The Muscle Imbalance Epidemic: An Overlooked Problem That Needs to Be Addressed

back-painHave you heard about the two health conditions called Lower Crossed Syndrome (LCS) and Upper Crossed Syndrome (UCS)? If you’re a regular reader of Darwinian-Medicine.com, you undoubtedly have, as I’ve mentioned these disorders many times here on the site in the past. However, if this is the first time you’ve stumbled onto this site, I’m willing to bet that you haven’t.

Everybody knows that bad posture and lower back pain are very common problems in our society today; however, what a lot of people don’t know is that muscle imbalance syndromes often lie at the root of these problems. The term muscle imbalance is both overused and misused. However, that doesn’t mean that muscle imbalances aren’t a very real problem.

Actually, muscle imbalance syndromes such as LCS and UCS are probably among the most prevalent health disorders in our society today. Despite this, they are rarely talked about. Most people have never heard about them and most health practitioners have no idea how to treat them. This is unfortunate, because these types of disorders can cause a lot of harm.

Muscle imbalance syndromes such as lower crossed syndrome and upper crossed syndrome cause a lot of suffering for a lot of people

When I started working as a coach/trainer many years ago, I quickly discovered that the aforementioned syndromes are ubiquitous in our society today. A large proportion of the clients that I took on and started coaching exhibited signs of LCS and UCS (e.g., arched lower back, protruding abdomen, hunched upper back) . Many of them also complained about musculoskeletal pain and other grievances that often go along with muscle imbalance syndromes.

Unfortunately, the education I had gone through in order to become a personal trainer/coach hadn’t prepared me to deal with these problems. In the anatomy and physiology classes I had taken, the primary focus was on the names, insertion points, and functionality of the different muscles that make up the human body; very little attention was devoted to what happens if the musculoskeletal system is somehow thrown “off balance”. As for the more practical courses, the teachers’ primary concern was that the students learned how to perform different exercises in a safe and effective manner. They didn’t devote any attention to the correction of UCS, LCS, or any other muscle imbalance syndrome.

I can clearly remember that one of the teachers I had back then showed the class a picture displaying the evolution of man – from fit, tall, and well-built hunter-gatherer to sick and fat westerner – and pointed out that the posture and physical characteristics of Homo sapiens have changed a lot over the past millennia. He also mentioned that a lot of contemporary humans suffer from musculoskeletal disorders such as LCS and UCS and shared a couple of strategies with the class that he meant were effective for preventing and treating these conditions. But unfortunately, not much additional instructions or information on the muscle imbalance concepts were provided after that.

So, since I hadn’t learned much about muscle imbalance syndromes in school, I had to learn about them for myself. During the first couple of years I worked as a coach/personal trainer, I spent a lot of time reading up on UCS and LCS, and I experimented with a variety of different strategies for treating them. The reason I chose to focus specifically on these two conditions is that a lot of my clients suffered from them.

Over time, I gradually put the pieces together and assembled a tool kit containing the tools I needed to effectively address the issues that I had come to find were at the root of LCS and UCS. Today, several years later, I still use this toolkit in my work with clients. I’ve replaced and polished some of the tools as I’ve learned new things; however, the kit still contains the same core components as it did a couple of years ago.

My experience is not unique. Most personal trainers, coaches, therapists, and other health/fitness practitioners didn’t learn much about muscle imbalance syndromes such as LCS and UCS in school. This is one of the reasons why I decided to write about these conditions here on the site. I don’t claim to know everything about these conditions; however, I do think I have, over the years, gained a pretty good understanding of why they develop and what can be done to treat them. 

The modern lifestyle stimulates the human musculoskeletal system in novel ways

But why do so many contemporary humans have bad posture and suffer from muscle imbalance syndromes such as LCS and UCS? To answer this question, we have to put on our evolutionary glasses and examine the path that got our species to where it is today.

There is little doubt in my mind that UCS and LCS are mismatch conditions – conditions that develop as a result of a mismatch between genes and environment. This statement is based on everything I’ve read and observed with regards to the health and physical structure of ancient humans and contemporary hunter-gatherers. The fossil record indicates that ancient humans were robust and physically well-built, which is not surprising, given that they led a very physically active lifestyle. Pictures taken by explorers, travelers, and researchers indicate that contemporary hunter-gatherers exhibit the same physical characteristics. There may be some exceptions to this rule, but in general, it’s safe to say that the posture and physical structure of the modern man differ markedly from that of the ancestral human.

It’s not really surprising that this is the case. All wild animals tend to be quite lean and fit. Humans are no exception to this rule. If you’re fat, sick, or unable to run or move efficiently due to muscle pains or bad posture, you will have a hard time surviving in a natural environment and your genes may quickly go extinct.

Today, the situation is very different. You don’t have to be fit or lean to survive in a modern environment. Also, your survival won’t be threatened by muscle pains or other problems associated with muscle imbalance syndromes such as LCS and UCS. What will be threatened, however, is your health and well-being.

The main reason that so many people today suffer from muscle imbalance syndromes such as LCS and UCS is that the modern lifestyle stimulates the human musckuloskeltal system in a very different way than the ancient human lifestyle did. Our primal ancestors didn’t sit in front of a computer all day long; rather, they were out walking, running, and engaging in other physical activities. They also rested a lot, but since they didn’t have chairs to sit on, they likely spent more time in flexed positions (e.g., deep squatting) than modern humans. This is the type of lifestyle that the human body is accustomed to. It’s not designed for a modern, sedentary lifestyle.

When you sit on a chair, your body is in a position that it’s not evolutionarily accustomed to be in for prolonged periods of time, and you run the risk of developing weak, inactive, and flabby glutes, tight hip flexors, and weak/lengthened upper back muscles, among other things. This can then result in bad posture and various musculoskeletal pains. Moreover, it can impair your ability to move correctly: you’ll likely start compensating for your poor glute and upper back strength by putting more stress on your quads, lower back, and pecs, especially during exercise. In other words, you enter into a vicious cycle. Top that of with an imbalanced training program and you got a recipe for disaster.

Reversing the process: How can we turn the vicious cycle into a virtuous one?

You don’t have to look far and wide to find a treatment protocol that promises to correct muscle imbalances and improve your posture. Unfortunately, many of the programs that are out there are pretty bad. I’m particularly skeptical to programs that only include light activities and exercises such as yoga and stretching. The problem with these types of programs is that they don’t really address the muscle imbalances that are a part of disorders such as LCS and UCS. You have to apply some tension to the system, or else, it won’t change. In my opinion, you can’t effectively treat UCS or LCS without strength training. You have to train heavy, but not so heavy that your form is compromised.

Another issue I find with many of the programs that are out there is that the exercises they include seem to have been chosen at random. There doesn’t appear to be a system to the selection process. Rather, a bunch of exercises that are generally perceived as being beneficial are put together into a weird concoction. This approach is unlikely to yield much fruit, and may actually, in some instances, make the muscle imbalance problems worse.

In order to correct a specific muscle imbalance syndrome, we obviously need to address the muscle imbalances that are a part of that exact condition: we have to target and strengthen the weakened/lengthened musculature and improve mobility/flexibility where it’s needed. In other words, my belief is that we have to try to reverse the process that caused the problem.

In the case of LCS, the muscle imbalances typically develop as a result of reciprocal inhibition involving a weakening/lengthening of the glutes and abdominals and a shortening/strengthening of the erector spinae and ilipsoas. Other muscles are involved as well, but those are among the major ones.

In my experience, the glutes and the upper back muscles are the key muscles involved in LCS and UCS, respectively. If you manage to effectively target, strengthen, and build those, then you’re well on your way to bring about positive changes in posture and physical function. This is often easier said than done though. People with muscle imbalance syndromes typically have difficulty performing multi-joint exercises such as the squat and deadlift with good technique and need to focus on learning how to move in a good movement pattern before they can start doing heavy strength training.

By taking steps to correct the imbalances and faulty movement patterns that drive the development of muscle imbalance syndromes such as UCS and LCS, it’s possible to turn the vicious cycle that underlie these conditions into a virtuous one. I’ve published two articles (UCS, LCS) here on the site in the past in which I outline some of the strategies I’ve developed for dealing with LCS and UCS. The guides should give both trainers/coaches and average Joes a general idea of how to treat these conditions.

It’s important to note though, that these guides are general in nature and are not to be considered exhaustive. I would strongly recommend people who suffer from muscle imbalance syndromes such as LCS and UCS to seek out the help of a coach or therapist who has experience with treating these disorders. I’m not saying this because I myself work as a coach (see this page for information about my coaching services), but because my experience is that a lot of people find it very difficult to correct their posture and train effectively on their own.

Comments

  1. benfury22 says:

    Yes, I helped many people with these issues in my years as a PainBUSTER.

    There is no quick fix for a whole body that’s crossed up. Low back pain is usually referred pain from hips that are unbalanced. And where hips don’t work right the entire back chain is usually fouled up all the way to the ground.

    I had some amusing arguments with clients who couldn’t understand why we were doing extended stretching and strengthening of their calves, ankles, arches, and toes when their main complaint was a painful knee or low back. For mechanical sorts, a car analogy would usually suffice:

    Me: If you have uneven tread wear, do you just slap on new tires and expect they’ll wear right?
    Client: No.
    Me: Why not?
    Client: Because you have to make sure everything that adjusts the angle of the rubber is set right. You’ve got to adjust suspension camber, caster & toe angles. You have to check to make sure you don’t have a bent or damaged tie rod while you’re at it too because that could make the adjustment slip.
    Me: And you’re body’s a LOT more complicated than a suspension linkage to tire chain on a car. THAT’s why we’re working on your feet, ankle, and calves to help your low back pain.
    Client: Oh, yeah. Guess that makes sense.

    All those linkages. As we age, they decay. The get damaged. They freeze up. They develop maladaptive movement patterns to steer around pain. It ALL needs fixing.

    For the stretching and corrective strengthening part, I find Active Isolated Stretching & Strengthening, the Mattes Method very effective.

    For overall strengthening, dumbbells and barbells are still my go to tools, but traditional programs are too front chain dominant. Unless someone is a football player or puncher, there’s absolutely no reason to include a front chain dominant exercise like the bench press. I’ve seen many, many men with hunched shoulders from pressing, pressing, pressing, and hardly ever pulling. DB rows and heavy bent flyes are critical to building the back chain to pull the shoulder back into proper place. In addition, the little fiddly bits exercises like L-flyes, cross body flyes, and side lying flyes are all crucial to build a shoulder that naturally wants to set back properly into a naturally good posture.

    For the hip structure, the barbell glute bridge is hugely useful. The key adjustment is to reset the back flat to the floor between each and every rep and maintain that hip angle during each rep. That limits spinal erector involvement and really targets the glutes. Then you can slap on an ankle cuff and work hip int/ext rotators and adductors/abductors. With stronger glutes and a hip structure that’s strong and stretched in all directions all the way to the floor, low back pain generally goes away. If not, time to refer out for an MRI. But 19 times out of 20, that fixes it. I’ve seen very few low backs that actually required surgery.

    This kind of work goes through phases and fads all the time. Right now, mobility exercises and foam rolling are all the rage. While there’s something to be said for these things at the appropriate times in a program, they don’t take the place of initial specific corrective exercise and active stretching. Clients tend to adapt drills to avoid using their weak/tight areas. They can’t help it. You teach, teach, teach and they avoid, avoid, avoid. They’re not trying to drive you crazy, they simply can’t force their body to do something that feels uncomfortable and unnatural. Once those areas are stretched and strengthened with specific isolation exercises, you can get them off the floor or table and get that new strength and flexibility moving in the real world. Suddenly, the unteachable movement becomes easy for them when their weakness and tightness transforms into strength and flexibility.

    When you see ten years roll off how a person looks because they’re standing taller and striding longer, it’s a great feeling. That’s what makes being a trainer a true blessing of a job. By transforming bodies you really can help transform lives.

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