Most people exhibit imbalances in their musculature or body posture in one form or another. Ranging from strength differences, uneven weight distribution from one leg to another, and physical or movement dysfunctions, a personal trainer must identify and work to improve these imbalances. One of the most common imbalances a certified fitness professional will encounter is the asymmetrical weight shift. Let's explore the symptoms and causes of this asymmetry as well as the corrective exercise that will help to improve the condition in most cases.
An asymmetrical weight shift occurs when one side of the body carries more of a load than the other when stationary or in motion. When assessing a client, you will notice a lateral or diagonal shift (sagittal or frontal plane) through the trunk, spine, and hips. We'll go over assessments to identify an asymmetrical weight shift later.
The common underactive muscles leading to this asymmetry are the gluteus medius on the same side as the shift, and the hip flexors, adductor complex, and anterior tibialis on the opposite side of the shift.
The most likely overactive muscles include the adductors and hip flexors on the same side of the shift, and the calf complex (soleus and gastrocnemius), piriformis, hamstring, and gluteus medius on the opposite side of the shift.
The symptoms of an asymmetrical weight shift can be subtle or aggressive and will vary between individuals. Pain in the hips, lumbar spine, pelvis, and knees often present no matter how severe the asymmetry. The lack of postural control is visible from most angles as well. On occasion, the shift is small enough to be missed, but, more frequently, it can be observed easily with the trained eye.
This imbalance affects people of all ages. It can be a result of a chronic health condition, a result of improper movement patterns over time, or injury. Some clients will opt to treat this with a physical therapist depending on the cause while others will employ a personal trainer and corrective exercise specialist to help improve the condition.
If left unaddressed, an asymmetrical weight shift can progress and cause strains in the groin, hamstring, and quadriceps as well as contribute to low back pain and knee injury. For this reason, it is vital to perform physical assessments with all clients to determine any potential causes of pain before implementing a training program. Gather all of the facts before beginning and always take detailed notes!
Children with varying degrees of cerebral palsy or idiopathic scoliosis and people of all ages who have suffered from chronic stroke will exhibit a lack of balance and a physical asymmetry. Palsy affects movement, posture, and muscle tone while scoliosis is a structural disorder of the spine. Stroke is a cardiovascular and brain condition that will affect only one side of the body and can be short-term or permanent. In fact, many research studies conducted on asymmetrical weight shifts are done on patients of strokes as the conditions are very much correlated.
Physical imbalances like uneven leg length, excessive pelvic tilt (anterior or posterior), and muscular imbalances can contribute to an asymmetrical weight shift as well. Overuse injury, poor posture, and improper movement patterns are common causes of pelvic tilts and muscular imbalances whether from exercise or repetitive movement.
As mentioned earlier, the physical shift in the sagittal plane or frontal plane is usually easy to identify with a trained eye. However, assessments are available to help a personal trainer or corrective exercise specialist identify a shift and pinpoint the potential muscles to address with corrective exercise.
Complete the squat assessment un-weighted, weight-bearing, or as an overhead assessment. Use the five kinetic checkpoints as a reference point during a squat assessment: neck, shoulders, hip, knee, and ankle. Pay special attention to the leg, hip, knee, and spine when looking for a shift.
A simple gait assessment can be a great tool to observe a weight shift as well in all components of the footstep. The hip, lumbar spine, and knee are the ideal places to watch and identify the overactive and underactive muscles.
The initial client questionnaire often has questions asking about pain, locations and frequency of pain, and self-perceived intensity of pain that can aid a fitness professional in identifying (or suspecting) a weight shift before a squat or gait assessment.
The goal of corrective exercise is to improve the quality of life and sport. Professionals use it to identify, address, and improve physical and movement dysfunctions. The components of corrective exercise include self-myofascial release and stretching of overactive muscles, strengthening underactive muscles, and then incorporating dynamic movement.
Consider again the muscles most likely overactive and underactive with an asymmetrical weight shift:
Same side of shift: adductors, hip flexor
Opposite side of shift: gastrocnemius, soleus, piriformis, hamstring, and gluteus medius
Same side of shift: gluteus medius
Opposite side of shift: tibialis anterior, adductor
Erector spinae, LPHC (lumbopelvic hip complex- more than 25 muscles that connect at the hip, pelvis, and lumbar spine)
Self-myofascial release (SMR), or foam rolling, works to reduce adhesions in overactive muscles and encourage proper length-tension relationships. For an asymmetrical weight shift, opt for SMR of the adductors on the same side of the shift and the gluteus medius, hamstring, and calf complex on the opposite side.
After performing SMR, continue to stretch the same muscles to encourage elasticity and ideal muscle fiber length. Read more on why flexibility training is so important in fitness in this informative ISSA blog post: Flexibility Training and Finding Your Best Range of Motion.
Standing calf stretch
Standing soleus stretch
Sit and reach stretch
Lying banded hamstring stretch
Seated butterfly stretch
Runners lunge stretch
Lateral runners lunge stretch
Lying banded hip openers
Now use exercises aimed to strengthen to target the likely underactive muscles. The focus of these exercises will be on the opposite side of the shift for the most part so unilateral movement is key. However, to prevent exacerbating the asymmetry or causing further concern, perform strengthening movements on both sides with the appropriate intensity.
Lateral band walks (with a focus on the same side of the shift)
Banded or weighted hip abduction on the same side of the shift
Standing pelvic tilts (anterior and posterior)
Unilateral or bilateral hip bridges
Plank with lateral hip dips
Side plank hip dip
Unilateral or bilateral supermans
A corrective exercise specialist will begin with gait and movement assessments to determine the client's weight distribution both weight-bearing and unloaded. The PAR-Q+ client intake questionnaire will also provide valuable information as far as pain levels and locations that will be added to the symptoms and physical presentation notes as a determination is made.
The warm-up is an ideal time during program design to introduce SMR techniques and flexibility training. This ensures proper range of motion and length-tension relationships within the muscle fibers while priming the client for exercise and movement. Clients with more advanced asymmetrical shifts may need sessions dedicated to SMR and flexibility before they can progress in their training program. This determination is at the discretion of the fitness professional. As always, educating clients as to your rationale for programing and timelines will improve program compliance and build trust.
Trainers can incorporate specific strengthening exercises into a workout at any point. In a lower body training session, the band walks and various forms of hip abduction will prove to be a solid warm-up before more dynamic, big lifts like squats, deadlifts, and leg press. With an upper body or full-body functional training session, the strengthening movements are a good addition and encourage core strength and LPHC stability.
Have you gotten your Certified Personal Training credential yet? That is the first step, to gain the required education and become a trusted fitness professional. Then, you can continue your education and learn so much more about dysfunctions like the asymmetrical weight shift as a Corrective Exercise Specialist! Your fitness future is waiting! Get started today!