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We look for symmetry everywhere, in nature, beauty, and our bodies. Asymmetry is part of our DNA, our heart & internal organ are off centre, the 2 halves of our brain are different, and we are usually one side dominant.
Let’s look at this topic because it is something that comes up with many manual therapists, chiropractors, physiotherapists, massage therapists, osteopaths… and they sound very determined to create symmetry in the body to reduce pain/injury. There are 2 things I have to say about that, then I’ll explain a healthier approach.
First, in terms of a general treatment, it is an outdated approach. The idea that our bodies will be even from the left side to the right side is nothing short of ridiculous. We know that if you mirror image your face (set up a mirror image of the left side of your face to make a complete ‘looking’ face… see how weird that looks) both sides are different. We know that our bone structure not only differs from another human being, but from one side to the other side. With these things that we know, then we have to ask… Does being asymmetrical really matter
?To quote Dr. Matt Jordan: “I would rather be strong and somewhat asymmetrical than weak and symmetrical”.
My biggest concern, and notable observation, is that the worst part of this search for symmetry is the language and perceived body image that they are setting up their patients with. I’ve worked with countless clients who have been told in the past by manual therapists that these noted imbalances need to be worked on. Often the areas where the imbalances are found are not even the areas of concern/pain/injury. Granted we know the body is connected and that one area can cause pain sensations in another, that is not the topic.
This negative approach to asymmetry leads directly to a more hyper vigilant nervous system in the way that the person told that their shoulders are not sitting evenly will now build a subconscious tension of trying to appear balanced for fear that they will end up with injury/pain. Then what happens… They end up with pain from the constant tension in their shoulders/neck.
My other main challenge with this focus of imbalance leads to a stronger sense of kinesiophobia. They are again patients are leaving the session more conscious about how they are moving and possibly contributing to the imbalance, so they become scared of moving incorrectly then possibly scared of moving in the first place. Again, more hyper vigilance and more likely to cause pain due to the fear/pain cycle.
What is the answer?
Surely we can’t just fully ignore this and go on with our lives, as there is evidence that asymmetry in the body can cause injury. Like most things that I work with, I like to find some middle ground. So let’s open our curiosity about our body. Less judgment, more movement.
Best example, when I am teaching Lagree. It is fairly obvious as you move through a class that your left leg is different than your right, that you can rotate your spine one way easier than the other, that you can balance easier on one leg than the other. Instead of being annoyed and frustrated, let’s break down the movement a little more, but with a caveat.
Many years ago I had a yoga teacher, Larry Schultz (IYKYK), teach about ‘Living in the Question’. That was the basis of where my practice went. Each day will be different, don’t judge, notice but don’t analyze, take note but with less intensity. The basic message: Practice building an awareness, working toward balance, at the same time be completely content and accepting of the imbalances.
When these imbalances appear I ask participants in classes and sessions to build awareness of 3 things:
What is the difference in strength from one side to the other?
What is the difference in mobility in the two sides?
Does one side have better connection to balance than the other side?
Often, these differences are fairly obvious and you know the history of the ‘why’. Even in that case, I would still recommend living in the question. Explore as you move, workout, walk, run how that is affecting your day. Is the difference more prominent on some days more than others? Does this difference lead to you compensating more in a certain way when you are tired?
What is the answer…
Just like I talk about while teaching, let’s train the weaker movement patterns. Let’s work toward balance, even if it seems unlikely.
And yet…
Does asymmetry matter? Yes! Mainly when we are working with injuries. Best example is after an ACL reconstruction. An athlete needs to reach a certain level of symmetrical strength and range of motion in both legs to return to play. This makes sense. There was an injury/surgery. To get back to a full exertion of movement/play you need to have both limbs functioning fairly equally (within 10% of each other). How does this apply to the person who goes to the chiropractor because of back pain and gets a scan showing them all the imbalances? Refer back to my 2 main points in this article about the language and effect on our fear/pain cycle.
Let’s find the middle ground and do better for all that are experiencing pain and want to live better.
Paul Grilley, Bone Photos; https://paulgrilley.com/bones
Science for Sport, Asymmetry between limbs: Does it really matter? Research Review; https://www.scienceforsport.com/asymmetry-between-limbs-does-it-really-matter/