Over the past few weeks, I’ve been writing about How Skeletal Muscles Work, and what happens when they go wrong and you create a muscle imbalance. Today, I’m writing with the good news – how you can treat muscle imbalance using my unique RSM Model – Release, Stabilise and Move.
A quick recap
In How Skeletal Muscles Work, we discussed a classification system which divides skeletal muscles into three types. We have prime movers which provide the power, local stabilisers which support the individual joints, and global stabilisers somewhere between the two.
In an optimal situation, you decide to move, your local stabilisers make sure your joints are controlled, your global stabilisers then join in; and finally your prime movers activate, and off you go.
However, when things are not optimal, the sequence also goes wrong, resulting in your joints becoming jammed rather than stabilised – ie, muscle imbalance.
Last week, we looked at the butt muscles – the glutes – and what happens when there’s muscle imbalance there. Essentially, the prime movers go into spasm, and the stabilisers get inhibited, and the resulting disharmony can affect your walking gait, your control, your shock absorption and your flexibility, potentially ending up with damage to joints and cartilage.
But the good news is that muscle imbalance can be retrained.
The RSM Model
In my practise, we call the sequence we use to reverse the injury process our unique RSM Model – Release, Stabilise and Move.
Release
First, we release the tight prime movers which are causing the bones to jam together. We have a variety of techniques that we can use for this, from massage to acupuncture to joint mobilisation to visualisation; but what we are really doing is just changing the tone of the muscles and encouraging them to switch off a bit. This creates a bit more space, and allows the joint to move better. We also encourage active movement of the joint as this stimulates sticky synovial fluid to become more liquid again, and also to encourage fluid flow in and out of the joint, restoring a more normal pH. In turn this alters the chemistry within the joint and reduces your pain levels, breaking the vicious cycle and creating an environment sympathetic to healing. It also allows you to get your body into a more aligned position – when the prime movers are too tight, good alignment is virtually impossible.
Stabilise
The alignment in turn gives us a window of opportunity in which we can retrain the stabilisers. (If we try to retrain the stabilisers without first releasing the power muscles, they would have no real job to do as the joint is being stabilised, albeit badly, so they will remain inhibited.) Initially, we will often start by activating the stabiliser muscles in isolation, because imbalance can create some pretty odd nerve-firing patterns, and muscles that should be working separately, start only working together. In the glute area, something I’ve noticed happening a lot is that gluteus medius (whose job is to control internal rotation of your femur) tends to get a bit inhibited, and the hip flexors (whose job is to raise your knee) tend to get a bit overactive, and after a while people forget how to use the muscles independently. So we will often start just by getting you to switch on your gluteus medius without your hip flexors – which can be surprisingly difficult!
Move
Once we have managed to activate the stabilisers in isolation, we can start to retrain movement patterns, using both stabilisers and power muscles in the correct patterns, starting with simple movements and gradually progressing to more complex tasks. For example, we might start by getting you to just shift your weight from one side to the other, but this will gradually progress into being able to do bigger movements and activities, like squatting, walking, going up and down stairs, and running (if that’s something you want to be able to do!)
This rebuilds neural pathways gradually, until the more complex tasks can be done well, automatically and habitually – and when you get to this stage, you’re no longer at risk of your injury recurring.
This process is called neuroplasticity – the brain’s ability to reorganise itself by forming new neural connections. As you learn new movements and regain control, the physical structure of your brain and nerves changes, and this overwrites the dysfunctional patterns that were there before.
Want to know more? Over the next few weeks, I’ll be explaining how to use our RSM Model to treat your lazy glutes – but if you can’t wait, call my team on 0207 175 0150 to book an appointment. Alternatively, you can go straight to my new website, How to be your own physio, where you can either take the self-assessment course to work out why your glutes might not be working as well as they might, or you can go straight to my hip rehab course which teaches you how to release, stabilise and move your glutes. I also have a short course specifically about the RSM Model itself.