By Joel Lyons, PT, OCS
Everybody knows that no one is perfect, but when is an imperfection a problem and when is it nothing to worry about? The simple answer: It all depends. Some imperfections can cause a cascade of problems when compensations lead to further ailments. Other imperfections can be mild enough to be completely ignored.
resolved. For example, an ankle sprain could leave the calf weaker if it doesn’t heal within two weeks. For this reason, one should not only care for the ligament, but pay attention to strengthening the calf. Another reason for side-to-side differences could simply be a more dominant side. For example, a soccer player who always uses his strong leg may get a stronger quadriceps on that side. This could lead to problems at the knee, hip or back. A common imbalance for many athletes, runners included, occurs when the quad and hamstring are significantly different in their strength. The quad is supposed to be stronger than the hamstring but only twice as much. The problem is usually because of the weak hamstring. I’ve observed that many people just do not like working on their hamstrings. For one thing, it is not that comfortable to do one of the most common hamstring workouts: a hamstring curl while lying on your stomach. It’s a simple exercise, but many just don’t like lying on their stomach. At the gym there are often seated ham curl machines that are more comfortable. Other ways to strengthen them is to do a dead lift. When performing this exercise you would hold a weight in your hands and lean forward at your hips, not your back. For that reason dead lifts can be dangerous. It is too easy to do it wrong and injure the back. Regardless, when a runner injures the hamstring, the recovery is usually much longer than they would expect.The imbalance was most likely at the root of the injury, but it could have been caused when someone tried to do a workout that they just weren’t ready for. Speed work when they weren’t ready probably caused it. My advice: Please do not avoid working the hams. It’s a tough injury to recover from. In the upper body a muscle imbalance often results from overworking the chest at the expense of the
Leg-length discrepancies
First, there are several reasons for an apparent leglength discrepancy. One could be that there is a true difference in length when measuring from the top of the femur to the floor. In that case, either the femur or the tibia is longer on one leg compared to the other. Usually, if the difference is ¼ inch or less, there may not be a problem. If it is greater, there may be a need to put a small lift in the shoe. Another reason for the difference could be from a pelvic asymmetry. When one side of the pelvis is rotated in a direction opposite to the other side, one leg will appear longer than the other. In this case, you will probably need to consult a physical therapist to help with realignment. He could help with muscle strengthening, stretching and/or manual mobilizations that can put the bones back where they are supposed to be and help them stay there.
Please do not avoid working the hams.
Muscle Imbalances
There are several types of muscle imbalances. One could simply be that a muscle on one extremity is significantly weaker than the same muscle on the opposite side. A common reason for this could be that the recovery from an injury hasn’t completely 27
