Why It’s Never Too Early to Correct Musculoskeletal Imbalances

 In Musculoskeletal Imbalances

Derek Marsette


The musculoskeletal imbalances we develop at a young age set us up for a lifetime of dysfunction — I’m proof.

As a middle-school sprinter, I suffered a serious groin tear.
As a high-school wrestler, I tore the MCL, ACL, and meniscus in my left knee.
As an army recruit, the collapsing arch in my left foot was flagged as a concern.
As an army specialist, I tore my left rotator cuff.

Noticing a trend? I’ve always trained carefully and thoughtfully, so why did I keep getting hurt?

Early in my career as a personal trainer, I developed serious pain on and off in my left hip where I suffered the groin tear in middle school. When it’s on, It’s hard to even swing my leg to get out of the car without having a serious sharp pinch in my hip. I can’t squat. I can’t deadlift. I can’t lunge.

After a decade of injury, a friend of mine who is a physical therapist finally diagnosed that I have a femoroacetabular impingement in my hip. I could have been born with it, or it could be a result of how my bones have reacted to repetitive stress — either way the injuries it caused were completely preventable.

A hip impingement or drop hip created stress on my entire left side and it was only a matter of time before things started to go. From my left flat foot, to my left knee, to my left groin, to my left shoulder — it’s all a joint deviation. It’s all a movement pattern disruption.

If it’d been identified in a physical or by training staff early in my life, it could have made a huge difference in how my body ended up. I could have had scholarships. I could have had a better experience in the military.

I’m fine, I’m just happy that I now get to spend my life correcting these issues for others. But what about these kids that are growing up that have no idea why they’re hurting and don’t know how to explain it?

Musculoskeletal imbalances are extremely common, but just as commonly ignored. Nobody talks or knows about them. Why is no one catching it? These kids they get physicals every year, there’s plenty of time to say, “Hey, here’s what’s going on, I’m seeing some deviation in your ankles or in your knees. We really need you to start doing this.”

Injuries that stem from imbalances are 100% preventable —we just need to be aware of what’s happening and why.

What are Musculoskeletal Imbalances?

Musculoskeletal imbalances are injuries and compensations that affect the body’s Human Movement System (HMS). Basically, it is some form of an adapted movement pattern disruption where some muscles are overactive and others are under active. This typically happens as a result of a repetitive action such as sitting for an entire day at work and then in your car on the drive home.

However, this is not limited to sitting. It can pertain to any movement pattern that is done to excess. Some examples of musculoskeletal imbalance are as follows; tendonitis, muscle or ligament strains, thoracic outlet syndrome, degenerative discs, herniated discs, along with multiple other semi and common ailments.

Don’t let this stop you from doing something you love.
If you like to run, that’s fine you can — but you shouldn’t only run. Try to do other things that vary the constant flexion of your hips.

Let’s break down the imbalances that can result from repetitive action.

Types of Musculoskeletal imbalances

Upper-Crossed Syndrome

Upper-cross syndrome is a way to explain multiple upper body muscular problems that can happen at once or to show how certain muscles can affect others that may seem unrelated.

Upper cross syndrome relates to four major areas:

  1. (Anterior) Cervical Flexors (Weak),
  2. (Posterior) Suboccipitals upper traps/levator scapula,
  3. (Anterior)Pectorals (Shortened and tight)
  4. (Posterior) Rhomboids/lower traps (Weak).

For example, if you have shortened, overactive chest muscles this will often cause a  lengthened weak and underactive upper back. This causes something called anterior shoulder rotation, which in turn can cause a forward head tilt. The shortened tighter muscles pull your posterior chain muscles in your upper back to the front and force you into a forward flexed position that creates deviation in the regular functions of your shoulders and neck. 

Lower-Crossed Syndrome

Lower-Crossed Syndrome is very similar to Upper-Crossed Syndrome, but it’s in the lower body.

  1. (Anterior) Lower Abdominals (Weak)
  2. (Posterior) Thoracolumbar Extensors (Tight from over lengthening)
  3. (Anterior) Hip Flexors (Shortened and tight)
  4. (Posterior) Glutes (Weak)

Just like Upper-Crossed Syndrome, Lower-Crossed Syndrome is self-perpetuating and somewhat of a “closed loop.” What I mean by that is that the four primary areas affected are cross-laterally interconnected and have strong relationships with one another which creates a constant state of compensation.

Much of the time, tight immobile extensors play a role in the tightness of the hip flexors, specifically the iliopsoas. At the same time, weakness of the laterally-based abdominal muscles plays into the weakness of the glutes and can create consistent dysfunction in the lower back, specifically in the areas like your L4, L5, S1( this area being very close to your sacroiliac joint which has a lot of nerve roots inherently creating a greater chance of irritation or injury).

This is a generic explanation and the degree of deviation for any one person is specific to them solely.

How to Prevent Musculoskeletal Imbalances from an Early Age

  1. Be sure to purchase the proper shoes for your kids.

Dont skimp on these or go with the “style” especially for performance based shoes. Take the time to have a professional do a foot scan and have the child fitted properly for shoes. This is a huge mistake most people make. Our feet are very important.

Think about the tires on your car. They wear out and become misaligned. When the tires get beat up you replace them. This is the same for our shoes. However, if you leave the tires too long then you can cause permanent damage to the vehicle itself. Once this happens it is much more costly to fix.

This is all too similar with our bodies. If your feet and ankles become compromised as a result of falling arches or pronated ankles there will most certainly be long term repercussions in the form of RSIs(repetitive strain injuries).

So lesson 1 is get fitted for good shoes, take the time to learn what you and your child need individually, and keep up with them roughly every 6 months.

  1. Encourage flexibility and mobility-based exercise daily!

Think about the large muscle groups that most commonly become contracted/over tightened (chest, hip flexors, hamstrings, glutes). Pick a couple of movements and go through them with your kids nightly.

By starting this at a young age you will prevent them from developing imbalances early as well as give them an early understanding of how to prevent these things from happening/what it is they are trying to prevent!

  1. Be present at their physicals.

Not just physically but mentally as well. Ask questions about the child’s movement patterns and if the medical professional notices anything that is out of the ordinary (even if its seemingly small or insignificant).

These medical pros see your kids maybe 3 times a year. You see them everyday. Notice what draws the doctor’s attention so you can better monitor your kids and take corrective action sooner.


Click here to contact us for a fitness evaluation to learn if you have muscle imbalances that are correctable, but are causing repetitive injury.  

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