Your body has muscles (or groups of muscles) that are attached to either side of a joint and work against one another to control the movement of the joint. It’s a bit like the handlebars of your bike: you can ride with one hand, but two hands working against each other gives you much better control.
When one side of the opposing muscles is stronger than the other, you have a muscle imbalance. For instance, if you regularly use the muscles on one side a lot more than the other, they get stronger muscles – and shorter and tighter. On the other side, the muscles get weaker – and longer and looser. The shorter, stronger muscles pull that part of your body out of position, and your whole body will end up making adjustments to compensate.
In the bicycle analogy, if one of your arms was slightly shorter than the other you would have to adjust your riding position slightly to keep riding in a straight line.
Picture your two hands on your cars steering wheel. While the pull on your left and right hands is equal, the steering wheel will stay in the middle position and the car will stay in the middle of the road. This is a balanced system. With only slight adjustments made to the pull on either hand the wheels can be made to turn in either direction in a very precise and controlled way.
In this balanced and finely adjusted system, the car can not only be kept in the middle of the road, it can easily and precisely be steered around the curves and corners, keeping it safely in the middle of the road.
Now imagine what it would be like if the inherent pull of your right hand was even slightly more than the left hand. There would be an underlying tendency for the wheel to be turned to the right, meaning that the car would always be drifting to the right of the lane. You would therefore have to constantly correcting the direction by turning back to the left, but as soon as you stop actively correcting, the wheel is being pulled subtly to the right again.
What will happen in time however, is the car is going to head closer and closer to the central reservation and eventually bump into it, damaging the wheels or more (this is like an episode of pain/strain etc that seemingly occurred for no reason). You then position the car back in the middle of the road and continue on the journey.
However, as there is still the underlying imbalance in the system, the tendency to drift to the right is still there, and before long, there is another episode of bumping into the central reservation (another episode of pain/strain etc).
Now there may be a few months or even years between these episodes but while the underlying imbalance exists, it will happen again. And as more episodes get added to the history of the car, it starts to show the signs of the bumps and scrapes. In the body, this is (premature) wear and tear. What tends to happen is that with every episode, the time it takes for the next episode gets less.
So the answer is to identify and correct the underlying imbalance, making sure that there is equal pull on both sides of the steering wheel. In the bio-mechanical system, that is it ensure that there is always equal muscle length, strength and activity on both sides of the system (joint or motion segment).
It is therefore the responsibility of the skilled Physiotherapist to not only help with the immediate effects of the pain/strain/overload but also to identify and correct the underlying imbalance that is creating the tendency towards straining the system.
Muscle imbalances are often caused by something you do as a habit and usually due to the little things that we do everyday. You might regularly sit slumped at your PC for a long time, or maybe you train one group of muscles but not the opposite group.
We all have positions we spend a lot of time in. If one of these positions puts your spine and other joints out of their normal balanced alignment, this is a postural dysfunction – and your muscles will adapt and become unbalanced, as described above.
When a muscle imbalance pulls one of your joints out of position, this puts a strain on that joint. When that strain stresses the nerves around the joint, you feel pain. If your body readjusts itself to ease the pain, other sets of muscles can become imbalanced – and the cycle can continue. A small, local problem in some muscles can become a neuro-muscular-skeletal problem that affects distant parts of your body.
Postural problems can manifest in a wide range of different ways such as:
Once properly assessed, muscle imbalances and postural dysfunctions are fairly easy to correct. Generally we focus on three main areas: