What Comes First: Muscle Imbalance or Compensation?

[John Izzo]

I posted this question a year ago to my Roundtable and I would like to know what you guys think. We all exhibit muscle imbalances--some worse than others--but what we don't understand is do muscle imbalances cause compensatory patterns, OR do compensatory patterns cause muscle imbalances. If we are all agree that muscle imbalances can be caused from improper lifting techniques, as well as poor postural habits (sitting prolonged periods, computer, reading. etc.), then what comes first? They sound like they go hand in hand, sort of like the question, "what comes first: the chicken or the egg?"

I will say that compensatory movement patters that are fostered from young ages facilitate muscle imbalances. As humans grow older, research has shown that we lose flexibility. I don't believe that flexibility just goes **poof** and goes away one day. I believe that taken the actions that we participate in everyday contribute to faulty movement patterns seen by many therapists daily. I think that faulty movement patterns are a direct result of purposeful incorrect movement in life: work, playing, exercising, etc. We learn the wrong way to exercise and we pay the price 3-5 years later with an aching shoulder or painful knees. We slouch in our chairs and sit 1 inch away from a computer monitor and we suffer from stiff necks and aggravated cervical discs. Then, in a quest to better ourselves, we hit the gym and perform these exercises we learned in "muscle magazines" and further damage our posture and muscle-joint relationships. The moral of my story? Be aware...be more aware of your body more-so than your therapist. Be aware of how you lift, be aware of how you sit, walk, and sleep. Find sources that preach correct exercise strategies and programming and learn how to NOT exacerbate muscle imbalances so compensatory movement patterns can be corrected."

Not sure between the difference? Try this: Stand in front of mirror with your arms out-stretched to the side (like a crucifix). From the side of your body, make big circles with your arms, slowly and gradualy go faster. Do your hips "dance"? Can you perform the movement with the same amount of ROM without your hips moving? That is core compensation.

That is an drill my colleague Josh Henkin taught me.
What do you guys think?

[gobbla]

It probibly depends largely on the person and their activities. Assuming that they're consistantly active...the imbalances probibly came first followed by the compinsation from. An inactive person probibly didn't have the mobility to do the excersises right to begin with and then just gets cluster f*cked when they get in there and *try* to do good, using the bad compinsation to create the imbalances.

neat stuff.

[Adam H.]

Maybe I'm just a stickler for language, but the term "compensatory pattern" implies that the body is moving a certain way (compensating) because it lacks the ability to move properly. A muscle imbalance would therefore result in a compensatory movement pattern. However, this compensation may have the adverse affect of making the muscle imbalance worse or possibly creating additional imbalances.

So... a muscle imbalance causes a compensatory movement pattern, which in turn leads to more muscle imbalance.

I hope this makes some sense to someone.

Adam

[John Izzo]

Awesome thread Adam!

Picture this: You break your ankle and wear a cast for 6 weaks. You remove the cast and your lower leg muscles have atrophied...thus causing muscle imbalance and compensation in lower body function...AND possibly up the rest of the kinetic chain. If you strengthen your lower leg muscles, does the compensation pattern dissappear?

My Roundtable had a hard, but interesting time with this topic.

[Adam H.]

You started the thread, John, not me.

Regarding the hypothetical scenario that you suggested, I think that the goal of a successful physcial rehabilitation program is to eliminate imbalances and the resultant compensation patterns caused by the injury, and return the body to the state it was in before the ankle break. Of course, I'm assuming that the ankle heals so that the function of the lower leg is not disturbed in any way. If a structural difference exists between the two limbs, I cannot see a way to eliminate the compensation pattern... the body must compensate for the new morphology of the joint. At this point, the goal would be to minimize the impact that this new movement pattern has on the rest of the kinetic chain.

Adam

[John Izzo]

Originally Posted by Adam H.

You started the thread, John, not me.

Regarding the hypothetical scenario that you suggested, I think that the goal of a successful physcial rehabilitation program is to eliminate imbalances and the resultant compensation patterns caused by the injury, and return the body to the state it was in before the ankle break. Of course, I'm assuming that the ankle heals so that the function of the lower leg is not disturbed in any way. If a structural difference exists between the two limbs, I cannot see a way to eliminate the compensation pattern... the body must compensate for the new morphology of the joint. At this point, the goal would be to minimize the impact that this new movement pattern has on the rest of the kinetic chain.

Adam

Again...awesome POST!!!!

[Sam S]

Define muscle imbalance.

[Adam H.]

Define muscle imbalance.

First Google hit for "muscle imbalance":

The relationship between the tone or strength and length of the muscles around a joint is known as muscle balance. When examining an athlete we need to assess stationary and dynamic strength and length. Muscles can be divided into two types: mobilisers and stabilisers. These two groups of muscles have quite different characteristics.

Mobilisers

The mobilisers are found close to the body's surface and tend to cross two joints. They are typically made up of fast twitch fibres that produce power but lack endurance. With time and use they tend to tighten and shorten. The mobilisers assist rapid or ballistic movement and produce high force.

Stabilisers

Stabilisers, by contrast, are situated deeper, invariably only cross one joint and are made up of slow twitch fibres for endurance. They tend to become weak and long with time. Functionally the stabilisers assist postural holding and work against gravity.

Imbalance

Whilst initially both groups of muscles work in a complementary fashion to stabilise and move, over time the mobilisers can inhibit the action of the stabilisers and begin to move and attempt to stabilise on their own. This inhibition of the stabilisers and preferential recruitment of the mobilisers is central to the development of "imbalance" and is the essence of what we want to detect and if possible reverse.

This could be considered a working definition for this thread.

Adam

[Sam S]

Weak.

You can't group muscles into stabilizers and mobilizers because a muscle's function depends on the demands of the activity in question.

the whole concept of muscle imbalance is flawed by implying that there is one correct alignment, ideal method of function, or perfect balance that can be identified. Consider the infinite variations of squatting seen in weightlifters. Some utilize greater ankle range of motion others more hip range and varied trunk postures. Even when trying to reproduce the exact same task such as throwing a baseball, the most skilled athletes can't reproduce it exactly. Does that mean they have muscle imbalances? No. Joint range of motion and muscle force production, and muscle recruitment patterns change with speed of movement, load, fatigue, and sensory input. If muscle balance was identifiable (they try to do it with isokinetics), you'd have to test a client at every speed and from every angle at varying levels of fatigue with every task they may encounter.

[Lisa~]

Does it matter which comes first? We meet a client in whatever state they find themselves. We work with them from there.

[Adam H.]

Good points, Sam.

In my opinion, every individual has an equilibrium state, or ideal muscle balance about their joints. This balance is specific to the individual and based on their genetic phenotype. Different athletes squat differently because their body types work better within certain movement patterns. That doesn't mean that a weak psoas wouldn't be easily assesed in all of the athletes through a basic imbalance check.

What I was referring to earlier is an individual's ideal muscle balance becoming undone due to either acute or chronic trauma.

Just because the body is unable to exactly duplicate a complex task does not mean that the muscles in the joints do not have an optimal strength and elasticity equilibrium. This equilibrium (dependent on load fatigue, etc.) should allow the body to perform most tasks effectively and without pain.

Adam