Firstly as per the title shows, humans are not born symmetrical. We assume that we are with all our testing and training and rehabilitation that what happens on the left should happen on the right.
This unfortunately is a very common belief. Once you understand that the body is not symmetrical, the simplicity of the human bodies physiology and makeup arises and you can see why the human body repeats the same dysfunctions, pathologies and injuries that we see with athletes as well as the general population.
First thing to understand is what are our asymmetries? We have a heart on the left side and a liver on the right side. We have 3 lobes of the lungs on the right but only 2 on the left due to the space needed for the heart. This means that the diaphragm muscle fibres on the right side are bigger and stronger but they also attach to the lumbar spine on the right side. This leads to the tendency to shift and rotate our spine to the right more often than the left. The liver being positioned on the right assists this directional pull on the spine and pelvis as this keeps the right larger diaphragm better positioned for breathing and respiratory activity. The left diaphragm leaflet is much smaller and typically does not have the potential to pull the ribs up and out upon inhalation, so the left abdominal wall tends to get underworked and relaxes more often than not. This leads to long standing abdominal weakness on the left ribcage. We are designed to be right sided dominate human beings.
This most commonly seen pattern is termed the Left Anterior Interior Chain pattern. It depicts our normal human state and the weakness in the left anterior interior chain, the dominance of the right brachial chain and the right posterior back muscles (PEC pattern) of the body.
This right sided dominant pattern compliments our right sided use of our extremities. There is a reason why most humans are right side dominant. This can be seen with most of us kicking or throwing a ball with our right extremity or such as shifting of our weight through the day to the right more comfortably. Among other patterns of movement above and below the pelvic floor, they can also lead to soft tissue overcompensations. The ribcage and pelvic floor have a relationship so what happens in the ribcage also has to affect the pelvis orientation, pelvic floor, and muscle control in and around the pelvis as well.
This is clear in breathing and airflow as an example. Air will typically move more easily into the left chest wall than into the right because of our rotational and muscular influence of the ribs on the right side as mentioned above. Think about a tube of toothpaste or a balloon filled with air. The air moves into the path of least resistance, and as our muscles are stronger and more dominant on the right and weaker on the left ribcage, air moves into the left anterior ribcage more easily. This can lead to a lack of underlying internal support and therefore structural support from the ribcage, abdominals as well as the pelvic floor.
The pattern mentioned above and how it pulls and rotates the upper trunk to the right, once this becomes a long standing pattern, can also limit air movement into the left chest wall. This means when we rotate more comfortably to our right during everyday movement, we now have more resistance breathing into our right ribcage and therefore now our left ribcage as well, which means the air we get in our lungs has to be pushed into our belly and we start to use our accessory breathing muscles like our upper trapezius or scalenes to lift the ribcage to help pull in more airflow and oxygen into the lungs as a compensatory method of breathing. This overdominating pattern can become chronic and can create a long standing pattern, which creates tension and strain on the soft tissues of the body. This hasn’t even taken into account the creation of movement of the body on this imbalanced and asymmetrical foundational structure. This usually results in chronic muscle overuse, inflammation and pain, such as one would see in someone diagnosed with fibromyalgia (nerve pain) or scoliosis.
Now that you know this, is there anything we can do about it? Of course there is!
Proper Initial Testing and Assessment can reveal what areas you are missing range of motion and movement capacity, those areas you don’t have access to. We can then restore what compensations were occurring and reduce the domino effect and asymmetrical dominant bias of the right side. This is done with specialised breathing patterns, targeted and specific movement, and exercises and to restore and rebuild some of the weaknesses in our foundational structure. The most important thing to understand here is that the Diaphragm affects everything, and that it is therefore king.
Once this correction is established, the body can organise its allostatic and joint stability better and restore its optimal function and control, and reduce the physiological stress on the body and any pathologies or chronic conditions that were previously present. As there is no need for the symptomatic dysfunctions to be there anymore this reduces the bodies need to compensate and leads to a better homeostatic and allostasis balance.
Examples of these awareness and positive changes are present with Postural Restoration Institute, those many individuals who have learned from Bill Hartman and his IFAST clinic.
How does this affect my lower body as well as my upper body then you ask? The left pelvis is typically seen anteriorly tipped and forwardly rotated as the pelvis and pelvic floor muscles oppose the ribcage and its position so the body can stay balanced and stable. This anterior pelvic tilt and rotational influence of the lower back and spine to the right, creates a learned pattern of the body which affects the trunk, upper extremities and the cervical cranial mandibular muscles as well. This is seen greatest of all on the rib alignment and position, which therefore influences our breathing patterns and what muscles we recruit and use to breathe. As the neck, head, scapula and upper extremities all sit on and are influenced by the ribcage position and therefore breathing as well, are also modified in positioning and therefore stability once the ribcage position and breathing has altered.
It is my belief that a lot of respiratory and allostatic dysfunctions, are influences and to some degree predominately caused by this dominant pattern becoming overbearing and imbalances throughout the body. These may influence things like the presence of asthma, shortness of breath, stress related diseases and dysfunctions, upper extremity neck, shoulder, arm pain or tightness, lower back pain, lateral hip pain, knee pain to say a few.
Typical presentation I see with most clients that come through my door is that their body is under stress, either physically, emotionally or mentally. These different stressors all influence the physical body in the same way. The brain and nervous system cant distinguish between them and it just perceives a threat that it needs to be ready for. Now that would be great if there was actually a short term threat for our lives like running from a lion, however when it becomes long standing and chronic the body gets flooded and overloaded with stress or as typically called our fight and flight state which releases hormones to help the body better combat, run, fight, dull pain, boost, heart rate, blood to muscles, etc.
The more I learn and understand the more everything comes right back to stress. It is underlying a lot of our current day chronic pathologies and snowballing this over dominant asymmetrical pattern keeping us in this dysfunction.
Myself being an Exercise Physiologist spending years on education at university, when I learned of this approach and understanding of how everything the body does is influenced by patterns. It was like I was looking through a keyhole and suddenly the door had been opened and I could see how simple everything was now.
It is becoming more and more presenting now that Health professional like Physiotherapists, Exercise Physiologists, Physical Therapists are all evolving and learning and starting to conglomerate into very similar client rehabilitation pathways. I believe the more education we get the more our roles will become the same thing all establishing a client orientated approach around creating movement, strengthening, and managing stress on the body for optimal allostatic balance.
I believe the best action and hope for health professionals like myself to better evolve into the best versions of ourselves for our clients is to understand and to start taking into account patterns in what symptomatic clients present with and why they might be presenting with these occurrences in the first place. Only then can we step away from our superficial and bandaid approaches to health care and ultimately reach our goal of the underlying long term relief and management we are pursuing for all our clients as well as ourselves.
Luke Bell
Director, Movement Preparation Coach, Exercise Physiologist, AEP, ESSAM,
Bachelor of Exercise Science and Rehabilitation, Bachelor of Exercise and Sports Science
