You probably wouldn’t pick sand as your top choice for the foundation of your dream house. It’s not sturdy for the long haul and could end in disaster down the road. Yet, according to certified athletic trainer Jason D’Amelio, MS, ATC-L, ART-C, many individuals are making a similar mistake every day in the gym. The dream house in this scenario is a healthy body and the sand is a metaphor for muscle imbalances.
“About 65 percent of injuries—both athletic and lifestyle-related—come from overuse.”
Simply put, muscle imbalances occur when one muscle is stronger than its opposing muscle. For example, if you sit all day at a computer or overwork your mirror muscles (like the chest and abs), your shoulders are likely pulled forward creating a strength imbalance between the front of your body and the back. While these muscle imbalances may not be a problem at first, the real issue occurs over time. As D’Amelio explains, “Without a well-balanced foundation that focuses on stabilization and mobilization, you can strengthen as much as you want, but at some point, the foundation is going to break down.” In other words, unless you identify and fix whatever imbalances exist, you could be headed straight for injury.
According to strength coach Mark Verstegen, president and founder of EXOS and Core Performance, “About 65 percent of injuries — both athletic and lifestyle-related — come from overuse, which is repetitive use of joints that are rendered dysfunctional by muscular imbalances.”
D’Amelio, who has worked with pro teams like the New York Yankees and the New York Giants, says identifying these imbalances early is key. Read on for the best strategies to get athletes of all levels moving in the right direction.
Move Right: The Functional Movement Screen
When an athlete comes into see D’Amelio for the first time, they might think they’re headed for a tough workout. In fact, they’re more likely to go through a series of bodyweight tests known as the Functional Movement Screen, developed by physical therapist Gray Cook. “With some of my new clients, I won’t even have them touch a weight or use any particular equipment until I can fully feel comfortable knowing we’ve corrected all movement dysfunctions,” he says.
To identify these improper movement patterns, therapists use the seven tests in the Functional Movement Screen (including deep squats and trunk stability push-ups), and grade participants on a scale of 0 (movement was painful) to 3 (perfect) for each one. The practitioner then totals up the grades for a composite score for the entire assessment. Some research has shown that the end score can be helpful in predicting injury rates on subjects ranging from children to professional football players, getting them one step closer to correcting potential issues before they manifest.
Ready to put your form to the test? D’Amelio highlights five of his favorite assessments from the Functional Movement Screen for diagnosing muscle imbalances and identifying injury risk. While these are great to practice at home, it’s always recommended to get assessed by a professional. The Functional Movement Screen requires a trained eye for spotting slight movement irregularities, and a certified coach or therapist will catch subtleties that other individuals will likely overlook.
Test: Deep Squat
How it’s done: This isn’t your traditional back squat. For the deep squat, athletes will hold a dowel rod locked out overhead (like in an overhead squat). Then, they’ll sit back on their heels and drop into a squat before pushing through their heels to stand back up. Ideally, the bar should remain locked out overhead throughout the entire move.
What to look out for: While the movement seems simple, a lot can go wrong with the deep squat. For one, many individuals have trouble keeping their knees over their ankles due to weaknesses or limitations in their hips, says D’Amelio. This causes their knees to cave in. Spinal alignment is another common flaw. Ideally, your spine will be in a neutral (flat back) position, not leaning forward or rounding. Poor spinal position can indicate a weak core or inflexibility in the hips. Finally, your feet can reveal a lot about your quality of movement. If your heels are coming off the ground, for instance, that could be a sign that your calves are too tight.
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Test: In-Line Lunge (or Split Squat)
How it’s done: Prepare for a real challenge. This movement pattern puts hip, knee, ankle and foot stability to the test. It also reveals mobility, flexibility and any asymmetries (as it’s performed on both the right and left sides). Start by standing with the right foot forward and left directly behind it (about a shin’s length apart). The feet must be in line with one another meaning if you drew a line from the heel of the right foot it would run right into the toe of the left foot. From that position, hold a dowel rod behind the back so that it runs up and down along the spine (if the right foot is forward the left arm is on top). Next slowly descend into a lunge, dropping the back knee straight down towards the ground, and then return to the starting position.
What to look out for: Many individuals don’t have adequate strength in their hips and quads to control their knee during a lunge. In that case, the front knee dives in or out rather than staying directly in line with the foot. Like the deep squat, this normally indicates a weakness in the hips and quads. Lack of ability to control the knee can lead to trouble in sports where athletes are continuously jumping and landing on their feet (basketball and volleyball for example). Another error is allowing the torso to fall forward. In that case, the dowel rod would tip forward as opposed to staying perpendicular to the ground. This could indicate several things including tightness in the hip, a weakness in the legs, or both.
Test: Rotational Stability
How it’s done: Spoiler alert: Core strength is essential for almost everything from running to just preventing back injuries. This assessment is the ultimate test to see how your midsection measures up. Starting on all fours, extend their right arm and right leg at the same time until both are parallel to the floor. From that position, bring the right knee and elbow back underneath their body and touch them together before returning to the extended position. After a few reps, repeat on the left side.
What to look out for: It’s hard to believe that the toughest test of the Functional Movement Screen might occur on all fours. The Rotational Stability test is incredibly challenging for the core in particular. It’s common for individuals to lean too far to one side or rotate excessively while going through the movement to compensate for an asymmetry or weakness in the core.
Test: Hurdle Step Over
How it’s done: Unless you’re a track and field athlete (or a frequent mud runner), you probably haven’t cozied up to a hurdle in a while. Not to worry — these hurdles won’t require any jumping. But, they do provide a great assessment of symmetry between your right and left sides. Holding a dowel rod across the shoulders just like in a back squat, athletes will stand behind a hurdle set at knee height. From that position, they’ll raise one knee up, reach that foot over the hurdle, and touch their heel down on the other side. Then, they’ll slowly return to the starting position and repeat on the other side.
What to look out for: When D’Amelio puts his clients through this test, he’s evaluating two things in particular. First, iso-lateral strength, which indicates if your hips equally balanced. Individuals that are overly strong or weak on one side will likely wobble back and forth. This test also hones in on hip and ankle mobility. Those with movement restrictions won’t be able to lift their hip up high enough or point their toe while clearing the hurdle.
Test: Trunk Stability Push-Up
How it’s done: A push-up might be one of the most common exercises ever, but this particular variation is a bit different. Start lying on the ground like normal. But instead of placing your hands at shoulder height, men will start with their hands aligned with their forehead, and females with their hands directly under their chin. From there, participants simply push up while trying to maintain a flat back before dropping back down for another rep.
What to look out for: The trunk stability push-up measures a handful of attributes including upper-body strength. For one, the push-up should occur in one fluid movement. If the lower back dips down, it could be a sign of core weakness. Trained coaches can also watch how the shoulder blades move and how the shoulders are positioned to identify potential imbalances between the chest and upper back.
What to Do Next
“Often, too much of the focus is on weight, and not enough focus is on movement quality.”
So, you’ve gone through all the tests and identified a few areas you need work on. Unfortunately, fixing these imbalances doesn’t happen overnight. They developed over years of improper movement. So, it might take a few months of well-focused training before you’re moving more optimally.
D’Amelio explains that part of the equation for fixing your movements is honing in on the right cues. While coaches won’t provide you with many instructions during the actual assessment since they want to see how you move naturally, you should come away with some specific pointers to keep in mind and you progress with your training. Simple cues like “Push your hips back when you squat” can go a long way in fixing your movement patterns.
At the gym, use what you have in front of you, D’Amelio adds. “Mirrors are there, not so you can check yourself out and see how good you look, but to give you biofeedback on performing the correct movement patterns.” Instead of flexing your muscles between sets, use the mirrors to see if your movement patterns are improving from the initial assessment.
The last part of fixing lingering dysfunctions might be the hardest point of all. It requires changing your entire mindset in the gym. As D’Amelio explains, “Often, too much of the focus is on weight, and not enough focus is on movement quality.” In order to improve your movement patterns and be injury-free for the long haul, you might have to take a hit to the ego and drop the weight for a few weeks while you refine your technique.
At the end of the day, it’s all about being proactive in (and out) of the gym. Also known as “prehab,” addressing common muscle or movement imbalances, such as the shoulders and hips, before they sideline you should be the goal, Verstegen says.
Identifying muscular imbalances is tricky work. It takes a variety of assessments to really tease out what part or parts of the body aren’t functioning optimally. Fixing the issues can be even trickier, taking weeks or even months to fully correct. But, the struggle is worth it in the end. With a solid foundation, you’ll be stronger and less injury-prone than ever before.
Originally posted September 2014. Updated August 2015.