Individuals experiencing symptoms at the knee, hip, groin, sacral-iliac joint, back, top of shoulder, between the shoulder blades, neck, face, or TMJ, will demonstrate inability to fully adduct, extend or flex their legs, on one or both sides of their body. They usually have difficulty in rotating their trunk to one of both directions and are not able to fully expand one or both sides of their apical chest wall upon deep inhalation. Cervical rotation, mandibular patterns of movement, shoulder flexion, horizontal abduction, and internal rotation limitations, on one or both sides, will also complement the above findings. Postural asymmetry will be very noticeable, with one shoulder lower than the others, and continual shift of their body directed to one side through their hips.
The pattern that is most often prevalent involves the left anterior interior chain, the right brachial chain, and the right posterior back muscles (PEC) of the body. The left pelvis is anteriorly tipped and forwardly rotated. This directional, rotational influence on the low back and spine to the right mandates compulsive compensatory movement in one or more areas of the trunk, upper extremities and cervical-cranial-mandibular muscle. The greatest impact is on the rib alignment and position, therefore influencing breathing patterns and ability. It is very possible that respiratory dysfunctions, associated for example with asthma or daily, occupational, repetitive work positions can also influence pelvic balance and lead to a compensatory pattern of an anteriorly tipped and forwardly rotated pelvis on the left.
Other common, objective findings secondary to compensatory physical attempts to remain balanced over this unleveled pelvis include elevated anterior ribs to the left, lowered, depressed shoulder and chest on the right, posterior rib hump on the right, overdeveloped lower right back muscle, curvature of the spine and asymmetry of the head and face.
This particular pattern of neuromuscular imbalance is enhanced and generated usually at early ages of development in the pre-adolescent and adolescent years. Since the fibers from our diaphragm that attach to the front low spine and our diaphragm is generally stronger on the right, we all have the tendency to shift and rotate our spine to the right sooner and more often than to the left. The liver also assists this directional pull on the spine and pelvis because it keeps the right larger diaphragm better positioned for respiratory activity. We do not have a liver on the left side. The left diaphragm leaflet is much smaller and does not have the advantage to pull the ribs up and out upon exhalation, so there is a tendency to relax the left abdominal wall. Consequently, these abdominal muscles on the left become weak.
This pattern complements our right dominance of extremity use, our daily shifting of weight to the right and overcompensating patterns of activity above and below our pelvic floor. Airflow for example, will generally move more easily into the left chest wall than into the right because of the rotational influence on the ribs, as previously described. Lack of underlying structural support exists on the right that does not exist on the left due to pericardium position.
Rotation of the upper trunk to the left will generate less activity on the neck when in this pattern because of the dynamic respiratory, structural phenomena. However, rotation of the upper trunk to the right limits air movement into the left chest wall. This created torque on soft tissue, secondary to movement on an imbalanced foundational structure, usually results in chronic muscle overuse, inflammation, and pain, such as one would see in someone diagnosed with fibromyalgia.