Muscle Imbalance, Part 2.

By April 29, 2015 May 4th, 2015 Exercise

A long history surrounds the concepts, theories, and practices that employ muscle imbalance. In brief, here are some of them:

– In 1741, French physician Nicolas Andre was one of the first to discuss muscle imbalance in his writings. He coined the term “orthopedia” which means “straight child” and advanced the notion that scoliosis, abnormal curvatures of the spine, was due to muscle imbalance.

– In 1890 French scientist Étienne-Jules Marey made the first recording of a muscle’s electrical activity, and coined the term electromyography. This would become a common instrument to measure muscle imbalance.

– In 1900, Nobel laureate Sir Charles Scott Sherrington, an English neurophysiologist, proposed his law of reciprocal innervation, which stated that muscle inhibition usually generates tightness in opposite (antagonist) muscles. Despite this notion, most of the therapies associated with muscle imbalance were directed at tight and painful muscles, which, within the tight/weak model of muscle imbalance, were the most symptomatic and easiest to detect. This involved using braces and surgery by many practitioners.

– In 1949, American physical therapists Henry and Florence Kendall’s first textbook on manual muscle testing appeared, which evaluated weakness in polio patients. This marked a change in approach in treating muscle problems as both tight and weak muscles were observed and measured.

– In the early 1960s, clinical pioneers Dr. George Goodheart from the U.S., and Czechoslovakian Dr. Vladimir Janda took different paths in their pursuit of treating patients with muscle imbalance. Goodheart, influenced by Kendall’s work, promoted the idea that muscle inhibition (weakness) was the primary cause of muscle imbalance associated with everyday aches and pain, along with more serious disabilities. This triggered a muscle-testing revolution among many clinicians seeking to find and fix mechanical dysfunction. Janda took the tight muscle road like some of his predecessors, directing therapy at the tight side of muscle imbalance. Both clinicians developed huge multidisciplinary followings that continue today.

– As the jogging and fitness boom of the 1970s evolved, strength exercises such as weight lifting and various workout machines became popular. One result is that many people developed muscle imbalance by creating too much strength in one muscle in relation to another.

Today, there is usually a clear division among the many types of therapists who treat muscle imbalance. Some see the primary cause, and therefore direct their treatment, to the tight side while others focus on the weak muscles to correct the problem. On one hand, there are chiropractors, osteopaths, physical therapist, medical doctors, and massage therapists (to name a few) who evaluate and treat the tight part of muscle imbalance. While others in these same professions evaluate and treat weakness as the primary cause of muscle imbalance. I have always considered the weak muscle to be the primary problem in most cases, with the tightness a secondary problem.

Self-Care of Muscle Imbalance

While treatment by a health-care professional is sometimes necessary, many people are able to correct their own muscle imbalances. There are a number of ways you can accomplish this. Furthermore, the following approaches to correcting muscle imbalance can also prevent a recurrence.

– First and foremost is to address the cause or causes of muscle imbalance (discussed in Part 1).

– Second, allow your body to do the work. Muscle imbalance will often correct itself naturally in a body that’s most fit and healthy. This included the right exercise routine, a healthy diet, and proper management of stress.

– One powerful way to correct muscle problems is by developing a great aerobic system. In particular, the process of warming up before a workout and cooling down afterwards can immediately correct many dysfunctional muscles.

– Spending more time being barefoot can encourage many muscles to function optimally, correcting imbalance. Since the muscles in the foot significantly influence body-wide posture, being barefoot can help all skeletal muscles.

– Eliminating chronic inflammation can correct muscle imbalance—as the body’s natural anti-inflammatory chemicals are also powerful regulators of muscle function.

– Since pain can cause muscle imbalance, finding the source of pain, and eliminating it, also can correct muscle problems.

– The application of cold (cryotherapy) can also help correct muscle imbalance. But extended, continued use of ice placed directly against the body must be pursued with discretion to prevent muscle damage.

NSAIDs and Inflammation Can Cause Muscle Imbalance

Many people use NSAIDs when they have aches and pains, including aspirin, ibuprofen, Advil, Motrin, Nuprin, Naprosyn and other prescription and over-the-counter drugs. But these can weaken muscles as one of their side effects. They can even worsen the problem despite providing symptomatic (and temporary) relief.

The balance of dietary fats control inflammation, and conversion of the omega fats to inflammatory and anti-inflammatory chemicals relies on an important enzyme called cyclooxygenase, or COX. There are actually two COX enzymes, and many people are familiar with the term “COX-2 inhibitors.” Aspirin and other NSAIDs temporarily block the COX enzymes so much less of the inflammatory chemicals are formed. While this reduces the inflammatory chemicals, it also lowers the beneficial anti-inflammatory ones. In addition, the cause of the problem—fat imbalance—goes untreated. So, if taking NSAIDs makes you feel better, it usually indicates that your fats are not balanced. Here’s a quick review on how to improve the balance of fats to control inflammation:

1. First, eat approximately equal amounts of omega-6 and -3 fats. It does not necessarily have to be at each meal, but in the course of a day or week, strive for an overall balance. While this 1:1 ratio of -6 and -3 is ideal, the typical Western diet is often 5, 10, or even 20:1. It’s no wonder there’s an epidemic of chronic inflammation, pain, and muscle imbalance. One reason for this is the high intakes of omega-6 vegetable oils such as corn, soy, safflower, canola and peanut, and the low consumption of omega-3 fats, especially from wild fish, which is the best source, with beans, flax seeds and vegetables contain much smaller amounts.

2. By eliminating vegetable oils (substitute olive or coconut) and taking fish oil capsules, which are high in the most potent omega-3 fat, EPA, the balance of fats can significantly improve. (The omega-3 flax oil is less effective.)

3. Avoid refined carbohydrates, including sugar, which can increase the conversion of omega-6 oils to inflammatory chemicals.

4. A number of other dietary factors can impair the production of anti-inflammatory hormones, thereby increasing the inflammatory ones: low levels of vitamins B6, C, E, niacin, and the minerals magnesium, calcium, and zinc (these should come from a healthy diet); trans fat; low protein intake; excess stress; and aging, which increases the risk of more inflammatory chemicals.

A Note About Other Types of Pain Drugs

In addition to NSAIDs, a second type of over-the-counter drug used for pain relief includes acetaminophen. The most popular non-prescription one is Tylenol, which doesn’t act by reducing inflammation, and therefore is less likely to interfere with healing and recovery. In fact, it’s not entirely clear how it works, but liver stress is among the side effects; the body needs to break down these drugs in the liver, which requires large amounts of the amino acid cysteine (best obtained in the diet from whey consumption).

Narcotics, such as opiates, are another type of pain reliever. These act in the brain to reduce the sensation of pain and also don’t affect inflammation. However, they are easily addictive, and their use as a pain reliever wears off as the brain cells become desensitized. Common narcotics prescribed for pain include morphine and other opioid drugs such as codeine and oxycodone (OxyContin).

Yet another pain-relieving drug is THC, the active component in marijuana, which controls pain by stimulating certain receptors in the brain, similar to those that opiates act upon. THC can stimulate the brain’s natural opiates, like endorphins. The only prescription form is the product Marinol, although many states now have medical marijuana laws.

Manual Biofeedback

Among the many tools I used in private practice to help correct muscle imbalance was manual biofeedback. It’s a safe and effective, and relatively easy approach for use by most healthcare professionals, with its basic techniques used by many lay people as well.

Manual biofeedback helps the brain and body restore and balance muscle function. It addresses the problem of muscle imbalance that’s due to a wide range of problems. It can be used in children and adults of all ages who have suffered minor local muscle injury to more serious brain and spinal cord injuries. This therapy helps restore muscle balance by strengthening weak muscles and relaxing tight ones. It’s a simple hands-on system that requires no equipment.

Most people who have injuries associated with muscle imbalance fall into at least one of two categories:

• Local muscle injury is the most common cause of physical problems, and is often associated with trauma to the muscle itself, such as the result of a fall, a so-called pulled muscle, a twisted ankle, or other injury. Micro-trauma is even more widespread; it’s the accumulation of minor physical stress in a muscle or joint, often unnoticed while it’s happening, eventually causing a more obvious muscle problem. Daily living produces significant wear and tear on the body’s mechanics—a stress that most people should adapt to well. But often, this stress is not compensated for and muscle imbalance develops. In addition to exercise, too much sitting, repetitive motion injury, or walking in poor-fitting shoes often leads to micro-trauma, which in turn ultimately causes muscle problems. Local muscle injuries can result in anything from minor annoying ache to a serious or chronic debilitating condition.

• Brain or spinal cord injury can occur at any age, even before birth, and usually milder forms can be found in many individuals who don’t realize they have a relatively minor problem that still causes muscle imbalance. Trauma, infection, or reduced nutrient supply can easily cause brain or spinal cord damage resulting in poor muscle function. Many people are also involved in an auto accident or other trauma that can often sustain a brain or spinal cord injury—sometimes so apparently minor that many doctors or hospitals say you’re fine, even after an MRI or CT scan.

Manual biofeedback can help promote and restore muscle balance; it not only helps locomotion and posture, but can improve brain function as well, including speech, vision, balance, memory, and even intellect. And because muscles have other important functions, such as energy production, circulation, and immune activity, increasing physical movement can improve overall health.

Manual Biofeedback Can Be Used by Anyone

While healthcare professionals regularly apply the art and science of manual muscle testing, biofeedback and other hands-on assessment and therapeutic activities, there are tens of thousands of other individuals who learn to use these important techniques everyday. Almost everyone has used tweezers to take out a deep splinter (minor surgery), bandage an abrasion (emergency first aid) or in some instances even save a life by learning CPR (cardiopulmonary resuscitation). And it’s not uncommon to see, in many public areas, including airplanes, restaurants and malls, automatic cardiac resuscitators for emergency treatment in cases where a person’s heart stops—complete with instructions for the average person to use to save a life.

Manual biofeedback is just as practical, if not easier, than some of these techniques, and its successful application to the majority of physical aches and pains can be surprisingly simple once a bit of experience is attained. Manual biofeedback can be used in the young and old, including children, athletes, and everyone else.

While traditional EMG biofeedback uses computer equipment, including mechanical sensors and electrodes attached to the skin, manual biofeedback does not use any equipment. Instead, it relies on the neurological sense of the person using manual biofeedback. This personal approach also allows for the recruitment of more brain-body stimulation with verbal, visual, tactile, and other sensory cues that further enlists the patient’s participation and motivation. Like many forms of biofeedback, manual biofeedback relies on basic manual muscle testing.

While it takes another person to use manual muscle testing and the basic biofeedback therapies, with respiratory biofeedback, you can do it on yourself without assistance from others.

The Family Hope Center, which is based in Philadelphia, helps brain-injured children and teaches their parents how to apply many home therapies. A couple of years ago, the Center asked me to make an instructional DVD on manual biofeedback. I was happy to be of assistance. The DVD and users manual that I created contains an introduction to the concepts of muscle imbalance and how to remedy it, respiratory biofeedback and proper breathing techniques. It also includes the detailed use of manual biofeedback, and a library that demonstrates how to test and perform manual biofeedback on all the body’s major muscles.

This DVD is now used by virtually all types of individuals dealing with sports injuries, common aches and pains, as well as improving brain function. (For more information, visit the manual biofeedback pages.)

Breathing Muscles

Of all the vital muscles necessary for optimal health and fitness, one of the most important is the diaphragm. This breathing muscle is located on top of your abdomen and under your lungs. The large flat muscle allows you to breathe by pulling in oxygenated air and expelling unwanted carbon dioxide. In many people, the breathing mechanism may be the weak link to improved overall function.

Poor diaphragm muscle function—muscle weakness—can lead to various problems such as general fatigue or poor function of many body areas due to reduced oxygenation. In this case, less air enters the lungs and the blood does not receive the proper amount of oxygen. Moreover, poor exhalation does not eliminate the necessary amount of carbon dioxide. Correcting diaphragm muscle weakness can allow the body to improve the function of many other muscles.

Everyone can incorporate the actions of normal breathing into their day—not necessarily only during exercise, but also during rest or down time. This can help improve one’s health, but also repair muscle imbalance.

Normal Breathing

It’s natural to take breathing for granted, until you experience a breathing difficulty. But some people breathe improperly and don’t even realize it, while many others could improve their breathing by controlling stress. Normal breathing is associated with proper muscle movement—the most important being the abdominal muscles in the front and sides of your abdomen and the diaphragm muscle. These muscles work together allowing us to efficiently breathe in and out. Without normal breathing, the abdominal and diaphragm muscles may work improperly, and even cause other muscles to not work. In this scenario, body movement—posture and gait, for example—can become impaired, oxygen can be reduced, and other problems can occur.

The abdominal muscles also help physically support your body structure—the spine, the low back, pelvis, shoulders, and even the neck. The abdominals not only help you walk, jog, play any sport like tennis or golf more efficiently, but also sit, stand and even sleep properly. In some cases, improper breathing is the beginning of a complex set of imbalances causing an injury to the low or middle back, hip, and shoulder.

Given the importance of the abdominal and diaphragm muscles, let’s look more closely at the two components of normal breathing—inhalation and exhalation:

1. During inhalation the abdominal muscles relax and extend outward, while the diaphragm muscle moves downward. This movement allows air to enter the lungs more easily and is accompanied by a slight whole-body backward extension, especially of the spine.

2. During exhalation the abdominal muscles contract and tighten, and are gently pulled inward; the diaphragm muscle “relaxes” with an upward movement. This helps push air out of the lungs, with a slight whole-body flexion.

By watching another person’s breathing, especially the belly moving out on inhalation and in on exhalation, one can often tell if it’s correct. You can also evaluate your own breathing by feeling the muscles move. So try this quick experiment:

• Place the palm of one or both hands on the abdomen (over your belly button).

• Slowly breathe in and feel the abdominal muscles expand outward. Your belly should get bigger during inhalation.

• Slowly exhale and feel the abdominal muscles tighten and be pulled inward. The belly is more flat on exhalation.

During normal breathing, most movement occurs in the abdominal areas, and only slightly in the chest, which expands more with much deeper breathing.

Those who breathe improperly often move their muscles opposite that of normal—for example, they sometime pull their belly inward on inhalation. In other cases, the chest is quickly and fully expanded and the abdominal area doesn’t get a chance to move properly. These poor patterns of breathing can be caused from stress, the stigma of not showing their belly during inhalation. The use of so-called slimming garments that wrap around the belly can actually cause the abdominal muscle to weaken and therefore should be avoided. Even over-exercising the abdominal muscles—typically with sit-ups or crunches—making them too tight to relax. In a real sense, poor breathing is the result of muscle imbalance—weak diaphragm and tight abdominal muscles are a common example.

It’s particularly important to be aware of your breathing during times of stress, which is often when breathing can switch from normal to abnormal as you hold more tension in your abdominal and pelvic muscles.

If your breathing is abnormal or irregular it’s important to immediately retrain the breathing mechanism. This can be done using respiratory biofeedback (see the 5-Minute Power Break). The procedure is simple using the steps just outlined above for normal inhalation and exhalation.

Muscle Balance and Bone Health

In general, by maintaining proper muscle balance and by being healthy and fit, you can significantly reduce the risk of bone problems, including fractures and osteoporosis—injuries that occur in both men and women.

There are a number of other factors that significantly influence bone strength, in particular, the proper mineralization of bone. This is referred to as bone density. Your bones are not unlike muscles, intestines, skin and other tissues throughout the body. They are full of life—living parts of us. As such, bones are always metabolically active. This means there is always an ongoing influx and output of nutrients—calcium, sodium, magnesium, zinc, protein and others—which provides us with our level of bone density. If your bones lose more calcium, for example, than they take in, you risk weak bones vulnerable to injury and disease. Combine this with even minor muscle imbalance and the risk of bone injury is high.

In addition to muscle balance, here are some other key factors that greatly influence bone health:

– Aerobic fitness: this helps maintain support of bones.

– Gravity stress: this is associated with physical activity that improves bone density. For example, someone who only bikes for exercise might add walking or jogging to their workout routine.

– Hormone balance: both estrogen and testosterone in particular help regulate bone mineralization, as do adrenal hormones that regulate sodium.

– Adequate calorie intake: low-calorie diets can weaken bones.

– Proper fat and protein intake: both are necessary for bone health.

– Avoiding chronic inflammation: this problem can reduce bone density.

– Sun exposure: your main source of vitamin D, which regulates calcium.

When a bone is stressed, whether from physical strain, dietary or hormonal inadequacy, too little vitamin D, or disease, at least three types of injuries can result.

– A stress reaction is a subtle bone injury, microscopic in nature. It causes vague discomfort following physical activity, even just walking around. This problem can’t be seen on an X-ray or other scan, making it somewhat elusive.

– A stress fracture, which is more painful and usually restricts activity, can occur if more stress affects the bone. It can often, but not always, be diagnosed with an X-ray. It is also an example of a microscopic bone injury.

– A bone fracture or break can occur with higher levels of stress. There are many different classifications of fractures depending on how extensive it is and where the break is located. While more serious fractures can require surgical repair, many others are capable of healing with just a cast, or little or no support. In some cases, poor health is associated with bone injury, such as osteoporosis where reduced bone density contributes to a compression fracture (collapsed vertebrae). Fractures are more obvious on X-ray.

If you experience trauma—a severe twisted ankle, a hard fall, or drop a heavy weight on your foot—and injure a bone, healing occurs much more rapidly if you have better muscle balance and are healthier overall. This is true even for an extreme case where surgical repair is necessary. Most importantly, whether a stress fracture from exercise or a more serious bone injury such as a broken hip from a fall, there are usually key causes of more severe health problems that need to be addressed.

Stress fractures

The most common bone problem in active people is stress fracture. They can occur without obvious trauma, and are often due to muscle imbalance interfering with weight bearing, gait, and other movement. While the bones in the legs (tibia and fibula) are common sites of stress fractures, they can also occur in the foot’s metatarsal and navicular bones, the pelvis, and wrist.

Pain from a stress fracture typically improves with rest and worsens with activity. There is often some swelling in the area, but sometimes it’s not noticeable. The swelling around the site of fracture may prevent a proper diagnosis by X-ray if taken within the first two weeks of injury. Only after some healing has taken place will the X-ray show the problem. In these situations, a bone scan may help locate the stress fracture when the X-ray can’t.

Most stress fractures will heal well in a healthy person without major therapy. Rest, cooling the site of fracture, cessation of weight-bearing exercise, and hard-soled flat shoes are often sufficient, but each case must be treated individually. Aspirin and other NSAIDs must be avoided as they can delay bone healing.

Just as important is the fact that something caused a stress fracture to occur; and that something—some imbalance in muscles, hormones, diet, or often a combination of problems—must be found and corrected. If this does not happen, you are vulnerable to future fractures.

A low-fat diet may be associated with a higher incidence of stress fractures—statistically more in physically active females. Fats are important for many aspects of health, with certain fats helping to carry calcium into bones and muscles.

The importance of optimal muscle function for bone health is often not addressed by health-care professionals. However, this may be the most important contributing factor in stress fractures. Three muscle problems can exist in this context:

– Muscle imbalance can cause reduced support and increased stress on specific areas of the skeleton.

– Poor aerobic function, as seen in the aerobic deficiency syndrome, can result in the daily loss of bone support.

– Low muscle mass, such as that seen in sarcopenia, is associated with poor strength, loss of bone support, and increased vulnerability to falls and other injury.

Muscle balance is a key part of physical health and fitness. An imbalance of two or more muscles typically results in one being weaker, and often not symptomatic, and another too tight. This imbalance can be a primary cause of various aches and pains, some minor and merely annoying but others debilitating. Correcting muscle imbalance is something you can do—it’s one of the jobs of a health and fit body. In some cases, finding a healthcare professional may be necessary to accomplish this task.


  • Nick Toadvine says:

    I had shoulder surgery 15 years ago on my left shoulder. My left pectoral muscle is, at least to me, noticeably smaller and weaker than my right. I’ve tried training just that side on a separate day for over a year and nothing is happening. It doesn’t get the pump my right side does no matter what I do. I’d be really interested to know your thoughts. I live in central Florida and don’t know who I’d could see here for help. Thank you.

  • Ansh says:

    I can’t contract my left bicep as much as I can contract my right one. The same problem arises while gripping something. My left grip is much weaker than my right hand grip.

  • Sebastian says:

    Hi Ivan,

    Could you please advice on an exercise routine, it’s mentioned in this article. I’m interested in what kind of exercises are the best to fix muscle imbalances and in particular a bad posture. Do you happen to know the Anatomy for Runners by Jay Dicharry? As advised by you I stopped stretching the way the author presents it. I’ve lost my confidence if the exercises presented in this book are good. Thank you in advance.


    • Sebastian:

      I’m sorry to say that I’m not familiar with the book. Fixing posture is not a simple endeavor: you have to have a very good idea of what your muscle activity across the body looks like presently, and you have to have a very good idea of what it should look like. The problem with most exercises isn’t that they don’t work, but that understanding when and where to apply them takes expert-level understanding.

  • un consejo para recuperacion de esguince de rodilla,esquiotovial izquierdo,gracias.

    • Raul:

      Descanso completo de la zona dañada (evitar cargar el peso del cuerpo) hasta que el dolor agudo se haya ido por completo. En ese período, hacer lo posible por movilizar la articulación pasivamente sin dolor (con ayuda externa de un tercero, por ejemplo de un fisioterapeuta). Ya que la articulación no tenga dolor alguno, comenzar a cargar el peso lentamente (caminando unos pasos, por ejemplo) aunque sea un poco incómodo.

  • Susan says:

    Hi Ivan,
    Thank you for your very informative articles. I have a question. I am 50, active, healthy diet, healthy in general. Two years ago I had my right hip scoped for FAI, 4 bone anchors, impingement – basically rebuilt. Since then I have had an ongoing battle with weak gluten. I am a former athlete, so I was slow and steady in my rehab as this surgery requires. Even though I am at war with my gluten, last September I played 10 minutes of hard competitive tennis. I was definitely careful, but I just could not help myself – it felt great…then both hip bursas got inflamed, my gluten ached and my thighs were sore. Everything cleared up in within a week except my right quads. That pain grew and by late October I had a constant ache that I believe began just above my anterior knee and worked it’s way up to mid thigh – then spread across my mid thigh. I did not think a lot of it because I continued doing everything I normally do but, I noticed I was having trouble trusting my leg when driving. It was not weak, but it was so achy I noticed that I was constantly adjusting in my seat, moving my foot, etc. I saw my PT and she dry needled me, hit a huge knot, found a couple smaller ones, then did manual stuff. I had three completely normal days then the ache and mild guarding came back. I have struggled with this since. It has never been so intense, I stretch before and after PT and probably walk a out 35 – 40 miles a week, on my feet constantly. I also do gently foam rolling and occasionally something like ICY HOT. I noticed 2 weeks ago an onset of hamstring discomfort same leg. It got worse over two weeks to the point where it really hurt to bend over. I took an anti inflammatory for a couple of days and the hamstring issue reduced but is not gone. I think that this is all due to muscle imbalance due to a week glute min. (I can activate and work both my max and med – I think those are pretty good) I have a lot of trouble working those due to bursa pain. Do you have any suggestions on what I can do to help restore muscle balance and get rid of my aching right quad? Thanks for any thoughts!

  • Scott Rose says:

    I would like to start off by saying thank you. Thank you for saving my life.
    I am a 42 year old male that lives in Australia and have been dealing with a very wide range of problems from a very young age that have gotten worse and more abundant over time. I am a qualified cabinet maker with 23 years experience and I love it. I used to love long distance running, skateboarding and clay target shooting. I have 3 beautiful kids aged 17, 10 and 8 that deserve to be given the world but I can no longer do any of the things I love or give my children the life they deserve.
    I won’t go to much into ALL of my problems but I will give a quik summery of the things affecting all aspects of my life.
    I am currently awaiting an hip replacement on my left side due to osteoarthritis and will also need the right replaced. I have had most of the cartilage removed from my right knee due to it being torn and locking in place. I have a piece of gauze like fly wire in my back to repair a hernia after the muscle had to be rejoined after it tore. I have irritable bowl syndrome, chronic obstructive pulmonary disease, scoliosis, spinabifada acolta, and numerous other spinal defects and problems. I am constantly exhausted and nausies and suffer dabilatating migraines every few days. My left eye has a stigma that gives me double vision and doesn’t focus, and I’m losing hearing in my left ear, and my balance is terrible and I suffer from virtigo so severe that it lasts for weeks on end and end up in hospital on a drip. There is more but I did say I won’t go into all of them. Ha. Any one or number of these things is not a big problem but as they get worse and more frequent they all add up to a very painful and sickening existence that you think can only result in death one way or another. I understand that not all problems are related and some are more psychological than physical but they all play a part in a very poor quality of life.
    Over the years I have seen numerous doctors and specialists ranging from Physio, chiropractic, surgeons, general practitioners, mental health and even holistic. Each one has helped in their own way to a point but none have pinpointed a cause for any of it.
    Then a memory came to me that I had blocked out of my father beating me ever time I used my left hand and went as far as strapping my arm behind my back so I couldn’t use it. This resulted in me learning to do everything with my right hand, arm, leg and foot and never my left. At one point I was told there were 9 muscles not working on the left side and still no one found a corilation between it all. So I started using my left side as my leading side a few days ago and low and behold, things are working in me like never before. Then I found this article and my world started getting lighter and brighter with every paragraph.
    Now I just have to find and stick to a regime that will help give me a life and a future.
    Thank you very very much. Any advice or direction would be greatly appreciated.

  • Angie says:

    I’m hoping you can give me advice on a good starting point… My right leg muscles are much weaker than my left. So much so that my right leg is shorter and I’m certain the muscle issue is the primary reason. I can see the difference visibly and feel it, when I run long distances especially– I often start limping without realizing it. In the past year, I’ve started having lots of left hip pain and during half marathon training last fall my hip would slide out of place. Let me give you my history… At the age of 4, I began to have knee issues and was later diagnosed with pigmented villonodular synovitis in my right knee. I’ve had three surgeries, at ages 9, 19, and 26. I’m 37 now and at this point have no active PVNS (it can and has recurred in the past). Most of my meniscus has been removed and I have chondramalacia and osteoarthritis, but amazingly my knee does really well and I rarely have major pain or mobility issues out of it– especially if I stay active and keep my weight down. I have run 5 half marathons in my 30s, interspersed between two pregnancies. I’ve never been a fast runner, but I’ve struggled over the past couple of years (since the birth of my second child) to get back to previous running paces and I’ve also struggled with the hip issues I mentioned. I know that the root of this problem is that I have favored my right leg for over 30 years. I’ve never trusted my right knee, so I’ve always led off or stepped up with my left. I never even started running until after my second surgery because I just thought I wasn’t physically able. I sat out of gym class my whole childhood! Add to that the fact that I drove a standard shift for seven years. I can see that all my right leg muscles are weaker. I don’t have full range of motion in my knee, but that’s probably mainly due to scar tissue. My ankle is also tight, though, and doesn’t flex as much as my left. I notice when I run that my right foot turns in slightly. Help! I want to keep running, and even get faster than I was before. I want to run — and walk– injury free. At my age, I think this imbalance will start to affect more than just my running unless I do all I can to correct it. Where do I start?

    • Angie:

      My best advice to you is to go to a physical therapist that specializes in gait in your area. I can tell you a lot about what you might try to do to solve it, but stuff like this is a huge can of worms that has to be addressed by someone with a lot of knowledge of your situation.

  • James says:

    Would cold therapy be recommended for lower back tightness/pain? Would this not back the low back muscles tighten more?

    • James:

      It depends on the cause of the lower back tightness. But there’s been a lot of science coming out lately suggesting that cold therapy might be detrimental to muscle tissue recovery. So the jury’s out on whether it helps. To put it another way, it might be a good idea for tightness or pain on a case-by-case basis, but only the specialist looking at your situation could tell you that.

      • James says:

        Hi Ivan, thanks. My lower back feels better whilst doing aerobic activities (especially after a proper warm up) but often tightens again a few hours after the workout and feels particularly bad after prolonged sitting and first thing in the morning. From what I’ve read here – do you think its weak abs causing the lower back to tighten ? I’ve been doing core exercises (abs plank) and respiratory bio feedback – anything else I can do to help ? I think this problem ia affecting my maf pace even though aerobic exercise seems to help albeit temporarily. Health professionals in my area only seem to suggest painkillers, rest, stretching etc.

        • James:

          It’s probably abs that don’t know how to stabilize the back in athletic activities, which means that the lower back is saddled with stabilizing the entire body, which means that they get tired, which means that you get pain. Off the top of my head, what i’d suggest is tall kneeling exercises such as the FMS exercises in this video. Then step up to half-kneeling exercise progressions, also from FMS.

          Without knowing anything about the particulars of your case, hitting it with a wide variety of tall kneeling AND half-kneeling exercises, going from simple to complex, would be my bet for improving your lower back issues.

          • James says:

            Ivan, thanks very much for this. I did 10 mins of the exercises in the video at the gym this morning and afterwards walked around and I just felt a lot more balanced. Even upper back and shoulder area felt less tight.

          • Good to hear!

            Keep poking around for variations of those exercises. There’s a lot of chops, barbell and kettlebell variations. Shop around for stuff that challenges you moderately, and then up the ante once you’ve mastered it.

  • Pete Eade says:

    Hi Dr. Maffetone,
    I am a fan of yours. I read and try to follow all that you say. My sport is ultra distance road cycling. Brevets. I am age 74. Keep my training rides to below 5 hours and work at maintaining a 107 bpm HR. My diet is high fat, low carb & pr.
    My problem is working our what to eat during competition, when my HR often goes above what I train at no matter how I try to avoid this. I eat fruit, dried fruit, nuts, cheese & date sandwiches, egg sandwiches. a sports drink that contains dextrose, caffeine, sodium, potassium, calcium, magnesium. Lately I am trying white rice cooked into small cakes with dates, coconut oil, eggs.

    Maybe my eating is not so bad, but can you offer advice on how to discipline myself to keep my HR down closer to my training level please?

    I am sure that the low HR training helps my recovery immensely, despite going as high as 140 HR occasionally during events. A tribute to your training advice. Please keep up the good work! Many thanks.

  • James says:

    Hi Ivan

    Do you know where I can purchase the manual bio feedback dvd?

  • Helene Walker says:

    I’m experiencing back pain for some time, and believe it might be from a muscle imbalance. Can you refer me to a doctor, PT or whatever, in the Washington DC (Northern Virginia area) who totally understands and treats muscles. Thank you.

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