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Muscle Imbalances
OR
How To Cure Most Back and Neck Pain
 

Treating Muscle Imbalance: One of the Best Possibilities to Resolve and Even Cure the Cause of Most Back and Neck Pain


In our article Identifying All the CAUSES of Back and Neck Pain we mentioned a statistic that 95% of back pain has no diagnosable cause. Unfortunately, if you have been given this explanation for your back pain you have also been prescribed a number of treatments that all fall within what your doctor would call the “Conservative Approach.” You would also likely be told that if you follow this treatment plan your pain would clear up within a few days to weeks.

We also mentioned that realistically, within 1 – 2 years, a minimum of 50% of such cases would go on to develop further recurrent pain episodes.

In our previous articles we asked you to look at; under treated pain; a lack of homeostasis; and a lack of a healthy well functioning metabolic system as major contributors to “premature” aging diseases, which by medical definition includes back and neck pain conditions.

Now we want to present to you another “cause” of back and neck pain. This is a cause which has been known about for decades. A cause, which when properly treated has a significant resolution and cure rate for a great many back and neck pain sufferers. This includes many people who have already been diagnosed with “degenerative spinal disease” conditions. Unfortunately, for a host of reasons, it was shut away in the dusty closet of useful medical treatment practices.

This Little Known and Rarely Talked About “Cause”?

“Muscle Imbalance”

(Often referred to as Somatic Dysfunction.)

Studies have show that a high percentage of people with back pain have nothing more than tight (semi-contracted) back muscles.

The fact of the matter is muscle imbalance can be the cause of any number of muscle, fascia, metabolic and mechanical postural dysfunctions and syndromes.

Left untreated these imbalances can and do lead to “degenerative spinal conditions” aka degenerative spine.  What causes this are the excessive forces unevenly exerted on the spine’s joints, ligaments and discs from overactive (hypertonic, semi-contracted) muscles and underactive (hypotonic, overly stretched) muscles.


Degenerative spinal disease, AKA - spinal “aging”. This “aging” is said to begin as early (sometimes earlier) as a person’s twenties, (which makes little sense, in our opinion.) A variety of terms are then used to describe the resulting symptoms of this “aging” condition. These terms include: osteoarthritis, disc degeneration aka degenerative disc disease (including everything from a bulging to a herniated disc) ligament dysfunction, facet syndrome, facet joint disease, spurring, arthritis, nerve entrapment, nerve impingement, and spinal stenosis.

Hypertonic muscle ((semi-contracted muscle) may “pull” neighboring vertebrae together closely enough to cause pinched nerve roots which exit the spinal canal, causing pain and numbness in the extremities. They may also cause the vertebrae to “twist” out of alignment. These powerful forces alter the movement of all the joints, including the facet joints leading to joint breakdown. When vertebrae are pulled closely together, discs between the vertebrae may get “squeezed” and eventually break down (bulge or rupture) from these long-term compressive pressures.

The same muscle imbalance that cause this type of “degeneration” in an around the spine is also a leading contributor (if not actual cause) of Fibromyalgia and other such syndromes.
 

A Little History About Muscle Imbalances
For many years now a branch of physical medicine has been able to explain why this 95% of back or neck pain can’t be traced to a diagnosable medical cause. This is because muscle imbalances cannot be seen with X-rays, or any other scanning apparatus. Studies from this branch of physical medicine have also explained why the lack of early treatment of this problem results in the progressive degenerative nature of back and neck pain conditions.

Even better news for new, and fairly new, back pain sufferers is that they have also developed highly effective, relatively easy, gentle, painless treatments.

These treatments even help to provide relief for people whose muscle imbalances have progressed to the chronic pain of disc, bone, ligament and joint problems. This method of treatment has often saved people the necessity to undergo various invasive and semi-invasive surgical procedures.

Could YOUR Back Pain Be the Result of Muscle Imbalance?
Let us help you to understand what Muscle Imbalance is all about. Then you can decide if any of this makes sense to you. If you think you should look into a treatment plan based upon this science be prepared to be your own advocate. Be prepared to ask, insist, and seek out people versed in this treatment process. Even though these practitioners may use different names for their treatment process, there are many who practice this specialized muscle treatment, so don’t be discouraged.

What is Muscle Imbalance?
It means just what it says; a person’s musculoskeletal system is not in proper balance causing restriction in healthy joint and musculoskeletal movement. However, it is a little more complicated then this.

The skeletal muscles work together to allow movement. For many reasons some of our muscles can become what is known as “HypERtonic” and when this occurs corresponding (paired) muscles will become “HypOtonic.”

Without getting too technical, a muscle that is Hypertonic it is a muscle that is shortened and tight, and over time (sometimes also weak) and is unable to “relax” or “release” the contraction fully when needed. It can develop into a muscle that begins to exist in a state of chronic, semi-contraction, which the body recognizes as suffering with a mini muscle spasm all the time. The paired Hypotonic muscles become chronically “over stretched” and weak and are unable to contract when needed. Of course, this set-up decreases correct movement of the joint causing it to move in an altered way, which can lead to joint breakdown.


FACT: A muscle that is chronically semi-contracted causes metabolic dysfunction within the muscle tissues. It also squeezes blood vessels and nerves running through the muscle. This interferes with healthy blood supply and proper nerve signaling.


An Example of How Muscles Work in Opposite Pairs
Muscles exist as “agonists” and “antagonists.” This is another way of saying – Muscles move the skeleton and joints by working in opposite pairs. For instance, if you bend your elbow to touch your shoulder, your biceps (muscles on the front of the upper arm) contract, and the triceps (muscles on the back of the upper arm) relax. It works the other way when you straighten your arm - the triceps contract while the biceps relax

What Causes Muscle Imbalances?
There are more reasons than we can cover in this article but here are some of the most common. See if you can relate to any

1. A lifetime of poor posture which gets poorer as we age. This can start from birth and become a pain and disability problem as early as our teens and twenties.

2. Jobs or activities that require a lot of forward bending (flexing) and/or lifting/twisting from that forward bend.

3. Jobs or activities requiring long or excessive use of extension (bending backwards)

4. Jobs that require static position or repetitive motion – like computer work, cashiering, etc,

5. A lack of exercise. Over exercise, and Incorrect exercising.

6. Repetitive Stress - Both Physical and Emotional - Just think about defensive attitudes, confidence, shyness and aggression. These immediately affect our musculature and it all shows up in our body’s posture.

7. Lack of restorative sleep

8. Of course it can also result from an accident injury

9. Here is a catch-22. Another cause of muscle imbalance results from the very injuries caused by muscle imbalances. Once injured, the pain and physical reactions to that injury can create further imbalanced muscle problems if not properly treated.


It’s All In Your Brain
Imbalances can be developing over time and you may be totally unaware of them. Your brain works hard at interpreting how well you are balanced. If it didn’t you would fall down every time you tried to move. Unfortunately, once something happens to interfere with a smoothly functioning well balanced spine, head position and extremities, your brain will send messages to the muscles to help stabilize everything. This means that certain muscles will tighten to help hold you up while others will be forced to stretch out. Without taking steps to “correct” this developing imbalance your brain will eventually see the need for these muscle changes to become permanent.


During this developing process you are “adapting” to your poor muscle posture and may not notice the tight and loose muscles in your body. What you may notice is you are not as flexible as you once were. Your body tires more easily – your muscles begin to “burn” after certain types of work or play. You have an inability to sit or stand for prolonged periods of time, or stiffness when rising from a chair after sitting for a while. You have a feeling of physical exhaustion at the end of the day. You are stiff and sore when you wake up and try to start your day. That’s “contraction imbalance” at work.


Muscle Imbalance Makes You Highly Prone to Easy Injury
Muscle imbalances leave a body very prone to a variety of easily caused injuries especially if those imbalances are occurring in the back or neck and very high percentages do occur in the back and neck. Generally, hypertonic muscle occurs in the large paraspinal muscles, which hold the spine “up” against gravity –. They allow us to bend forward (flex,) backwards (extend,) sideways and to rotate. When any of these muscles become hypertonic there are a number of other muscles that become Hypotonic - extend and weaken. The usual ones are abdominal, hip, and thigh muscles.

Once things progress just this far it takes very little to set off an acute back pain episode. Reaching for something when your body is slightly turned, bending over to pick up something small, a little weekend gardening or game of golf. That’s all it may take. Suddenly, semi-contracted muscles now go into full contraction - that’s muscle spasm and the cause of the excruciating pain that “lays you out” – also referred to as an “Acute Pain Episode.”

Many think of heightened muscular tension is a result of injury, and it can be. However, in most cases, heightened tension also precedes and causes injury through poor muscular coordination.

Muscle spasm is the most common cause of first time (and additional) acute pain episodes. These spasms usually occur as a reflex - meaning that you cannot control the contraction of these muscles. When any part of the spine is injured including: discs, ligaments, bones, or muscles, the muscles automatically go into spasm to reduce the motion around the area. This protective mechanism is designed by nature to protect the injured area. Muscle spasms can create intense pain and along with other injured tissues result in inflammation, and the release of stress hormones - both of which are specialized contributing pain producers.

We said it was natural for the body to immobilize an area using spasms to protect it from further injury. We did not say it was helpful to healing. Healthy healing depends on a level of healthy movement. Healthy movement for those whose problem was caused by muscle imbalance requires a totally different approach then for those whose injury is the result of other causes.

Any injury that results in pain also creates muscle imbalance as the person “guards” or “moves away” from the pain source. It’s easy to understand how these changes in posture can also create hyper/hypo muscle conditions.

Evaluating Common Exercise Treatment Options for Undiagnosed Back and Neck Pain
When the cause of back and neck pain remains undiagnosed you will normally be given treatment recommendations that are a part of the medical “Conservative Approach” For the greatest percentage of you, this is the only medically recommended treatment plan you will get. Thankfully more and more doctors are recognizing that “weak” and “tight” muscles play a role in back pain. Therefore, they are now recommending “exercise” as a helpful treatment. Unfortunately, these are generally made up from a one-size-fits-all photocopied sheet of strengthening and stretch exercises. These are wonderful for any person with reasonably healthy, well functioning muscles. When incorporated into a regular exercise program, they will help to ensure these people never go on to develop muscle imbalance.

However if the root cause of your back or neck pain is muscle imbalance these exercises can actually cause greater muscle imbalance and greater pain. Drop-out rates from this recommended portion of the “conservative approach” treatment are very, very high. Unfortunately, medical rational would like you to believe the reason for this drop out rate is because the patient is just too lazy.

Likely there actually are people who are too lazy, but research tells us the greatest reason for drop-out is because the program increases pain and decreases their daily ability to physically function.

Only you understand why you never enrolled or dropped out soon afterwards. And, only you can decide if this information about muscle imbalance better explains why normal “treatments” have been unable to provide you with any lasting help or relief.


WHY This Form of Muscle Exercise Does Not Work for ALL
There are two vitally important muscle physiology aspects being ignored by medical doctors when treating people whose back and neck pain could be the result of imbalanced muscles, especially if muscles have become chronically hyper/hypo tonic.

A hypertonic (semi-contracted) muscle cannot be “forced” to relax by stretching it again and again. Chronic semi-contracted muscle develops a “memory” The more you try to “stretch” out the contraction the more the muscle memory returns the muscle to its contracted state. Sometimes excessive stretching leads to an even greater level of that muscle contraction, or leads to other muscles shortening and contracting, because the brain believes the body is losing more of its “stability.”

Neither can you “strengthen” a hypotonic muscle that is being held at a stretch until its paired hypertonic muscle relaxes, thus providing that hypotonic muscle the ability to contract again.


Is There a Muscle Therapy Treatment That Works?
There is a specific muscle treatment that works to recondition or retrain this “memory” allowing the contracted muscle to relax and then stretch. It may sound crazy but this method employs a gentle form of contraction of the contracted muscle that allows it to “relax” and then stretch. There are a number of bodywork techniques that “reset” chronically semi-contracted muscles and they all employ “Isometric Contractions.”

Using isometric contraction the person gently tightens the muscle without moving the joint. When they stop, an effect called post-isometric-relaxation takes place, meaning that the muscle cells reset and allow the muscle to lengthen even more.


Is This Treatment Difficult or Painful?
In all cases these muscle (isometric) release techniques are always done at between 10 - 25% movement capacity and effort. The last thing one wants to do in these cases is “Work to the Max” – this only defeats the purpose. As a result muscle release techniques are as painless a rehabilitation exercise process as it is possible to participate in. However, once chronically shortened muscles begin to release – strengthening of the counter, stretched, weak muscle must also become a part of the exercise program. Once again – strengthening muscle is much, much easier and far less painful once you reach this stage. Rehabilitation includes Postural Retraining as poor posture is either a root cause of muscle imbalance, or poor posture has developed because of muscle imbalances. Rehab also will include a close look at the physical demands of your work, helping to ensure you learn how to use your body in ways that won’t compromise your muscle balance.


Common Treatment Forms:
Professionals, trained in muscle release therapy, provide assisted treatments in a clinical setting and this helps to speed the recovery time. However, you will be expected to do “homework” and it needs to be done a minimum of once daily. If your problem is long standing and you are already suffering from some of those “degenerative” spinal changes, this “homework” may need to be performed more often.

The point we are making is; if long-term recovery is to succeed - this type of therapy requires your ongoing fully active participation. If you believe that a therapist can resolve these muscle imbalance problems with a once a week treatment session – then you must believe that pigs can fly.

Now that we have made this important point lets look at the various “names” used for this treatment.

Post Isometric Relaxation Technique (PIR) is one of the simplest and most effective Muscle Release Techniques. PIR technique will rapidly release spasms, Hypertonicity and reflex compensations in muscles. The technique also lengthens fascia and allows the muscles to return to their proper resting length. Additionally, PIR technique is a quick and effective way to increase range of motion - reduce chronic pain and myofascial restrictions and finally to restore normal biomechanical function. PIR is the basis for all these other forms of muscle therapy

Muscle Energy Therapy (MET) utilizes neurophysiologic muscle reflexes to improve functional mobility of the joints. MET uses active muscle contractions (controlled isometric contraction-release) followed by complete relaxation and subsequent passive stretching to increase range of motion (ROM) of the related joints. “Passive stretching” means the therapist does the stretch for you.

(Hanna) Somatic Education is based upon a whole body therapy that helps to improve muscular function, control and teaches you the ability to “feel” your muscles (mind-body awareness). There are Hanna Somatic practitioners who can provide assisted therapy and once you understand and can perform the techniques properly you can do them at home on your own – a minimum of twice a day. If there are no practitioners in your area there are video tapes, CDs, and books available that provide detailed instructions on how to perform these exercises and help raise the awareness of how your own body/muscles are performing for you.

Myofascial Release (MFR) This technique coaxes muscles in spasm to relax, and breaks down adhesions in the fascia. Bodies respond to this therapy by releasing tension that has been stored in the fascia, thus allowing more functional flexibility and mobility of the muscles, fascia and associated structures. This technique is more useful for those with long standing muscle imbalances that have developed dysfunctional fascia problems as well.

Fibromyalgia: Both Imbalanced Muscles and Myofascial Dysfunctions are always found together in people suffering with Fibromyalgia. Fibromyalgia is made from 2 words. Fibro (fibrous) and Myalgia (muscle pain.) While it is believed that other kinds of metabolic imbalances result in a greater susceptibility for the development of Fibromyalgia. - the definitive breakdown of this syndrome’s name is still “fibrous” and “muscle pain.” As dysfunctional fascia often results from muscle imbalance and injury – treatment for both has proven successful for many Fibromyalgia patients.
 

1. Rest (not more than 2-3 days. During that period move with gentleness not in a manner that makes the pain worse. Try to stay body aware and RELAX
    
2. Also, use ice for the first 2-3 days if you know you have inflammation. Ice helps keep inflammation from getting and worse than necessary. The pressure caused by inflammation fluid build up creates pain.
    
3. Then use heat or a combination of heat and cold to speed resolution of inflammation and healing of the injured tissue. The Heat Treat Backpack is the perfect heat source for pain reduction and inflammation resolution. Plus, it’s the only therapeutic heat source that will not create or worsen any inflammation that is present in and around the delicate nerve roots and joints of the spine.
    
4. Set your first appointment with a muscle release therapist for the 2nd or 3rd day after your injury. This therapy also helps to reduce the muscle spasm and get you moving in a correct manner – helping to ensure healing of your muscles and other tissues is healthy and will not progress to further muscle imbalances.
    

If your injury involves a higher level of damage this procedure may take a little longer and you may also require a course of adequate pain medication. Pain makes movement difficult and it causes “guarding” (holding your body in an unnatural position.)

Remember that pain, itself, is the cause of even more pain. Often the Heat Treat Backpack is an excellent pain reliever requiring less or no drugs. However, if your pain is still not manageable it is very important to ask your doctor for medication that will properly control it. Adequate management of your pain is the first vital step in recovery.

 

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How Long Does Healing Take?
Damaged tissue can take a couple of weeks to heal, and up to 6 weeks for more significant damage. This is assuming you have allowed the tissues sufficient time to heal. For those currently undergoing long-term subsequent episodes, each episode can mean healing can take up to 6 months or may never completely heal – especially if you don’t get into a proper muscle therapy program as soon as possible.

One difficulty for the patient with a minor-damage spasm episode, the pain can disappear in 1-3 days. If actual healing of such minor damage takes up to 2 weeks to HEAL, it is not hard to see the contribution people are making to another episode should they assume they can once again go back to the same level or type of work, household, or sports activities simply because the pain is gone.