Finding a Balance Between Activating and Relaxing Weak Muscles
One of my biggest mantras in practice is to “Relax the overactive and strengthen the underactive.” Acknowledging that the body functions biomechanically as a “tensegrity system”, this approach allows us to create balance in the body and restore optimal biomechanics. Ultimately, it can lead to decreased pain/injuries and increased performance.
When it comes to strengthening the underactive, it usually requires that the person do some form of retraining exercises that target a specific muscle group, “turning on” the neurological signal to that muscle and “waking it up”. So we give our patients some exercises to do each day, they turn on the underactive muscles, and everything is good, right? Sometimes… But more often than not, it’s not that simple.
One of the biggest issues that I see with people is that they end up shortening and tightening (sometimes to the point of spasm) their underactive muscles in the process of rehabbing them. There’s a certain tone and length that we want in every muscle, and underactive, or weak, muscles don’t do a good job of maintaining it. As we begin working muscles that are underactive, their natural response is to tighten up. Neither the muscle fibers themselves, nor the neurological pathways that fire them, are equipped to handle the load that we place on them when we target those muscles specifically. They are after all, lazy underactive muscles.
Take for example gluteus medius, which is one of the most commonly underactive muscles for the hip (and entire lower extremity kinetic chain). This hip abductor is incredibly important in not only creating a stable hip and pelvis, but also in keeping other muscles (such as TFL, QL, and adductors) from becoming overactive and dysfunctional. A healthy and strong glute med also keeps the knee from caving in and the foot from pronating. Almost every person with dysfunction in the pelvis, and lower extremity, has some sort of issue with inadequate firing of one, or both, glute meds.
So we give them rehab exercises (classically, clams/reverse clams, hip hikers, lateral band walk, side lying wall abductions, etc) to strengthen and balance their glute meds. Many times this alone leads to the person waking up with overly tight glute meds that barely fire at all for a few days, further exacerbating the dysfunction that we’re trying to treat in the first place.
We oftentimes miss the crucial step of relaxing and lengthening the muscles after we activate them. Our mantra should really be “Relax the overactive and strengthen the underactive, but then relax the underactive as well.”
The first way to help facilitate relaxing while strengthening is to incorporate full relaxation directly into rehab exercises. For our gluteus medius example, we’ll do some side lying wall abductions, maybe some clams/reverse clams, or even some hip hikers to get started. With each of these, the natural tendency is for people to stay within the midrange of the movement and keep the muscle firing as much as possible. In this area of constant tension, people “feel the burn” and feel that they’re really working the muscle. In reality, they’re overtaxing a muscle that doesn’t have the resources or neural patterning to be able to sustain contraction, and they’re not strengthening the muscle in its full range of motion. This facilitates muscle shortening and tightening, sometimes even to the point of spasm. All of which are counter-productive to our goals.
A better approach is to, with each rep, think about fully relaxing the muscle at the end of the eccentric phase. This does a couple of things. First, it allows the muscle to lengthen, keeping us out of the hole of continuous shortening. This ensures that we won’t have spasms in the area. Second, by starting each contraction from a place of relaxation, we train the neurological system to more effectively recruit muscles fibers, throughout the entire range of motion.
As the person progresses, we can even add a slight activation of the antagonist muscle group to the end of our eccentric motion to help relax our target muscle via reciprocal inhibition. This not only creates the desired lengthening and relaxing of the muscle, but it also forces us to have to be able to fire the underactive motor unit after having been in an inhibited state.
This principle can be applied to any muscle group, and it’s the best way to ensure that not only are we getting the most out of our retraining exercises, but also that we aren’t creating even more dysfunction in the muscles.
Sometimes this approach isn’t possible, depending on the exercise that we’re doing. Or, simply relaxing between each rep still is not enough to stave off excessive muscle tightness and inhibition. Another way to avoid the overtightening of underactive muscles is to follow our rehab exercises with some sort of work to relax the muscles, whether it’s with a lacrosse ball, active stretching, myofascial release, etc. This works well when the exercises that we choose require that the muscle stays active for a period of time (think lateral band walks for glute med). It’s also beneficial if we are using retraining exercises to restore optimal biomechanics immediately before performing our usual training or competing.
It’s a delicate balance that must be achieved when first turning on underactive muscles. And, for many people, athletes especially, the goal is get those muscles firing as quickly as possible. We have to remember though that our first goal with rehab exercises is to neurologically “turn on” underactive muscles, not to build muscle mass. Strength gains are always going to be neurological in nature before the muscle fibers themselves adapt, so we need to do just enough to turn on the muscles, without fatiguing/tightening to the point of dysfunction.
Keep these ideas in mind both with your clients/patients, and with your own rehab exercises. Find that balance between turning on the underactive, but not to the point of creating further dysfunction. And remember that relaxing and lengthening muscles, as we strengthen them, is incredibly important for allowing us to get the most benefit from our work.
If you have any questions, comments, or concerns, don’t hesitate to comment below and get a discussion started, or contact us directly using the link at the top of the page!
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