Muscles Must Work Together

September 30, 2001|By Molly Martin The Seattle Times

It's natural to point to an injury and think the crux is right there: the sore shoulder, the tender knee, the aching back.

But often -- and increasingly as we age -- problems arise from an imbalance of muscle groups. No matter how strong or flexible one muscle might seem, if opposing muscles don't have complementary fitness, we may be primed for a sudden or chronic injury.

A muscle imbalance often can be traced to several factors, says Scott Jurek, physical-therapy director at the Institute for Prevention Solutions, a health and sports-medicine clinic in Seattle. "Usually it's a combination of flexibility and strength and something called, basically, body awareness or, if you want to use a fancier word, proprioception, which is the body's ability to react to a position, stress or force."

"Balanced" doesn't necessarily mean equal. One recommendation for good strength balance in the thigh muscles, which calls for the hamstrings (in the back) to lift 70 percent of the weight the quadriceps (in front) can lift, might vary according to a person's history, injuries or activities.

From the top down, here are some common imbalance problems:

Neck. Tight muscles in the front of the neck can cause chronic pain in the neck, shoulder and sometimes midback. One indicator of such inflexibility is difficulty pulling the head back so the ears are in line with the shoulders.

Chest/back. People commonly strengthen pectoral (chest) muscles with bench presses and flyes. But if they don't develop the midback with exercises such as rowing, muscles there can become weak and inflexible. That's often detectable by tightness or pain between the shoulder blades when pulling the shoulders back.

Back/abdominals. "A lot of people use their back muscles to lift -- which isn't good because they should be using their legs -- and so they have very strong back muscles," Jurek says. "But they don't do anything for their abdominals, or they don't `kick in' their abdominals." Sitting all day either slumped or "dumped" (arched back, pelvis forward) also contributes to the problem, which manifests in low-back tightness and pain, and sometimes excessive flexibility in the pelvis. Jurek likes crunches as well as Pilates, yoga and other systems that develop overall core strength.

Quadriceps/hamstrings. These muscles help stabilize the knee, yet the quadriceps are often flexible but weak, and the hamstrings tend to be tight. Physical therapists sometimes use electronic stimulation or other biofeedback techniques to help patients learn to contract the muscles.

Shin/calf. Tight calves and weak shins are often the cause of shin splints, though Jurek says some people are weak and inflexible on both sides.

A visit with a physician and physical therapist might be the fastest and most effective road to identifying and addressing muscle imbalances. Four books Jurek likes are The Whartons' Stretch Book by Jim and Phil Wharton, Listen to Your Pain by Ben Benjamin and Gale Borden, Awareness Heals by Steven Shafarman and Conditioning for Outdoor Fitness. The latter book, by sports-medicine physician Dr. David Musnick and physical therapist Mark Pierce, addresses common muscle imbalances throughout the body and presents exercises to counter them.

Jurek is also an ultramarathoner -- he has won the Western States 100 Mile Endurance run the past three years -- giving him plenty of opportunity to develop injuries. "If you don't pay attention when they come on, that's when you get into trouble because it's a long process.

"The key thing is staying active," he says. "Usually you're better off doing some form of your activity, even if it's a minimal or minuscule amount. Or you find ways of modifying your work station.''

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