MOST CHIROPRACTORS STRIVE FOR SYMMETRY.
Whether looking at radiographs or performing range-of-motion analysis, postural analysis, strength training or EMG analysis, chiropractic physicians like symmetry. Ironically, most activities of life, e.g., sports, work and survival, are asymmetrical. Consider these asymmetrical activities of life: carrying groceries or a small child, swinging a hammer, shoveling, sweeping, eating, using the computer mouse or gardening. These activities are performed with a dominant side performing most of the work. Functional asymmetry abounds. Asymmetry is even more obvious in athletics: tennis and all racquet sports, golf, baseball, boxing, martial arts, basketball, football and lacrosse. These activities require propulsion, primarily from one lower extremity, with the core stabilizing to transmit power. Think of a football lineman driving forward. One leg drives him forward, then the other. Meanwhile his core and upper extremities rapidly shift to adapt to the various resistances and obstacles encountered.
Even seemingly symmetrical activities like swimming, bicycling, walking and running are a synchronized, coordinated concert of alternating one-sided exertions. These activities require an alternating one-sided contraction of the muscles of stabilization and the muscles of propulsion.
In the Gym
We function in asymmetry. So why do we train almost exclusively in symmetrical workouts? Most gyms and rehabilitation facilities still utilize balanced, symmetrical resistance loading. Think of the exercises that are most often utilized at gyms: bench press, squatting, barbell curls, pull-downs, leg presses, leg curls and most weight-lifting machines. These symmetrical exercises train our muscles in a way they are not utilized in daily function. To maximize function and performance, we should train and rehabilitate our patients with asymmetrical loads and balance (see Image 1).
Most people separate their physical training routines into strength training, core training, aerobic exercise and flexibility as if these categories were mutually exclusive. Consider an exercise like the lunge walk with overhead weight (see Image 2). It enhances hip motion, works global body strength and the core, and if done correctly, will certainly work the cardiovascular system. This type of training has benefits that transfer into normal activities and sports much better than symmetrical exercises and the use of weight-lifting machines.
The spine is a flexible column, not a hinge joint; so we should not train the muscles supporting the spine as we would a hinge joint. We should not perform sit-ups, crunches or other truncal flexion exercises. We should train the core muscles to work in harmony with the extremities. The core is designed to inhibit spinal motion and transfer power. So training it by placing it under an asymmetrical load will train the core as it was designed. Symmetry of strength, flexibility and stamina are achieved through training each side with the same exercise and weight.
Many exercises can be incorporated into an asymmetrical exercise or rehab program. Some of these exercises are too advanced for patients with high levels of dysfunction. These may be more appropriate for enhancing sports performance and injury prevention than for patients in the early stages of healing. The use of dumbbells, kettle bells, sand bags, pulleys, ropes, sleds, elastic bands, medicine balls and sand balls are great tools for asymmetrical functional training. Here is a sampling of exercises that challenge the core with asymmetrical stresses.
• Single-leg, single-arm dead-lifting
• Lunge walking
• Lunge walking with a weight (barbell, kettle bell or dumbbell) in one hand or overhead in one hand
• Standing one-arm pulley exercises
• Farmer walking (see Image 3)
• One-arm overhead presses
• Turkish get-up
• Sled pushing
• One-arm clean and presses
• Squatting with a weight in one hand
Training to enhance performance and to rehabilitate patients following injury should emphasize functional motion patterns that provide a benefit and that transfer to real-life activities. Certainly not every patient should be put on an advanced program of asymmetrical loading. But if you are not training for function, you are training for dysfunction
Dr. Morgan divides his clinical time between a hospital-based chiropractic clinic and executive health clinics in Washington, D.C. He is adjunct faculty for a medical school and several chiropractic colleges. He is on the Board of Trustees for Palmer College of Chiropractic. His speaking calendar can be viewed athttp://bethesdaspineinstitute. com
. He can be reached through his website, www.drmorgan.info