You can’t always be balanced

Posted on October 12, 2011


Thomas Myers wrote up a post on symmetry that I wanted to expound on a bit.

The more you learn about alleviating joint pain, the more you realize the name of the game typically revolves around symmetry / balance. Balance of muscle length and strength, to be specific.  Meaning it’s more likely a joint will feel nice and healthy when all the muscles surrounding that joint are in balance.

Striving for this is an ideal goal and most often the way to feeling better. However, as Myers talks about, perfect balance is often unattainable. Myers gives some examples as to why this is the case, mentioning how our environments set us up for asymmetry as well as our internal organs. While reading this I had two clients come to mind and thought I’d talk about them and how they support Myers’ argument.

Marilynn is the first example. Marilynn was born with one functioning eye, which is her left one. Just to be clear, Marilynn can see with her left eye but not with her right eye.

Ok, so if you can imagine only being able to see out of your left eye (put your hand over your right for effect), you can see how you will have full peripheral vision on your left side, but your vision will stop about halfway into the site of your right eye.

Here are a couple drawings I made showing the difference:

Approximately normal peripheral vision with two functioning eyes

Approximate peripheral vision with only use of left eye

To compensate for her lack of vision out of her right eye Marilynn walks with her trunk and shoulders rotated to the right. Think of “rotated to the right” akin to the movement you go through when you reach for something behind you to your right.

Not only does she walk like this, she drives like this, sits like this, exercises like this, she basically does everything like this. This is so that instead of having her peripheral vision be unequal between the right and left sides it is now equal:

Approximate peripheral vision with only the left eye working and when trunk and neck are turned towards the right. Notice how the vision is more centered now. It’s not as good as having two functioning eyes but the vision is at least now symmetric between sides

The first thing you may think is, “Hey, what a great compensation. Now Marilynn can see pretty evenly between her eyes. It’s not as good as having two eyes but it’s better than the imbalance she originally had.” While this is true, this compensation unfortunately sets Marilynn up for musculoskeletal issues all over. Marilynn is more susceptible to lower back pain (due to the spine being constantly rotated) and shoulder pain than someone without this compensation.

So we clearly have an issue. Correct the trunk rotation at expense of her vision, or leave the trunk rotation at expense of her joints.  When it comes to deciding between your vision and your joints I think it’s pretty clear what wins. Marilynn can do all the corrective exercise she wants but at the end of the day when she gets in a car she needs to be able to see as much of the road as she can. Not only is symmetry not going to happen, in Marilynn’s case, we do not want it to happen!

We try to keep her as afloat as possible in regards to her pain, and for the most part she is pretty much pain free, but at the end of the day Marilynn is always going to be more susceptible to having some issues with her left shoulder and her lower back.  Especially considering she is 71 and just realized she does this!

Next example is Sarah. Watch this video and I’m sure you’ll recognize the imbalance pretty quickly:


If you’ve ever wanted to see a classic case of femoral anteversion, there ya go. As you can imagine having a right hip with that much flexibility, and a left hip with that little flexibility, can cause all sorts of issues in the hips, knees, feet and lower back. The thing is no matter how much we try moving her hip in the opposite direction or try to strengthen things it’s not going to change that asymmetry much, if at all.

At the end of the day we would need to basically morph Sarah’s bones into a different position to have any real effect on that asymmetry. And at the age of 23 (as opposed to say 5), that’s just not likely to happen. An important point here is that trying too much to manipulate Sarah’s hip in the opposite direction could actually damage her hip.

Like Marilynn there are things we do to hopefully keep her afloat and as pain free as possible, but Sarah is always going to be more prone to lower body ailments than someone without that degree of femoral anteversion.

I want to mention that when it comes to structural issues such as this, Marilynn and Sarah have to be VERY diligent in how they perform their daily activites and stay on top of their corrective exercise much more than someone without issues such as these. Because of their abnormalities (sorry guys, it’s true 🙂 ) they are already much closer to reaching their threshold for pain.

Summing up: Correcting imbalances is the primary idea behind getting rid of many different type of muscle and joint pain. However, it’s not always possible, nor advisable, to attain complete balance.


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