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Core Knowledge


How to Fix Muscle Imbalance


When one muscle is stronger than its opposing muscle, you have an imbalance. For instance, if you do push-ups or bench presses daily, but never do rows, pull-ups, or other upper body pulling movements, there's a good chance your chest is far stronger than your back, and you likely have a strength imbalance.

Dave Cruz

So why is this an issue? As far back as 1992, an article published in the journal Sports Medicine showed that an athlete is 2.6 times more likely to suffer an injury if an imbalance in hip flexibility of 15 percent or more existed.

And it's not just those who play sports who are at risk. “About 65 percent of injuries—both athletic and lifestyle-related—come from overuse, which is repetitive use of joints that are rendered dysfunctional by muscular imbalances," says Mark Verstegen, president and founder of Athletes’ Performance and Core Performance.

How It Happens

Your opposing muscles and muscle groups are supposed to work together. Those muscles must be balanced in terms of strength, flexibility, and even posture to be efficient and to prevent injuries. Here are some examples of muscle pairs and the movements they enable:

  • Biceps and triceps help bend and straighten the elbows.
  • Deltoids and latissimus dorsi lift and lower the arms.
  • Abdominals and erector spinae bend the spine forward and backward.
  • Quadriceps and hamstrings bend and straighten the knee.
  • Hip abductors and adductors move the legs toward each other or apart.

Who’s At Risk

For non-athletes, a simple daily activity such as picking up groceries, working at a computer, sitting in one position for a long time, or lifting a child can cause muscle imbalance over a period of time.

But for athletes, muscle imbalance is likely to be an overuse issue as a result of a particular motion used in their respective sports.

  • Weight lifters often develop the pectorals (chest muscles), while neglecting the muscles in the upper back (trapezius).
  • Pitchers in baseball often develop one arm and one side of the side without giving equal attention to the opposite arm/side.
  • In tennis, there is a condition informally called “gorilla arm,” which happens after years of doing almost every motion with the dominant arm to the detriment of the non-dominant arm.

Many conditions are caused by muscle imbalance. For instance, patellofemoral pain results from a band of muscle tissue that pulls the kneecap outward so that it grinds against the groove in which it lies. Runners’ knee, jumpers’ knee, low back pain, and Achilles tendinitis are other common athletic injuries directly or indirectly caused by muscle imbalance.

The Solution

The simplest—perhaps too simple—way to avoid muscle imbalance is to choose exercises that strengthen opposing muscle groups, such as bench presses (for your chest) and seated rows (for your back). But Gray Cook, author of Athletic Body in Balance, suggests that muscle imbalance is a more complex problem.

“Most researchers would rather look at movement pattern problems through a microscope, as though by looking at all the parts, they can assume the whole," says Cook. "Unfortunately, this is not the way the human body works, moves, or lives. The whole is always greater than the sum of its parts.”

Cook prefers the concept of movement imbalance training, rather than muscle imbalance training. Even if muscle testing reveals a muscle imbalance, the pattern of movements that caused the problem still has to be corrected—retrained. 

Cook uses a series of “chop” and “lift” exercises, which he says are fundamental right side/left side movement patterns and building blocks at the ground level of training. He emphasizes that training is for weak links in the body, not for practicing favorite activities. Examples of chop and lift exercises (illustrated in his book) include the half-kneeling chop, halved rope chop, half-kneeling lift, tall kneeling chop and lift, squat chance chop and lift, and scissors.


The “prehab” (prehabilitation) exercise routines you'll find in your Core Performance Program also address the muscle imbalance and movement imbalance issues. “Prehab,” explains Verstegen, “is the proactive means of training and conditioning often-injured areas of the body, such as the shoulders and hips, to prevent injuries and surgeries that would require rehabilitation.”

Pillar strength, Verstegen adds, consists of hip, shoulder, and core stability, which is the foundation of efficient human movement and which is vital to optimum performance and health.

Prehab is designed to strengthen the muscles supporting the upper back and shoulder rotator muscles. This improves posture by pulling the shoulder blades back and down. The ball and joint socket of the shoulder should then move freely and efficiently.

Examples of prehab exercises include:

Physioball Y, T, W, L

Physioball Pushup Plus, Glute Bridge

Sidelying Adduction and Abduction

Pillar Bridge Front

Pillar Bridge Side

Regardless of your age, gender, occupation, or physical condition, there are probably muscle and movement imbalances that need your attention. Find a qualified physical therapist (PT or DPT), certified strength and conditioning specialist (CSCS) or certified athletic trainer (ATC) who can give you an accurate assessment of your status in terms of muscle balance, imbalance and movement.

Including the appropriate exercises in your routine can make you stronger, more flexible, and more efficient in everyday activities and athletic performance.

Check out our Prehab channel for more info and a full routine.

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.

Tags: Injury Prevention, Total Body, Balance, Training, Sports Performance, Strength


  1. Mark Verstegen, author, Core Performance, Core Performance Essentials, Core Performance Endurance, Core Performance Golf, (Rodale, Inc.)
  2. Gray Cook, author, Athletic Body in Balance (Human Kinetics Publishers)
  3. Lyle Micheli, MD, author, The Sports Medicine Bible for Young Athletes, Sourcebooks, Inc.
  4. Muscle Balance Lecture Notes, Department of Physical Education, Health, Dance, & Athletics, Los Angeles Trade-Tech
  5. Penn State Sports Medicine Newsletter
  6. Wayne Westcott and Thomas Baechle, Strength Training Past 50 (Human Kinetics Publishers)