Muscular Imbalance

Muscular imbalance is an imbalance between the agonistic and antagonistic muscles involved in a particular movement. Imbalances of this kind often occur as a result of a lack of exercise, after trauma or as a result of neurogenic diseases. The therapy of choice is physiotherapy, in which the training sessions are combined with electrical stimulation under certain circumstances.

Muscular Imbalance

What is muscular imbalance?

To perform movements, humans rely on the interaction of opposing muscles, which are connected to the central nervous system via efferent motor innervation. Muscles never work alone when they contract. The movement-realizing agonist is dependent on an opponent or antagonist who enables movement in the opposite direction. If these are not equally strong, there is a muscular imbalance. See eshaoxing for Cerebellopontine Angle Tumor Definition and Meaning.

When an agonistic flexor flexes, the antagonistic extensor must extend at the same time. The return to the starting position is made possible by the flexion of the extensor, which in turn has the original flexor as the antagonist. For example, abdominal muscles are the antagonists of back muscles and vice versa. Agonistic and antagonistic muscles should be about equal in strength.

If this is not the case, there is a muscular imbalance. Poor posture, pain and irreversible damage can be the long-term consequences of such imbalances. In the context of rehabilitative and physiotherapy exercises, for example, balanced training for agonists and antagonists is the overriding goal. The sometimes most common imbalances affect the abdominal muscles, which are usually much less developed than the antagonistic back muscles.


The cause of muscular imbalance is essentially muscle shortening or muscle wasting of either agonist or antagonist. These phenomena can be based on one-sided force development, which at the same time goes hand in hand with neglecting the ability to stretch. The most important trigger for this phenomenon is the lack of, or no, use of the affected muscle.

However, one-sided stress during sports and everyday life can also be a cause. The muscular imbalance can also appear as a symptom of an overriding disease or as a result of trauma. The associated diseases are usually diseases of the central nervous system, such as the autoimmune disease multiple sclerosis.

If motor nerve tissue is damaged by such diseases, fewer movement commands from the central nervous system reach a muscle. As a result, the affected muscle can no longer be trained or stressed as much as its antagonist. This phenomenon can also occur in the case of motor nerve damage to the body periphery, for example in the context of neuropathy.

If the muscular imbalance occurs as a result of trauma to the musculoskeletal system, the cause is usually insufficient regeneration or incorrect stress caused by pain.

Symptoms, Ailments & Signs

The symptoms of muscular imbalances depend heavily on the primary cause. In the case of muscular imbalances due to muscle shortening, a muscle adapts to a specific stimulus through higher tension, while its opponent has not been exposed to any muscle stimulus and thus maintains its previous tension. This disturbs the foreshortening ratio between the two.

On the other hand, muscular imbalances due to muscle lengthening occur when a muscle adapts to a specific stimulus through lower tension. The tension of the other muscle again remains constant, which changes the shortening ratio. If there is an unfavorable load distribution between muscles and joints in the long term, arthro-muscular imbalance with painful muscle tension, tendon overload and muscular coordination or functional disorders arise.

Increased wear and tear of the articular cartilage can be the result. In the case of neurogenic imbalance causes in the peripheral nervous system, the sensitivity of the affected area is often limited in addition to the motor function. The same can be the case with central nervous causes.

Diagnosis & History

A pronounced muscular imbalance can be diagnosed by doctors and especially physiotherapists through visual diagnosis. In the anamnesis, previous traumata or known neurogenic diseases can indicate an imbalance. Symptoms such as a hunched back also indicate an imbalance.

Diagnosis is secured by tomographic images of the muscles, which allow an assessment of the muscle development. Patient prognosis depends on the primary cause. In principle, any imbalance can be improved with targeted training. With central nervous causes, however, there is generally a poorer prospect of full recovery of the muscle ratio than with other causes.


Muscular imbalances are common. Actually, everyone is affected at least to a small extent because certain muscles or muscle groups are always less stressed than others. Minor imbalances do not cause any problems. Greater muscular imbalances lead to chronic pain.

As a rule, the muscles can be trained evenly with a few exercises, so that the symptoms also disappear again. However, if nothing is done, complications will arise over time, often characterized by irreversible changes. What complications can occur? The most important complications include muscle tension, tendinopathies and arthrosis.

Muscle tension develops as part of long-term poor posture. They can be painless. However, pain often occurs with pressure or movement. The muscle tissue hardens. Muscle tension can also be reversed through various therapeutic measures.

Tendopathies are micro tears in the tendons of strong muscles. Sometimes these cannot heal completely. This can lead to degenerative changes. The tendon attachments show ossification and calcium deposits. These changes are not primarily inflammatory.

However, mechanical irritation can lead to secondary inflammation, which further accelerates the degeneration process. Sometimes the only way to relieve symptoms is through surgery. In the worst case, a muscular imbalance can also lead to arthrosis with subsequent joint deformation and severe restriction of movement.

When should you go to the doctor?

In many cases, this disease is diagnosed relatively late, since the symptoms are not particularly characteristic and can be confused with other diseases. In general, therefore, the affected person should consult a doctor if there is discomfort and pain in the muscles without a specific reason. These symptoms can indicate another underlying disease that should be treated.

In any case, a doctor must be consulted if the pain leads to restricted mobility, which usually does not go away on its own and lasts for a longer period of time. It can also lead to infection and inflammation. To ensure that these are not spread further, treatment should be carried out by a doctor. It is not uncommon for the permanent pain and restricted mobility to lead to psychological problems. In this case, you should also be treated by a psychologist. In the first place, a general practitioner can be consulted to diagnose the disease. In the further course, the treatment must then be carried out by a specialist.

Treatment & Therapy

The therapy of choice for patients with muscular imbalance is physiotherapy. In the case of neurogenic causes, referral to a neurologically trained physiotherapist is indicated. As part of physiotherapeutic care, antagonists and agonists are trained to the same extent in order to restore balance.

Especially in diseases of the central nervous system, this goal turns out to be an ambitious goal. When nerve tissue in the spinal cord or brain is damaged, contraction commands no longer reach the muscles adequately, making training significantly more difficult. This connection can also interfere with training sessions in the case of peripheral nerve diseases. In such cases, physiotherapy can be combined with electrostimulation.

The direct stimulation stimulates the muscle to contract independently of nerve impulses and trains it accordingly without involving the nerve pathways. Muscle tremors are particularly important during physiotherapy sessions. As soon as the muscles begin to tremble, take a break.

Outlook & Forecast

The further course of the imbalance depends relatively heavily on the cause of the disease, which is why no universal prediction is possible. However, the muscles become quickly irritated and overloaded. Muscle tension or functional disorders of the muscles also occur. In severe cases, these can also limit the movement of the patient.

If the imbalance is caused by an accident or trauma, it is not uncommon for patients to also suffer from psychological problems and need support from a psychologist. If the muscle imbalance becomes severe, pain sets in. These can restrict the everyday life of the person concerned. However, the pain often goes away on its own.

If tears in tendons and muscles do not heal properly, malformations and inflammation can occur. These also lead to restricted movement.

In most cases, the imbalance is treated with therapy. This primarily depends on the cause of the imbalance. If nerves have been damaged, it may not be possible to heal all restrictions.


Muscular imbalances can be prevented in everyday life through the correct execution of movement, sufficient movement and even use of agonists and antagonists. Since posture also contributes to correct movement, attending a posture school can make sense. After trauma, the imbalance can be prevented in the form of professionally supervised, as complete as possible regeneration as part of rehabilitation measures.


The therapy of a muscular imbalance can only have a lasting effect if there is consistent follow-up care. The patient can do this with a physiotherapist or sports teacher for the rehabilitation area, but also in the fitness studio. The goal is basically to compensate for the muscular imbalance or to avoid it in advance by strengthening weak muscles and stretching shortened muscles.

An example is stretching shortened chest muscles and strengthening the upper back in people who work in a bent-over position on a computer every day. The muscles are strengthened with targeted strength training, for which the patient can also have an individual plan drawn up by the physiotherapist or rehabilitation sports teacher. It is also important in the context of aftercare to organize this training efficiently with correct exercise execution and regular units as well as the individually optimal load dosage.

Stretching shortened muscles is just as important as strengthening when there is a muscular imbalance. Stretching is not only an important element before and after training. Even in everyday life, for example during work breaks, it can always be effectively incorporated into aftercare.

Special stretching classes are also often helpful, as is yoga, which is ideal for full-body strengthening and doesn’t neglect muscle stretching either. Anyone who tends to shorten certain muscles should also pay attention to an ergonomic design of the workplace.

You can do that yourself

Sitting correctly is essential to counteract muscular imbalances. It is recommended to sit ergonomically and dynamically on the office chair. A combination with a height-adjustable desk makes sense. The sitting position should be changed as often as possible, and working while standing and actively walking around is also recommended in everyday office life.

Muscular imbalances are often caused by a lack of exercise. It is therefore important to integrate more exercise into everyday life. It makes sense to cycle to work or park a little further away and walk a few minutes. The stairs should be used instead of the elevator and the printer should not be located directly at the workplace to get up from time to time.

Since muscular imbalances can be caused by one-sided training and a lack of stretching during sport, care should be taken to always warm up and also train opponents. Wearing suitable footwear is also important. In sports, rash increases in stress, falls, running on uneven ground and excessive demands on the muscles should be avoided. In this way, muscular imbalances can also be avoided.

Sports in which many muscle groups are balanced and used at the same time, such as dancing, gymnastics or martial arts, help with muscular imbalances. A varied training program with strengthening, coordination, balance and stretching exercises is also useful. If improvements are not achieved through self-help measures, sports therapy is advisable. Deficits in the muscles are corrected through targeted exercises under supervision.