It seems like almost everyone you meet has some type of physical problem with a muscle or joint. Mechanical pain, discomfort and disabilities affect many in the modern world. Back and neck problems, shoulder and wrist pain, chronic hip and knee dysfunction, and other muscle and joint problems are part of the long list of popular complaints. As common as these conditions are, most are preventable and relatively easy to remedy by improving fitness and health. For example, through the implementation of proper food and nutrition, inflammation can be better controlled (helping to heal and repair physical problems) and building the aerobic system improves muscle function and support of joints and bones. The result is often that many mechanical problems will disappear because the body will correct them. Some get better very quickly, while others may require more time as the body needs to make significant changes in its chemistry and physical structure. Of the remaining mechanical problems, most can be remedied by conservative means, often with the help of the appropriate health-care professional.

This chapter highlights some of the issues related to the common problem of mechanical imbalance. The vast majority of these problems are not permanent. In fact, in addition to allowing the body to correct many of these problems, some can be remedied at home with some simple guidelines. From head and neck, to shoulder, elbow and wrist problems, and down the spine to the hips, knees and feet, most problems are associated with muscle imbalance. This comes from overuse, trauma, or other imbalance caused by brain, spinal or local injury. And, in most chronic situations, muscle imbalance also has a chemical relationship – there is usually an inflammatory factor in the joint, muscle or other area that’s part of the problem. Correcting this part of the problem was discussed in relation to balancing fats to control inflammation.

Muscle Imbalance
The combination of muscle weakness and tightness is called muscle imbalance. The most common cause of muscle imbalance is muscle weakness. When this occurs, another muscle or muscles become tight. This pattern of weak and tight can occur anywhere in muscles throughout the body, on the front and back of the arm, thigh, leg, foot or other areas. The result is reduced movement in joints and reduced strength, often leading to pain and disability.

For a better perspective, let me explain about normal muscle movements. In the course of normal activity, muscles become tight as they contract, and looser when relaxed. We can easily feel this in our own muscles. While sitting, place one of your hands under your thigh, with your elbow bent. Then, pull up with your hand, and maintain that contraction. With the fingers of your other hand feel the muscle on the front of your arm, the biceps, and feel how tight it is. Now feel the back of the arm, the triceps muscle, and feel how loose it is. This is a normal pattern of muscle function during most movements.

When there is an imbalance, muscles become abnormally weak (too loose) and too tight; and they feel somewhat similar to the ones in the example above. This state of weakness and tightness can remain for weeks, months or years following some injury. The original injury that first causes muscle weakness can be from a fall, trauma directly to the muscle, overstretching or overuse. But in many cases the cause of the original weakness is well hidden and people don’t recall any event that would have caused a problem. And, the severity of the original injury is often not related to level of disability. I’ve seen severe low back pain that was debilitating — the patient was unable to move much, couldn’t get out of bed and was in constant severe pain. But the cause was due to a muscle imbalance that was easily corrected, and the patient did not recall any event and I could not find what caused the problem. (In this case, the patient recovered quickly once the imbalance was corrected and the problem never returned.)

It should be noted that muscles attach to bones through tendons. So when a muscle is not functioning properly, the tendons don’t either. Most tendon problems are secondary to muscle imbalance. Likewise, ligaments connect bones to other bones. And, muscles have an important support relationship with both ligaments and bones, directly and indirectly. So when a ligament or bone problem exists, there is usually an associated muscle imbalance.

The cause of muscle imbalance must be addressed if normal muscle balance is to be restored. Sometimes the body can accomplish this, especially when it’s fit and healthy overall. In fact, we are always correcting problems because normal wear and tear frequently produces relatively minor imbalances not only in the muscles, but throughout the body. Even without knowing it, the body is always working to restore balance.

During the process of correcting its own problems, the body may show relatively minor symptoms, but often none at all. When your body can’t fix a particular problem, symptoms develop and you may need additional help. Manual biofeedback is a technique used to help balance muscles.

Manual Biofeedback
Over the past 30-plus years I’ve developed various biofeedback procedures to help people improve physical balance, reduce stress, increase fat-burning and achieve other benefits. Manual biofeedback is one of these procedures. It encompasses most of the hands-on therapies I’ve employed and taught to health professionals and lay people throughout my career. Manual biofeedback can help improve muscle imbalance by evaluating and correcting muscle weakness whether from local muscle problems, or brain or spinal cord injury. It’s a safe and effective, and relatively easy, approach for use by many individuals, usually producing a rapid response. Manual biofeedback is very useful for almost everyone, including those with common aches and pains and patients with more serious physical ailments, special-needs children and disabled adults.

Most people with mechanical problems fall into at least one of three categories:
• Local muscle injury is the most common cause of physical problems, and is often associated with trauma to the muscle itself, such as the result of a fall, a so-called pulled muscle, a twisted ankle or other injury. Micro-trauma is even more common; it’s the accumulation of minor physical stress in a muscle or joint, often unnoticed while it’s happening, eventually causing a more obvious muscle problem. Too much sitting, repetitive motion injury and walking in poor-fitting shoes are common examples of micro-trauma that can ultimately cause muscle problems. Local muscle injuries can result in anything from minor annoying achiness to serious or chronic debilitating condition.

• Brain injury can occur at any age, even before birth. Trauma, reduced oxygen or nutrient supply, and infections can easily cause brain damage resulting in poor muscle function. A stroke is a common form of brain injury; others include cerebral palsy, Down syndrome and Parkinson’s disease. Some brain injuries produce only relatively minor physical problems, such as being uncoordinated or “clumsy.”

• An incomplete spinal cord injury is often due to physical trauma such as from a serious head or back injury, but a tumor or infection can also be a cause. A spinal cord injury can adversely affect nerves that go to muscles reducing their function. Like a brain injury, spinal cord injuries can cause a wide range of problems, from relatively minor physical ones, to very serious disabilities.

Not long ago, it was assumed that once injured, the brain and spinal cord could not recover. As a result, many of these muscle problems were not successfully treated. But over the last 30 years we’ve learned that the brain and body, at any age, has an incredible ability to repair itself, even in cases of severe damage. The goal of manual biofeedback is to help the brain and body recover from injury.

Manual biofeedback can help promote and restore muscle balance, and in doing so help improve overall physical movement. Increased movement is a powerful therapy in itself as I previously discussed in relation to the aerobic muscle fibers. Improved movement not only helps locomotion, posture, independence and other areas of fitness, but can also help improve most other areas of the body and brain, including speech, vision, balance, memory and even intellect. And because muscles have other important functions, such as energy production, circulation and immune activity, increasing physical movement can improve overall health.

Manual biofeedback utilizes procedures very similar to standard manual muscle testing — they are part of both the assessment and treatment aspect. Muscle testing is a commonly employed procedure first introduced in 1949 to evaluate muscle weakness in polio patients. Since then, many forms of muscle testing methods have evolved, for both evaluation purposes and treatments. Manual biofeedback incorporates the best of these into one system.

While traditional EMG (electromyography) biofeedback uses computer equipment, including mechanical sensors and electrodes attached to the skin, manual biofeedback does not use any equipment. Instead, manual biofeedback uses another person’s neurological sense to convey information and help the patient’s brain and body work better. This is a more personalized approach, recruiting more brain-body stimulation with verbal, visual, tactile and other sensory cues that further enlists the patient’s participation and motivation.

Fix Thyself
The concept that the body can fix itself is centuries old. As noted, the first step is to improve overall fitness and health so the body can perform its normal job of correcting imbalances. While many problems can get in the way, two body areas that often interfere with its ability to fix itself are the feet and breathing.

The feet are our physical foundation, and if they are unstable every structure above can become unbalanced, especially the muscles and joints. I discussed two important issues about the feet: the first was finding the best shoes to wear and the second is going barefoot. Both are associated with improving muscle function in the foot, ankle and leg to help maintain a stable foundation. In other words, you’ll strengthen chronically weak muscles that will allow tight muscles to relax and restore muscle balance.

Breathing Mechanics
We take breathing for granted, until we have a breathing difficulty. But many people breathe improperly and don’t even realize it. Normal breathing is associated with proper muscle movement — the most important being the abdominal muscles in the front and sides of our abdomen, and the diaphragm muscle, which is on top of our abdomen — and under our lungs. These muscles move together allowing us to efficiently breathe in and out. Without normal breathing, the abdominal and diaphragm muscles work improperly, and many other muscles may not work as well either. In addition, body movement is impaired, oxygen can be reduced and many other problems can occur.

Let’s look at the two components of normal breathing, inhalation and exhalation:
1. During inhalation the abdominal muscles relax and extend outward, while the diaphragm muscle contracts and moves downward. This allows air to enter the lungs more easily, and is accompanied by a slight whole-body backward extension, especially the spine.
2. During exhalation the abdominal muscles contract and tighten, and are gently pulled inward; the diaphragm muscle relaxes with an upward movement. This helps push air out of the lungs, with a slight whole-body flexion.

We can observe or feel another person’s breathing and often tell if it’s correct, especially watching the belly or feeling it move out on inhalation and in on exhalation. We can also evaluate our own breathing by feeling muscles move:
• Place the palm of one or two of your hands on the abdomen — in the area of your belly button.
• Slowly breathe in and feel the abdominal muscles expand outward. Our belly should get bigger during inhalation.
• Now exhale, and feel the abdominal muscles tighten and be pulled inward. The belly is more flat on exhalation.

This is normal breathing. Most movement occurs in the abdominal areas with only slight movement of the chest, which expands more with much deeper breathing.

Those who breathe improperly often move their muscles opposite that of normal. This happens for various reasons. Brain, spinal cord and local muscle injuries can disturb normal movement of the breathing muscles. In some individuals, poor breathing can come from stress, the stigma of not showing a big belly, and even over-exercising the abdominal muscles, making them too tight to relax.

Improving the breathing mechanism can help many areas, including movements of the spine and pelvis, getting more oxygen and eliminating carbon dioxide, and reducing or even eliminating pain.

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