Dynamic Dialogue with Danny Matranga - 277: 9 common imbalances and sources of pain + to fix them

Episode Date: April 6, 2023

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Welcome in everybody to episode 276 of the Dynamic Dialogue podcast. As always, I'm your host, Danny Matrenga. And in this episode, I'm going to be discussing seven common sources of pain in the body. This could be low back pain, shoulder pain, knee pain. We're going to talk about a variety of common pain and what one might be able to do with their training to address potential muscle imbalances, weakness without a diagnosis. Because the truth is it's very hard to diagnose pain without seeing a medical professional. And if you've been in pain for an awful long time, you should go to a physical therapist. You should seek out somebody who can diagnose the source of the pain so you can attack it. But if you have occasional pain or tightness or stiffness,

it could be because you're training some muscles too often and other muscles not enough. So we'll discuss that today in great detail. Sit back and enjoy. This episode is brought to you in special part thanks to our awesome partners over at Gooder Sunglasses. If you're active like me and you do lots of things outside, whether it's going for runs, walking the dog, cycling, lifting, saunaing, cold plunging, on the boat, on the land, on the mountain, you name it, you need headwear and eyewear that holds up and protects your eyes from the sun's harmful UV rays. It's also a big plus if the lenses are polarized and make the world around you look like a freaking James Cameron's Avatar movie. Now, here's the thing. Normally, you'd have

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Legion is my go-to supplement manufacturer for what I like to call my big rock supplements. This would be my protein powder, my pre-training formula, my post-training formula and creatine, and my kind of ancillary vitamins and micronutrient protection. So why do I like Legion so much? What sets them apart? It's quite simple. Legion uses all natural ingredients. All the formulas include natural coloring and natural sweeteners. No artificial sweeteners, just stevia. And every single formulation, be it a pre-workout or a vitamin, contains clinically effective dosages of ingredients shown to work in humans in clinical research supported by robust trials. No filler, just legit ingredients in each and every formulation proven to work. The whey protein isolate is so light. It's fantastic. It mixes in

water. It tastes amazing. And I drink it every day, even as somebody who's lactose intolerant. That's just how high quality this whey protein is. And it's sourced from Irish dairy cows that are raised well, eat their natural diet and packaged in climate friendly packaging. I love their plant protein too. For those of you who like something that's a little on the thicker side and you aren't a fan of animal products. Also, I love Legion's pre-workout, but specifically the pre-workout that does not contain caffeine. That would be their Stem Free Pulse. I'm a huge, huge fan of beta alanine and L-citrulline, but I don't like taking in wildly high amounts of caffeine. So if you are somebody who likes pre-workout with caffeine, you can try Pulse. Or if you like it without caffeine because you

maybe want to enjoy your morning coffee or monitor your caffeine consumption, try the Pulse Stim Free. My favorite flavors there for sure are the new grape and the amazing, amazing tropical punch. As for my creatine, I get that from Legion's Recharge, five grams each and every day. I take it on the days I train as well as the days I do not because Recharge also contains L-carnitine, which can help with promoting muscle recovery and decreasing soreness, as well as some ingredients to help with creatine utilization. And of course, my favorite supplements for my ancillary micronutrient health are Legion's multivitamin and Legion's greens powder. Not only do these two products contain a ton of high quality vitamins and minerals, they also contain unique adaptogens like KSM 66 ashwagandha and reishi mushroom, which I like to take each and every day to promote my health.

If you want to cover all your bases with a high quality protein, creatine post-workout, or the ancillary micronutrient health stuff like greens, powders, and multivitamin, I encourage you to go over to legionathletics.com and check out using the promo code Danny. That'll save you 20% on your first order and you'll rack up points that you can use the same way as cash every time you use the code and you'll also be supporting the show. Okay, folks. So first, I need to start off by saying this, and that is, if you have pain and you don't have a root cause, you don't know what it is, guessing isn't more effective than getting a legitimate medical professional to look at the problem. I work closely with a physical therapist every day, so I know that guessing is never as good as assessing.

never as good as assessing. So before you do or try any of the things we talk about in the podcast today, or at any point, quite frankly, always consult with a medical professional or a specialist. I've come to learn a lot over the years, but that's no substitute for legitimate assessment, diagnosis, and medical treatment if your pain requires it. So before you try anything we talk about today or make any broad sweeping generalized assessments about you obviously suffering from this muscle imbalance or this musculoskeletal abnormality, if you will, just take a deep breath and run it by your doctor. It would mean a lot to me and it would keep the attorneys off my back. I'm kidding, of course, but always proceed with caution. Okay, so the most common cause of

chronically elevated pain that I have come across in 10 years of personal training is simply not moving enough. Now, this is not entirely evidence-based. I'm sure that there are a actual set of criterion and maybe even genetic factors that we know of that can increase pain, decrease pain tolerance, right? But I would say not moving enough is the singular greatest general and controllable factor for elevated musculoskeletal pain. I say that because I've had thousands of people stand in front of me and do personal training, general fitness assessments over the last decade. And some of those people presented with really general pain, pain that we could attribute to, let's say, arthritis. So we would consider arthritis a big cause of pain and discomfort. One of the best things that you can do for arthritis is move your body, especially

through ranges of motion and with resistance. Weightlifting specifically seems to be beneficial for arthritis. And while it does cause pain on the front end, it's going to decrease sensitivity to pain on the back end. So just simply not moving enough and dealing with like general arthritic pain or pain that could oftentimes be due to muscular weakness. This is a very common cause. A lot of people would step in front of me and they'd say, oh, I just kind of got aches and pains. My body doesn't move like it used to. You get them on a four week long fitness program where they move their body through a full range of motion on some compound movements, like no joke, guys, two to three times a week, the reduction in whole body pain, even specific pain, like that, that achy shoulder, that Anki, that, that weird knee, that funky, cranky low back, they're all just magically doing

a lot better. And that tends to happen when people start moving, especially through full ranges of motion. But even things like steps, increasing the amount of movements you do across the day, decreasing the amount of time you spend sitting, We're going to talk a lot about that here in a second, folks, which is just simply the kind of habitual trends physically that people put their bodies into for long periods at a time that are not the best for it. But the number one thing is just not moving your damn body enough, not having enough free unstructured movement. Get up, get moving, move through full ranges of motion, sit, you know, all the way down into a squat, move your body freely. And you will notice that I think writ large, you do a little bit better with pain, assuming you're not suffering from something like

extreme hypermobility induced pain. Okay. The number two thing that I think people do that causes a lot of elevated pain, and it stems on, or it's built off of what I mentioned last time, not doing enough, and it's doing too much when you do actually do enough. So we all know that one person who goes way too long between periods of consistent exercise. Oftentimes we see this with a lot of different lifestyle change, whether it be sleep or food, nutrition, right? So we're talking specifically about, I don't exercise often, but when I do, I go to the super intense, crazy bootcamp and it absolutely kicks my ass. It just beats me down. I love it. I kick ass. This type of person oftentimes is the weekend warrior type. They don't do much Monday through Friday, but maybe on

Saturday they go to a crazy two-hour boot camp. And their body's just simply not maintaining conditioning or fitness enough in between those sessions so that when they go over, do it, they have aches and pains that trail off long into the week, or they last two, three, four days. And this is acknowledging that overdoing exercise can be negative and have negative effects on the body. What's fascinating to me as a trainer is if you take your time working up to it gradually, the human body's ability for extreme volumes of exercise or to tolerate extreme volumes of exercise is remarkable. Like it is a truly, genuinely remarkable thing. Some of the people that I know that are big into doing endurance

like events, they specialize in endurance specific type events. They've trained their body to be able to handle so many miles, whether it be on foot, on the bike or in water. But you take somebody they specialize in endurance specific type events. Um, they've trained their body to be able to handle so many miles, whether it be on foot, on the bike or in water. But you take somebody who's like an equivalent good resistance training shape, for example, and you make them do a short run or a moderate distance bike or a very short swim. And they get so blasted, um, from that kind of work. But my point in saying this is you can elevate your body's capacity for almost any type of work. But if you don't do much ever, and then you come out and you bombard your body at all angles with crazy shit, which a lot of people do, this is like the actual

destructive pattern. A lot of people are in with exercise, they do nothing. And then they go join like F 45, get blacked out, hammered, smashed at 5am for three days. And then they go join like F45, get blacked out, hammered, smashed at 5am for three days. And then they're like, yeah, no, that's not for me. And then they go to F4 or not F45. What's the other one? Orange theory or Barry's bootcamp. And these things are not bad at all. Actually, I think that like in general circuit training can be super effective and super efficient and can be really good for general population. But if you're just going ham and you're not really regulating your output, you don't know much about recovery, maybe you're combining this with a crash diet, that can cause pain and injury too. So those are

two things specific to exercise that I see as a very common source of pain and poor recovery. A musculoskeletal one, we're getting into the things that are more postural, musculoskeletal, and specific to muscular imbalances. This one happens at the pelvis, and it's pretty common, and there's nothing wrong with it, but it's oftentimes an indicator of a need to increase the strength of two very important muscles, the glutes and the core. And this is what we call anterior pelvic tilt. So what I like you guys to think about is your pelvis or your pelvic girdle. Think about the bones below your belly button and above your private parts that are essentially acting as the point at which your trunk muscles intersect with the big muscles of your lower body. When the back part of your

pelvis is up higher, okay, and so there's a downward slope, there's an elevation of the backside of the pelvis. A lot of times what we see is pain in the low back because the lordosis or the curvature of the low back is overextended too long. And the way that we correct the position of the pelvis when this happens, typically, not that it needs correcting, let's be careful with our language, but the way we move the body out of this position enough to reduce pain and strengthen the other muscles is by strengthening the glutes, which perform the opposite function. They perform posterior pelvic tilt and strengthening the abdomen while we do things like mobilizing the hip flexors. A big cause of weak core and weak glute muscles that could present

as anterior pelvic tilt is sitting for eight hours a day. We'll talk about the fourth postural musculoskeletal thing. It presents as an imbalance. It presents as a postural display that, okay, this person's spending a lot of fixed time in one position and not doing enough of the antithetical movements. This is, this is, uh, perhaps the most effective way you can go about treating pain and stiffness. It's like, okay, if you're low back hurts and you know, for a fact that you don't have anything specifically like, uh, specific injuries that would prevent you from for a fact that you don't have anything specifically like specific injuries that would prevent you from doing this, if you're like stiff and your glutes are weak and your core is tight, simply strengthening your core and glutes is very likely going to reduce your back pain.

Now, anterior pelvic tilt does not always cause back pain. It doesn't always cause pain at all, and it's not always bad. And just because you display anterior pelvic tilt does not mean you have weak glutes or a weak core. But if you sit a lot and you notice like, oh, my core is weak. My glutes are weak. I have low back pain. It looks like my pelvis is elevated on the backside. These are displays that it might be good to do more extension work for the glutes and to do more core strengthening. Okay. Another often commonplace imbalance, if you will, is the display of the shoulders rounding forward. Okay. So we call this forward shoulder look oftentimes a desk neck. It's oftentimes associated with individuals who watch a lot of television, who spend a lot of time in front of a monitor, who spend a lot of time texting, a lot of time driving. So this oftentimes is paired with a forward lean through the mid back. So it's kind

of hunched back and forward shoulders look. And this is really common. A lot of times this is due to weak extensors in the back. So weak shoulder extensors, rhomboids specifically, we will see tightness start to form in the pec. So sensitivity in the pec muscle due to stiffness and tightness. So we see this, this a lot. I see this a lot when people come in and they have just weak muscles in their posterior chain and they sit a lot. So they're really stiff and tight up front. So what we tend to strengthen is yes, the glutes, sometimes the lats, a lot of times the rear delts and the rhomboids. And so for most people, if you're dealing with like this neck, that's just wrapped down these forwards, uh, shoulders is roundedness through the mid-back, performing more extension can really, really help with that. And a good idea would be to work that extension

in when you're in that seated position. So if you're sitting for one, two hours straight at a bout of work, maybe it's at school, maybe you're doing what I'm doing right now and you're sitting at a desk recording a podcast with a slight forward lean. If you're doing that 30 minutes to an hour straight, get up and do 30 seconds of banded rows or body weight rows, something where you're pulling yourself into extension. A cobra is a great stretch to pair with this. You can always do hip extension movements like bridges, even though this is more of an upper body kind of thing. What we're talking about specifically here is just getting out of that position because the seated position, which we talked about already for the lower body and the upper body tend to be the position in which most people spend the most time other than maybe lying down

when they sleep. So a considerable amount of time is spent in these positions. What's going on guys? Coach Danny here, taking a break from the episode to tell you about my coaching company, Core Coaching Method, and more specifically, our one-on-one fully tailored online coaching program. My online coaching program has kind of been the flagship for Core Coaching Method for a while. Of course, we do have PDF programming and we have app-based programming. But if you want a truly tailored one-on-one experience with a coach like myself or a member of my coaching team, someone who is certified, somebody who has multiple years of experience working with clients in person, online, somebody who is licensed to provide a macro nutrition plan, somebody who is actually good at communicating with clients because they've done it for years,

whether that be via phone call, email, text, right? This one-on-one coaching program is really designed to give you all the support you need with custom training designed for you, whether you're training from home, the gym, around your limitations and your goals, nothing cookie cutter here, as well as easy to follow macro nutrition programs that are non-restrictive. You'll get customized support directly from your coach's email or they'll text you or they'll WhatsApp you. We'll find the communication medium that best supports your goals as well as provides you with accountability in the expertise you need to succeed as well as biofeedback monitoring, baked in accountability support, and all of the stuff that you need from your coach when you check in.

We keep our rosters relatively small so that we can make sure you get the best support possible. But you can apply today by going over to corecoachingmethod.com, selecting the online coaching option. And if we have spots available, we'll definitely reach out to you to see if you're a good candidate. And if we don't, we't put you on a waiting list, but we'll be sure to give you the

best shot at the best coaching in the industry. So head over to corecoachingmethod.com and apply for one-on-one coaching with me and my team today. Common muscle imbalances more globally. And this is going to be very true for those of you who are athletes, who are training at a really high level, who have to maintain symmetry for either aesthetics or performance can happen when you do a lot of fixed work on machines and with barbells. Our bodies are not symmetrical and they're not supposed to be perfectly symmetrical, especially when we play sports or anything that involves overhead or rotational movement where we play to our handed dominance. So things like baseball, basketball, lacrosse, where we are dominant, usually one side

and we have a rotation generating on one side. How are you going to stay balanced doing that? It's like, well, I'm a hockey player. I hit a thousand slap shots today. I'm a baseball pitcher. I throw the ball at least a hundred times a day. And then when I pitch, I throw it a hundred times at 95 miles an hour. You're not. So the idea of being perfectly symmetrical is something that I'd like you to let go of. But the best way to maintain whole body symmetry and minimize the development of imbalances that might, let's say, exacerbate the ones you already have or create ones that you don't necessarily want is to just include some unilateral work. Okay. And this is also very true for individuals who have a one side of the body that aesthetically is developed better than others. Okay. So this means doing a barbell curl. We might instead do

a dumbbell curl, each arm moving one implement. Okay. That helps a lot when you notice an aesthetic difference. If you notice a strength or athletic difference and you're doing something like, say, a barbell squat, switching to a dumbbell squat doesn't change the problem. What makes a big difference, though, would be switching from a squat to something like a lunge, where each side works specifically. So there's ways in which we can eliminate imbalances aesthetically and performance wise by changing the way we load an exercise or changing the exercise entirely. So when it comes to building biceps or building any muscle, if you can do work where each muscle has the opportunity to move its own weight, meaning a chest press where each arm moves

independently, a cable fly, a dumbbell press over something like say a barbell press, the likelihood of you cultivating a big disparity between one side or the other in terms of strength goes way down, which will help long-term with your hypertrophy, maintaining as much, let's say, symmetry as is reasonable. And then in terms of just generally feeling good, moving good, having one side of the body that's usually about as strong and stable as the other, incorporating more unilateral work, meaning taking the time to do lunges and single leg RDLs and one arm rows and half kneeling presses, stuff that a lot of people skip on can be really, really beneficial.

Okay. A very, very common pain point or problem that I've seen over the years. This is number six on the list. We've talked about pain from being too sedentary. We've talked about pain from overdoing it when you go from periods of inactivity to high activity. We've talked about anterior pelvic tilt. We've talked about desk, jockey, body position, desk, neck. We've talked about asymmetries in strength and asymmetries in aesthetics. Now we're going to talk specifically about pain when pressing. I find this to be the most common pain point for individuals when they're doing upper body work, and that's pain when pressing overhead or horizontally. So think about dumbbell presses, chest presses, barbell presses, overhead presses, machine chest presses, machine shoulder presses, you name it, right? I'm talking about people for whom when they press,

they get pain usually in the top or front of the shoulder. This I have found is usually caused by a lack of mobility. And again, a lack of strength on the back of the shoulder and choosing the wrong implement. A lot of shoulder pain that is associated with pressing machines and barbells goes away when you switch to pressing dumbbells. So that's first order of business. And I know that might seem really reductionist and really simplified, but the reason for it is a dumbbell allows you, and you can do the same thing with cables, have more degrees of freedom for the joint. Okay. If you have more degrees of freedom for the joint. Okay. If you have more degrees of freedom for the joint, you can have a greater opportunity to find a comfortable position. If you're using

a machine that's very fixed or a barbell, you don't have as much degrees of freedom or as many degrees of freedom. So with that, your body and yourself, your conscious mind loses its ability to self-organize into a position where it has less pain and less discomfort. You're kind of trying to do this all the time when you're training and you have pain, you're trying to figure out the perfect position to get into tweak it just a little bit in between each rep. The problem is you don't have as much opportunity to do that when you do fixed pressing. So dumbbell swap here makes a lot of sense. Another thing that I found works really well, strengthening the posterior aspect of the shoulder, specifically the rhomboids and the rear delts, working on extension, working on getting the shoulder up or the elbow and arm up overhead and performing things like FRC cars to articulate the glenohumeral joint as much as possible and open up as much overhead space as you can. I think hanging, hanging from a bar, getting traction

and getting that kind of movement in the shoulder capsule is amazing, amazing, amazing. And so those are the ways that I have found one can really attack that kind of pain with some swaps and some substitutions that make a big difference. Something that seems to come up a lot are things like impingements though. And when you have an impingement, it can be really tempting to do a lot of back work, but sometimes overhead loading I found even with like a thing like a lat pull down can sometimes cause some issues. So be careful there, get your pain assessed. can sometimes cause some issues. So be careful there. Get your pain assessed. Okay. This next one coming up is knee pain. Okay. So knee pain is something that, again,

if we don't know the cause, we shouldn't assess, or sorry, we should always assess. We should not guess. So that's me telling you, don't hear what I'm saying. Di yourself, go get a professional to perform an adequate diagnosis for you. It will make a substantially bigger, it's just going to help you heal so much faster. But let's say when you do this squat and when you do the lunge, you just have general discomfort in the knees. This is not uncommon, especially for people who do not move a lot or for people who have had knee injuries in the past or deal with some degree of arthritis in the knee. And so what you can do here, if this sounds like you, you're somebody who's like, well, I can squat, but only so deep. And I can lunge, but only so deep. And when I do this, there's a lot of pain. Try to move into those range of motion without pain with assistance, utilizing things like boxes, utilizing assistive tools like

TRXs or sticks to help you out of those uncomfortable positions. Don't be afraid to take weight out of the equation for sure. Don't load anything into pain. And if you want to go heavy when training those lower body muscles, because a lot of times I find people are looking to develop their glutes or their posterior chain muscles, but they have pain in their knees. Remember, you can strengthen your glutes. You can strengthen your hamstrings with movements like Romanian deadlifts and hip thrust that do not put a lot of torque and stress on the knees. So those can be the exercises that you work really hard on. And when those muscles on the backside of the body are strong, the joints on the opposite side tend to be a lot happier. Think about what we talked about with the shoulder. You got shoulder pain? Hmm. If you

strengthen the muscles on the back of the shoulder, the front of that joint starts to get a lot happier. The same thing's true here I found with knee pain. If you can strengthen that posterior chain, you're going to do a lot better over time in managing this. And then just generally assess the depth to which you can squat and you can't lunge. And if you can get a squat or a lunge to where that joint is parallel with the floor, I don't think you need to go too much lower than that. You can still get a great benefit from those exercises and you're just making considerations for your joint. And that is training in a nutshell, especially when you plan on training for a very, very long time. You have to be able to make

adjustments. You have to be able to make tweaks. Okay. Here's a very, very interesting one. This one is postural and it is the knees caving in when people squat. We see this a lot. It's probably the most common thing you'll see in the gym when people are performing a big exercise that just jumps out at you as looking a little funky. And this is very oftentimes caused by weakness in the gluteus maximus, strong adductors. The adductors are oftentimes used to extend the hips. The adductor magnus is strong. So when it contracts, it could pull the knees in. But the big culprit is weak gluteus medius. And I used this as a talking point to just generally discuss the importance of the gluteal complex. So when we've talked a lot

about pain and dysfunction and discomfort in this podcast, and you've probably heard me mention the upper back, the shoulders, back sides of the shoulder and the glutes a lot because those muscles really matter. They're important for our body. And if we don't train hard, sprint and do the things we evolved to do, those muscles don't get the strength and the work that they need for us to live the pain free way we're used to living. And so the gluteus maximus plays a huge role in the positioning of the pelvis. And a big gluteus maximus is a huge role in the positioning of the pelvis. And a big gluteus maximus is going to help you with sports. It's going to help you with strength production. But the tiny little guys on the side of the glute, the medius and the minimus are really

important for hip abduction and keeping your knees happy and helping your body actually move that big old femur bone into the positions it needs it to be in. And a lot of times when we train, we don't train the medius and the minimus. We only train the maximus. So you should say a lot of times when we train glutes, we only train the hip extension or the gluteus maximus. We don't train a lot of hip abduction. And so hip abduction is a really, really helpful tool for making sure that those really important muscles, they're kind of like the rotator cuff of your hip in a sense. They're often forgot about as we strengthen the muscles around them that perform more glorious functions and aesthetically

appear to be more important, right? That's why when you go to a lot of physical therapy clinics, you'll see these sideline clamshell being given as an exercise because most people have very weak hip abductors. So if you're noticing that you have randomized hip, lateral hip pain, occasional knee pain, maybe your knees cave in when you squat and, or you're just like a normal person. You probably have weak abductors. So it's never a bad idea to work some hip abduction into the mix. Um, and then nine, uh, this is a very generalized one, but this is just, if you have what you feel to be weakness in and around your core and low back, specifically a lack of stability, You don't feel comfortable in the gym. You're worried about doing things like squats, lunges, bending over to pick things up,

strengthening your glutes, strengthening your core through stability, meaning doing static hold bridges, marching, hip bridges, not even thrusts, planks, plank shoulder taps, side planking, bird dogging, dead bugging, these very reduced exercises that can build global stability are really, really good for not necessarily managing pain, but helping you to develop a little bit more confidence in these oh so important movements. And this is big for those of you who have been sedentary for a while or who work with populations who have been sedentary for a while is just building up confidence and movement and creating stability is super, super important. And we oftentimes think about, uh, stability training as being like, oh,

I'm standing on this unstable surface on this wobbly ball, but it's oftentimes the ability for the body to create stability for periods of time, specifically from the trunk and the pelvis that people need to start with. Okay, guys, so there you have it. That's nine common imbalances, musculoskeletal deviations, things that can cause pain and movement dysfunction, and what I tend to do to help my clients with them and what I've seen to work well. Again, I'll remind you if you're dealing with pain, you should seek medical help, professional help, because you don't want to be in pain for a long time. It will decrease the quality of your life and likely decrease the

amount of movement you do. So thank you so much for tuning in to this episode and every episode. I understand you have a million different podcasts you could listen to. So I'm super grateful that you give mine the time of day. And I want to continue to have your subscribership. And I'll do that by providing content that I think is of the highest quality. You can help me by shopping through our partners at the show notes below, shopping with our sponsor for this episode, Gooder Glasses at gooder.com slash Danny, and by subscribing to the show on both Apple and Spotify, where you could leave a five-star rating and review. That would help so much. Thanks so much for tuning in, guys. Share this with somebody

who needs it, and I'll catch you on the next one.