joints. If your imbalances are severe this will probably not happen and frequent attempts can make matters worse by irritating the already stressed tissue and loosening an already loose area further. If manipulations haven't worked in a few weeks look to the muscles. Also sometimes a manipulation will work and relieve your pain only to come out a few days later. A sure sign or muscle imbalances, the muscles are pulling the area back into its normal faulty alignment and only sorting these muscles out will make the manipulation permanent.

Some common examples of muscle imbalances are:

Weak Gluteus Medius - overactive TFL, piriformis and quadratus lumborum.

Weak Gluteus Maximus - overactive erector spinae and hamstrings.

Weak iliopsoas - overactive TFL and rectus femoris.

Weak transversus abdominus - overactive rectus abdominus and muscles of the thighs.

Weak external obliques - overactive erector spinae, rectus abdominus.

Our exercise program is developed so you can test your own muscles for length and strength and adapt the exercises accordingly. Sometimes a partner will be helpful in the testing so they can see areas of your body you can't.

Remember the most important thing is to never assume! This is where a standard exercise program will fail, it doesn't allow for the fact that everyone is unique and has their own particular movement patterns which over time cause muscle imbalances.