Health and Fitness

The Criminal vs. The Victim – Targeting the source of your muscle and joint pain

Like any system, the human movement system relies on a complex integration of muscles, tendons, ligaments and joints that, when in balance, allow us to move freely without pain. But if one of those becomes impaired, a cascade effect follows where other parts of the system have to work harder and harder, or move in an unnatural way, to compensate for the part that’s not doing its job. Targeting the root cause of that pain (the “criminal”), and actually fixing it rather than dulling the symptoms (the “victim”), is the purpose of what’s known as corrective exercise.

In our technology and automation-driven world, our bodies become physically molded by furniture, inactivity, and gravity. As a result, muscle and joint pain is much more common than it was 40 years ago.

Let’s take an example of low back pain. It’s one of the most common forms of musculoskeletal degeneration, affecting nearly 80% of adults – especially office workers and people who sit for more than 3 hours at a time. While certainly spinal issues such as disc degeneration, stenosis and other orthopedic conditions cause low back pain, these are far less common causes. Instead, more likely this pain is coming from tight, or “overactive” muscles (the “victim”) brought on by weakness in one or more other muscles, that aren’t doing their job properly (the “criminal”).

In the human movement system, every muscle has a “partner” it works with to achieve movement. When one is contracting, the other is relaxing, and vice versa. For example, when you walk or run, the hip flexor muscles pull the legs forward while the glute muscles relax, then the glutes flex to pull the leg back while the hip flexors relax.

When a muscle is in a constantly tight state, its partner will tend to just “give up” because it’s tired of fighting the tight partner, becoming underactive. So when you sit for long periods, your hip flexor muscles are in a constant shortened position and so become perpetually tight. As a result, your glutes have to remain in a perpetually relaxed state to accommodate their tight partner.

Now you stand up from your desk chair after sitting for 3 hours. Your glutes suddenly have to work to bring your legs to a straight position, and they’ve been asleep forever so they simply can’t do their job. Other muscles have to fill in and do the job for them – something they’re not accustomed to doing. In this case, it’s likely your body will recruit the hamstrings (backs of the legs) and the erector spinae (lower back stabilizers). Both of these start working with all their might to get you upright, but because this isn’t their primary function, they become overworked quickly. Repeat this process over and over, and injury to those muscles, and corresponding pain – is the result. So the “criminal” causing the pain is really those tight hip flexors, and the low back muscles are the victim.

Attempting to ease pain by numbing or soothing the “victim” only treats the symptoms temporarily, and doesn’t address the real cause – muscle imbalances.

Corrective exercise is a special type of exercise programming designed to address muscle imbalances and resulting pain or dysfunction.[1] It starts with a comprehensive assessment of where those muscle imbalances exist, using some simple movement patterns. Once identified, a continuum of four basic steps follows:

  1. Inhibit, or relax, the overactive (tight) muscle: using myofascial release techniques such as foam rolling or trigger point pressure, the muscle adhesions (“knots”) that have formed are gently broken up.
  2. Lengthen the overactive (tight) muscle by static stretching.
  3. Activate the corresponding weakened muscle, through an isolated strengthening exercise.
  4. Integrate: teach the muscles to work together as intended by performing an exercise that uses both of them.

This process is not especially time-consuming, and is quite effective when performed consistently and correctly. It can be used as standalone exercise, or added on to a regular workout routine. A properly designed corrective exercise program can help alleviate a host of common problematic issues, including knee, hip, shoulder and neck pain.

Remember – go for the criminal, not the victim!

[1] Corrective exercise is not physical therapy, nor is it intended to diagnose or treat any disease or medical condition.

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