Why ‘unbalanced’ muscles can cause you pain

NEW YORK – When you head out for your daily run, with each stride, you are strengthening your quadriceps, hamstrings and upper calf muscles. The muscles on the sides of your hips, however, are not growing much.

If you regularly do one sport – like running, biking or tennis – and rarely do anything else, you run the risk of having muscle imbalance.

Imbalances happen when one muscle is significantly stronger than another. The two muscles can be on opposite sides of a joint or bone, or across the body.

For example, if a weightlifter overtrains his or her biceps and ignores the triceps, or an office worker spends 10 hours a day peering at the computer screen, leading to weak shoulder muscles, imbalances can emerge. This can lead to pain, poor posture and injury.

Dr Ann Crowe, a physical therapist in Clayton, Missouri, who works primarily with runners and cyclists, said most of her clients’ foot, knee, hip and back pain can be traced to these imbalances.

Runners and cyclists typically focus on the cardiovascular benefits of their sports, but neglect strength training, she said. As a result, they often have weak glutes and strong quads.

Studies suggest that muscle imbalance can especially contribute to shoulder, lower back, elbow and wrist injuries in athletes who play sports with overhead movements, such as water polo, tennis and basketball.

Another study found professional soccer players with strength imbalances were four to five times more likely to suffer a hamstring injury as compared with those with no muscle imbalance.

Muscular imbalance is also caused by sitting in a chair for hours on end. When experts studied office workers, they found muscle imbalance tied to neck pain in as many as 70 per cent of subjects.

While muscle imbalance does not always cause pain in the short term, experts say it is important to focus on strengthening all the major muscle groups in your body, which over time can help prevent pain and injury by improving your body mechanics.

When is muscle imbalance a problem?

Opposing muscles around a joint or bone need to work together to function, but occasionally, one muscle becomes too weak, too strong, too tight or too loose. That is not always a cause for concern, and everyone has some degree of muscle imbalance in his or her body, said Dr Darren Calley, a physical therapist at the Mayo Clinic specialising in orthopaedic physical therapy.

For instance, experts do not typically worry as much about left-to-right muscle imbalance, said Dr Aimee Diaz, clinic director at University of Southern California Physical Therapy.

A pitcher might have a strong right arm, but the contrast with his left side is not an issue unless he or she experiences pain. However, front-to-back imbalance, such as tight hip flexors paired with weak abs and glutes (often caused by too much sitting), can lead to lower back pain.

Although you can isolate some muscles and train them independently, muscles need to work together for everyday movements, said Dr Jessica Curran, a physical therapist at Chicago-based non-profit rehabilitation research hospital Shirley Ryan AbilityLab.

“They need to be equally strong and flexible,” she added.

What are the signs

Symptoms of a muscle imbalance differ from person to person, and from muscle to muscle, but Dr Curran said one sign might be aches and pains that do not seem to dissipate, or if you feel sore in the same general area even when you are not working those muscles.

The only way to know for sure, she added, is to visit a doctor or physical therapist for an evaluation.

The pain might also show up differently in each region of the body. Someone who has stronger chest muscles and a weaker back could experience a pinching sensation in the shoulder, and a muscle imbalance in the lower body could show up as lower back pain, said Dr Diaz.

How can you prevent it?

Both preventing and addressing a muscle imbalance usually requires strength training, especially if you focus on one activity or sport.

“Runners should do strength training, whether they’re new to running or doing really high mileage,” said Dr Crowe.

For runners, she recommends single-leg squats with one leg elevated, holding onto a table if necessary, because those target the muscles on the sides of the hips, which are often weak for them.

For cyclists, who often have weak glutes, she recommends reverse sliding lunges or step-ups, either weighted or unweighted.

People who develop muscular imbalances from habitually sitting at a desk should work on strengthening the upper back, which can become weak when hunched over. Some exercises to try include bent-over rows, kettlebell swings or Romanian deadlifts.

Ultimately, whether you are a weightlifter, an endurance athlete or a deskbound worker, you should vary your movement at least a few times a week. Long-distance cyclists could try swimming or hiking, and office workers should take breaks during the day to change positions and move around.

Fortunately, it does not take long to address the problem, Dr Calley said, if you are intentional about strength training and regularly vary your movements. NYTIMES