If you’re an athlete who is doing all the right things with training, nutrition and recovery yet constantly struggling with chronic muscle and joint pain, perhaps you’ve never made the connection between your position (posture) and condition (symptom/pain).
Questions to Ask to Identify Imbalances
If you’ve never thought about it, stop for a moment and ask yourself the following questions:
- Is your massage therapist constantly working on the same problematic areas?
- Do you frequently get adjustments to the same areas?
- Do your adjustments or pain relief from different therapies last a few days or less?
- Have you been told you have a leg length discrepancy and need shoe inserts to correct it?
- Is physical therapy helpful to you only while in treatment but does not last once it ends?
- Have you had surgery or physical therapy and not had the kind of pain relief you were hoping to receive or worse, had the same thing return weeks/months later or feel worse than when you started?
- Have you faked your way through massage, chiropractic or physical therapy just to get out of it because it hurt and made you feel worse versus better?
If you answered yes to any of these questions, there are undoubtedly muscle and joint imbalances within your body which place it under repetitive stress. Over time, these imbalances manifest themselves itself in a variety of ways, from sudden acute injury (not related to accident/trauma) to chronic muscle and joint pain and less than optimal range of motion and function in physical performance.
Without a basic understanding of how the body should be aligned and balanced, very often people get caught in the chronic pain or symptom-chasing cycle. One of my goals as a Corrective Exercise Specialist (CES) is to help educate people that pain (symptom) has far more to do with the body as a whole (posture).
The Connection Between Pain and Posture
When it comes to posture, you simply cannot fix what you don’t know.
If you’ve never made the connection between pain and how your body is balancing, you’re not alone. If you have unresolved chronic muscle and joint pain that just doesn’t seem to go away, it is so important to understand that you are more than just a body or a collection of pieces or parts. Pain that does not resolve itself with symptomatic treatment is often the result of a whole body issue.
Take chronic low-back pain. If you came in to see me, I would evaluate your posture and first assess the foot/ankle complex. Very often someone with chronic low back pain presents with over-pronating and over-plantar-flexing of the ankle and the foot turns out. Now you have to think about all the muscles that act on and cross the foot/ankle complex to understand what is out of balance muscle- and joint-wise.
Then you can better understand how these imbalances affect the rest of the kinetic chain (knees, hips, pelvis, spine, shoulders). Often this overlooked position can make problems worse and result in low-back or pain problems in the body. Treating the back helps for a time but not correcting the underlying cause leaves you vulnerable to its return.
If you’re intrigued, the first step in becoming aware of the difference between your symptom (pain) and condition (posture/underlying cause) is to do a simple posture assessment. You can do one in the comfort of your home on your own or with the help of a friend.
Try This Simple Static Posture Assessment
To begin, I suggest you wear minimal clothing and tie your hair back so you can see the major landmarks of the body. You’ll need access to a full-length mirror if on your own or have a friend take a few posture photos. This is a great way to evaluate your progress if you implement a corrective exercise program.
Ask a friend to take posture photos for you. Be sure the camera is level and you are standing against a light-colored and bare wall if possible. Create a plumb line (as if there was a string with a weight at the bottom hanging straight down from the ceiling). Stand in front of that line and have it centered between your feet (front/back facing) and when facing the side, aligned just in front of the ankle bone (lateral malleolus). Take four photos, one facing front, back and each side. Ask the same questions listed below when evaluating the photos.
Take a small walk around the room or simply march in place for 30 seconds. Then stop and stand in your normal stance facing a full-length mirror. Pay attention to the feet, knees, pelvis, shoulders, head. Working your way up, you essentially are looking for notable differences. Ask questions like:
- Is your body weight heavier on one foot versus the other or evenly balanced? In each foot, is the weight more in your heel, ball or evenly balanced front to back? Do the same for the inside and outside edge of the foot.
- What direction are your toes pointing? Straight ahead at a 12:00 position? If not, where are they pointed (10:00, 11:00, 1:00)? Do they point out or in equally as compared to one another or are they at two completely different time locations?
- Do your ankles roll in at the mid-line of the body or sit higher toward the outside edge?
- Are the knees facing straight or pointing in different directions? They can turn out, in or a bit of both. If different, do they do so equally or does one turn more than the other? Are your knees narrower or wider than the feet?
- Does your waistband sit straight or does it slide up or down? Find the crest of the pelvis. Does one side look higher or more forward in the mirror than the other?
- If you stand against a wall, is there a large amount or little to no space between the wall and your low back?
- Look at the level of your shoulders. Does one appear higher/lower than the other or more forward (closer to the mirror) compared to the other?
- Do the hands sit higher or lower than the other? Can you only see your thumbs or is the back of the hand (knuckles) in front of your hips and facing the mirror?
- Is your head sitting centered over your breastbone? Does it tilt (ear higher/lower than the other) or turn more to one side?
- Check your balance by comparing your stability standing on one leg. Is it easier on one side? If you wobbled, did you lean to one side or rotate your hips? Shoulders?
What the Results Mean
Any differences you noticed in the four major load joints are highlighting posture (muscle and joint) imbalances. When these body segments are out of optimal muscle and joint alignment for extended periods of time (daily posture), the muscles eventually adapt by either lengthening or shortening. The result? Without actively working to bring balance to these areas, you’re taking this posture into your workouts and placing the body at risk for chronic pain.
Continually chasing symptoms without addressing the underlying causes is often why the body never really heals or performs optimally. The long-term and effective solution requires that you teach your body how to reposition your alignment to distribute body weight evenly side-to-side, front-to-back and top-to-bottom. Incorporating a program of self-myofascial release (mobility), stretches and corrective exercises to train your neuromuscular system to hold good alignment is worth the time investment.
If you need help putting together a program unique to your specific postural imbalances, find a local CES or mind-body instructor to partner with who is well versed in postural analysis and programming and can help you.