How can I prevent and correct muscle imbalances?

Muscle imbalances often arise when we perform one kind of physical activity, without adding any supplemental exercises.

When we only do one kind of activity, the body adapts to that activity and gets very good at using the muscles associated with it. The other muscles are neglected.

Over time, we start to use the stronger muscles for all of our daily tasks. This leads to a vicious cycle in which the overactive muscles become tight and painful. The neglected muscles become weaker and are used less. 

The best way to prevent the formation of muscle imbalances is to diversify your physical activity. Try new stretches and exercises to find things that are challenging. Try to avoid exclusively repeating exercises and targeting muscle groups you are comfortable with.

If you are involved in a sport or exercise class that requires you to repeat the same type of exercises, focus on your technique. Make things more difficult by correcting your posture rather than by doing more repetitions. Use supplementary exercises to maintain mobility and strength.     

Here are a few examples of muscle imbalance formation.

One common culprit is exercise classes which involve high volume, low resistance exercises. There is an incentive to complete many repetitions at high speed, and the body resorts to using the strongest muscles in its arsenal. It does not devote energy to the weaker areas, which are often important for the prevention of pain and dysfunction. 

Imbalances can also be formed by activities that require repetitive stretching, like yoga. Certain parts of the body are more mobile than others. Those parts tend to move more when we perform a stretch, while the tighter parts don’t stretch as much. This problem compounds itself in a vicious cycle every time we stretch, unless we mix up our routine.

How do I know if I’m doing an exercise correctly?

Many of the exercises are complicated and it can be hard to know if you are doing them correctly. You may be unable to feel an exercise working particular muscle groups at first, and this is perfectly normal. Muscles which are not very active can be hard to feel, and as you repeat the exercise consistently over time, your control of the muscle will improve. 

Check to make sure you are doing gan exercise correctly by watching the demonstration video and reading the Method and Common Mistakes sections. It can be useful to exercise in front of a mirror or film yourself and compare your video to the demonstration to see where your technique could improve. If everything looks good, it’s just a matter of time before you get the desired effect from the exercises.

If you need an outside eye to check your exercise technique, book a video consultation with Phyx through the My Physio page. We will review your technique and customise your prescription.    

How long does it take for symptoms to resolve?

This depends on many factors, including the source of your symptoms, your age and activity level, and the degree of injury. Healing times for most musculoskeletal conditions range from six weeks to four months, with some conditions resolving earlier and later than that.

How long do I need to keep up my exercises?

Keep performing the exercises as prescribed until your symptoms have resolved. Keep working until you have progressed through all of the exercises in your prescription. Then, integrate the exercises from your prescription into your physical activity routine. Whether you do a few stretches before you for on a walk, or strengthen the mid back before you lift weights at the gym, your prescribed exercise are a tool you can use to prevent and relieve symptoms as you live your life.   

How much resistance should I use when exercising?

You should use enough resistance to challenge you, but not so much that you cannot complete most of the repetitions using the correct technique. For example, when doing a set of ten repetitions, choose a weight that allows you to complete eight or nine with perfect technique, but that is heavy enough so that you struggle to complete the last repetitions with good form.

Should I see a health professional?

Consult with a health professional if you experience any of the following:

  • If your symptoms cause you to lose bladder or bowel control or sensation around the genitals or anus  
  • If an episode of back pain causes you to lose sensation and strength in both legs or arms at the same time
  • Weight loss that cannot be explained by exercise, diet, or other lifestyle factors
  • An injury that results in the inability to weight bear  

What are sets and reps?

The Dose section of each exercise prescribes sets and repetitions. A repetition refers to one movement of the body from the start position through the range of motion required by the exercise, and returning to the start position. For example, you perform one repetition of a squat when you squat down and then return to standing position.  

A set refers to a number of repetitions done consecutively. For example, one set of ten repetitions would require you to squat down ten times in a row before stopping. 

What is the difference between stretching and strengthening?

Stretches are typically movements which elongate a muscle or other body tissue. Stretches are normally passive, using body weight or other muscles to elongate the targeted muscle, and generally result in the muscle or tissue becoming softer and more pliable. 

Strengthening exercises are typically movements which require a muscle to contract against resistance. These are active movements, requiring the control of the muscle by the brain. Strengthening typically results in a muscle becoming larger and more tense.   

Stretching and strengthening can both be useful when it comes to relieving symptoms and reducing the risk of injury. It can be important to use a combination of stretching and strengthening movements in your physical activity routine, as doing too much of one and not enough of the other can result in dysfunction.   

For example, if the only exercise you engage in is yoga, this may result in the body being stretched so much that it becomes very loose and pliable, and it may be unable to tolerate resistance or loading when you ask it to. Activities like lifting children, or even supporting your body in a standing position for long periods can become symptomatic. You may be able to achieve adequate strength gains from exclusively practicing yoga, but it will take very focused practice to engage underactive muscles and expose the muscles to enough resistance.   

In a contrasting example, those who exclusively lift weights at the gym are prone to structures becoming too tense and not mobile enough, which can result in immobility and symptomatic dysfunction.  

One way to reduce the risk of injury and imbalance is to use a combination of stretching and strengthening to remain strong and mobile. For example, yoga practitioners may benefit from lifting weights twice a week, while weightlifters may benefit from adding a yoga flow to the end of their workouts. Check out the ‘How do muscle imbalances arise?’ FAQ for more information.

What should I do if an exercise causes pain?

In the short term, exercises may cause some pain. On a scale where 0 is no pain and 10 is the worst pain you can imagine, you shouldn’t push past a 3. If pain becomes greater than a 3 during the exercise, try reducing the number of repetitions, or the resistance you are using until it’s manageable. 

Exercises may cause muscle soreness when a new muscle is activated or challenged in a new way. Pain can be a sign of improving strength in these cases, and you can manage it by stretching the muscle or using self massage with a ball or foam roller after performing strengthening activities. 

If an exercise causes a sustained increase in your symptoms in the days and weeks following its initiation, it’s not a good idea to keep doing it. It may be that you are missing the correct technique, so make sure you check out the ‘Common Mistakes’ section of the exercise to make sure you’re not doing it incorrectly. In some cases, the exercise may not be right for you, and it’s okay to miss it and try another. If every exercise is causing you pain, you should consult with a clinician. 

What should I do if my symptomatic body part isn’t available to select?

Please let us know. Send an email to admin@phyxphysio.co.nz, and we will be happy to provide you with the material you need.  

What should I do when my symptoms resolve?

Even after symptom resolution, it is important to engage in a program that will maintain your body and reduce the risk of symptoms coming back. The best way to do this is to work towards meeting physical activity guidelines, and engage in regular stretching and strengthening for all major muscle groups.

Physical activity guidelines state that adults should engage in at least 150 minutes of moderate intensity physical activity per week, or 75 minutes of vigorous intensity activity per week, or an equivalent combination of the two.

Don’t worry if you’re not there at the moment, doing something is better than doing nothing.

Try to find something you enjoy that gets your heart rate up, makes you sweat, and makes you breath hard enough so that it’s hard to talk.

The guidelines also recommend strengthening all major muscle groups at least two times per week. You may want to include stretching in these sessions to avoid excess tension and muscle imbalance. You can use the exercises for each body part on the Phyx app for inspiration, or book a consultation with Phyx through the My Physio section of this app for a customized program. 

The most important thing is to make good physical activity habits consistent and sustainable. Low physical activity may increase the risk of injury and disease.    

When should I do my exercises? 

You can exercise at any time throughout the day, but you may find it useful to schedule your exercises at a particular time. Having a regular routine can help you to maintain consistency and achieve better results. For example, performing the exercises after you brush your teeth can take advantage of an existing habit. 

You can also perform exercises at particular times in order to prevent or relieve symptoms. Exercises which improve strength and control may help to prevent symptoms if performed before an aggravating activity. For example, performing the Band Inversion/Eversion exercise before running can help to reduce shin spints.

Exercises which stretch and relieve tension can help to relieve symptoms if performed when they come on, or before bed to reduce nighttime and morning symptoms. For example, performing the Chest Stretch before sitting down to work, or before bed can help to reduce shoulder pain.

When throughout the week should I do my exercises? 

If a prescription calls for an exercise to be performed several times a week, try to distribute the exercise regularly throughout the week, rather than performing them on consecutive days. This will give the body a chance to recover between bouts. 

Where is my pain coming from?

Pain arises when the brain interprets signals from the nerve endings distributed throughout the body. The particular structures that are sending signals to your brain through these nerve endings will vary depending on the nature of your symptoms.

One way to think about how to relieve these symptoms is to think of reducing irritation of those structures. For example, tight muscles in the lower rbak may be compressing the joints of the spine, and stretching those muscles may help to unload the spinal joints and stop them from sending pain signals to the brain. This ‘mechanical’ model makes sense to most people. 

However, mechanical factors cannot fully explain pain. Let’s consider what happens when the signals from the particular structure reach the brain. Before we are conscious of pain, the brain modifies the signals coming from the structure by turning them up or down depending on what else is going on in the brain. The end result of this modification is what we actually perceive as pain. 

This means that the pain we perceive is not always representative of what’s actually going on in the body structure. For example, the same body part can feel more intensely painful if we are stressed or tired, or less painful if we are distracted or happy. In our low back example, we might feel more intense pain if we think we have ‘slipped disc’ or ‘thrown our back out’, and we might perceive that pain as a lot less intense when we find out that back pain is pretty normal and will get better with time and exercise. Nothing in the back has changed when we find this out, but the brain turns down the pain signal because we feel more positive. 

This modification of pain signals by the brain can be useful when we are trying to relieve symptoms. It means that exercises can still help to relieve symptoms, even if they aren’t targeting the exact structures that we intend. Just exposing the brain to movement and tasks which involves loading can  help to turn the pain signals down. 

It’s important to remember that  hurt does not always equal harm, and mental state plays a large role in how the body feels.    

Why aren’t my symptoms improving?

Some symptoms can take a week or two to begin responding to exercises, so make sure you are consistent with the exercises.

If you have progressed through all of the exercises in the prescription, you may need to look at other lifestyle factors that are aggravating your symptoms. For instance, are you performing an activity regularly that may be contributing to your symptoms? Gym based exercises performed with incorrect technique, activities that involve prolonged postures, and everyday tasks like lifting children are all examples of activities that can provoke symptoms. It may be something that you started doing around the time you started experiencing symptoms.

Once you identify an activity that may be contributing to your symptoms, change how you are doing it, or how much you are doing it to see if that affects your symptoms. Check the Modifications page for examples of activities you can modify to reduce symptoms.    

If you are still having trouble, book a consultation with Phyx through the My Physio tab. 

Why is a hollistic approach beneficial when treating musculoskeletal conditions?  

While the source of your symptoms may be a particular muscle or joint, it works in conjunction with other body structures in daily function. To best manage the symptom, we will likely need to address the other parts of the system. If we focus solely on the source of symptoms, we may overlook factors that contribute to the onset of dysfunction.  

For example, rather than just strengthening the rotator cuff following a rotator cuff tear, it is important to target the muscles of the upper back and enhance mobility in the thoracic spine and shoulders to regain full function.

Likewise, rather than just stretch tight hip flexors again and again, strengthening the lumbopelvic muscles and relieving tension in the low back can help to manage the symptoms more effectively in the long term.  

In summary, a holistic approach is required because the body functions holistically, rather than in separate parts. 

Why should I perform exercises on both sides?

While you may only be experiencing symptoms on one side of the body, you should try to perform the exercises on both sides.

When you perform an exercise on the non symptomatic side, it forces the affected side to stabilize the body.

The brain also benefits from performing the exercise with the more coordinated limb. You will be able to feel the right muscles engaging and aim to replicate this feeling when performing the exercise on the symptomatic side, where the muscles are usually weaker and harder to engage.    

Should my Phyx prescription be considered medical advice? 

​​​​​​​While the content of your prescription is based on the most current strategies in the field of physiotherapy, it should not be considered medical advice.

The content available on Phyx is suitable for the majority of people with musculoskeletal injuries, but all cases are unique. If you would like specific advice from a healthcare professional, you should arrange a consultation with a Phyx physiotherapist by emailing admin@phyxphysio.co.nz.