A lot of people assume that humans should be symmetrical. But I’m not sure that’s accurate, so I’m not a fan of blaming injuries on asymmetry.
More importantly, many sports are unilateral in nature and require asymmetrical movements.
In this episode, we talk about how we deal with asymmetry for both injury prevention and performance enhancement.
To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.
#AskMikeReinold Episode 317: Restoring Symmetry in Asymmetrical Sports
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All right. Rachel from Hong Kong asks, is it important to restore symmetry in unilateral sports? I know it probably does not make sense to promote asymmetry, but in unilateral sports, in my opinion, sometimes the asymmetry is what defines elite athletes.
Rachel, I love that question. We talk about that a lot, and I think you phrased it really well. I love how you expressed your thoughts on it too. It was really good. I’ll start this off by telling a story. It was about… Heck at this point in time, it was over 15 years ago. But I remember we kind of had a full staff meeting with our health and performance department in baseball, and we started saying, “what could we do better to help with injuries in our athletes?” And we started listing all the potential asymmetries and things that they have. And we sat there and we looked at it for quite a bit, and baseball’s probably one of the most unilateral asymmetrical sports you could probably do. We looked at it a bit and then half my team started saying, “All right, well here are the asymmetries.”
Let’s say, “What can we work on for each one?” And we were kind of starting a checklist and I’m just sitting back thinking. And I said the same thing, Rachel. I looked at it and I’m like, “Well, wait a minute. This is what you need to perform their sport. This is what you need to actually excel. If we try to make them symmetrical, does that take away from it?” So, I’ll start off with that. I remember thinking the same thing as you, Rachel, and there are a lot of people out there that don’t work in sports that probably still harp symmetry, but we’re not really symmetrical. So, lots of avenues to kind of hit this from. Dave’s probably the more multi-dimensional athlete in terms of movement skills than we are. We always… Well, I mean in general. I mean everything’s repetitive. Dave’s making a face…
You mean me as a human or the gymnast that I work with?
No, the gymnast. The gymnast. Not you. Gosh, no, not you.
But I mean we do everything. I mean, we throw left, we run left, we swing left. I mean, we should just run the bases backwards every other day. So, just like the track in the gym. Monday, Wednesday, Fridays, we go to third base first and instead of… Anyway… So, who wants to tackle this one? Who wants to start and talk about this concept? Why don’t we start with this? Maybe I’ll try to lead the discussion a little bit. Are asymmetries normal or abnormal? Who wants to jump in?
One at a time. Good. All right. So Dave says, normal. As a human, are we asymmetrical or symmetrical? What are we? What’s even that concept?
I don’t know. I think in general, there’s always going to be asymmetry side to side. I think, right now, it’s kind of hot to say that asymmetries maybe don’t matter, right? In sports, but I think, to Mike’s point, it’s going to depend very highly on your sport, right? I think the sports that I’m involved in, they’re very sagittal playing and they’re not unilateral. You squat two legs, bench press two legs, Olympic lifts, you use two legs, two arms at the same time. And being symmetrical is actually pretty important for completing the lifts well, right? So, if you’re an Olympic weightlifter and you’re super stiff on one shoulder or super stiff of one ankle, it’s going to screw things up and down the chain, which may have some sort of impact on A: injury, B: performance, right? So, do asymmetries matter in certain sports? Definitely. And then in others, maybe that asymmetry is good, right? So, I think a big part is what are the demands of this sport? What are you trying to get back to? What’s limited? Is a specific asymmetry kind of related to their pain problem or performance? And you start from there.
I like that. I mean, think of certain ones. If you’re trying to do an Olympic lift, right? Symmetry would be probably advantageous, right? If you’re trying to throw a baseball and you’re trying to make both your shoulders symmetrical, one of them’s going to probably be in a jam, right? That’s just not the way it’s made, right? So, I don’t know. What are some of the other symmetrical sports? So, how about a symmetrical sport with an asymmetrical body? So, Kevin, talk to me about running a little bit here. And not to lead it a little bit here, but inherently as a human, we’re asymmetrical, right? Your heart’s on one side, your liver’s on one side. Nothing is exactly the same side to side, but you run fairly symmetrically. We’re supposed to. What about the flip of that? Kev, what do you think?
Yeah, I think similar to what Dan just said, where that sport is mostly in the sagittal plane. It’s more advantageous to be symmetrical, I think. You know, you want to see, especially if you’re doing hills and stuff, you know you want to look at people’s angles. And make sure that they have a good amount of dorsiflexion for something like that as well as normal knee range of motion and that type of stuff. I think upper body becomes a little less important for a runner. But I think for general movement, if they’re in the gym lifting, we would like to see some symmetry. And I think in sports like baseball, I think about it with what I’ve learned from you guys. There’s a bony change to the humorous and you can try as long as you want to make that symmetrical side to side, and it’s not going to be symmetrical.
So, I think in some sports, we have to accept it… Asymmetry. If you’re playing this sport as you’re developing and your bones are forming, you’re going to have a lifelong change. If I have a runner and I see some change that isn’t due to a bone changing as they’re going through puberty and stuff… To figure out maybe why this asymmetry occurred. Is this maybe just the shape of their hip bone on one side versus the other? Or is this due to maybe a past injury and that’s something that we want to work on. So, I think their sports history gives you a lens to look through in terms of why are we seeing this asymmetry. And if it’s something that’s relevant that we should clean up either for performance in the sport or just for general movement health.
I’m young enough to remember as a PT, us trying to make baseball players symmetrical as Mike mentioned. And we tried it because the whole GIRD phenomenon was out there and its internal rotation deficit. For those that are not familiar, not esophageal reflux disease. And we tried to equalize internal rotation, not realizing what we were doing because the research said they had a higher rate of injury with internal rotation deficit. We knew about retroversion, but GIRD was this hot topic. And it still is out there and doctors are still talking, even PTs are talking about it. But I think we learned the hard way when people’s careers ended because they got hurt. We created too much motion. We created an imbalance in their symmetries. So, we tried to make it symmetrical. It wasn’t effective for their sport, especially throwing a baseball. And so we learned from that. Hopefully, we learned from that. Some of us have, I think, but it’s always evolving.
You technically made your asymmetry worse by trying to work on your asymmetry in that fashion. So, what do you think, Mike?
Well, I was just going to say from a training perspective, if you’re in a unilateral sport, and golf is a great example where that’s a truly unilateral sport. Throughout your playing season, there are going to be tissues that are overloaded, tissues that are underloaded because you’re repeating the same motion on the same side over and over. From a training perspective, over the course of a year, you probably want to fluctuate how you’re training. So, in the immediate off-season, we may go into a period where we’re looking for a more symmetrical or more well-rounded kind of training program, where we’re trying to offload some of the tissues that have been overloaded over the course of a season, and then train the tissues that have been underloaded or under-stressed over the course of a season. So, I think it does have implications in your training program over the course of a year. And it probably does change the method and the way that we’re training that person in a unilateral sport.
I’m glad you brought that up, Mike. I think that’s a good way of phrasing it there too, is… The way we train them just depends on periodization throughout the year too. And there’s probably some time that we want to take some stress off those overused unilateral asymmetries and try to balance yourself a little bit. It’s not that we don’t appreciate that and we won’t work on that in the future, but maybe to take a little stress off it some time is good too. I like it. Dan, what do you think?
Yeah, I always talk about this. I think when people are trying to figure out why injuries are caused, oftentimes we kind of look at research. “Oh, asymmetry. That’s the reason why”… I just think that we need to be a little more concrete about the mechanisms of injury. Even for baseball, you can make a blanket statement that symmetry is important. Well, it’s like, okay, well you get a lot of hamstring injuries in baseball, but you get a lot of shoulder injuries in baseball and elbow injuries in baseball. And I think the way that you probably prevent those shoulder injuries is not as related to symmetry, right? I’m not a baseball expert, but I’m not the guy telling people to throw a hundred pitches with their opposite arm to build symmetry and throw baseball backwards on the throwing side arm. No, that’s not how we prevent those. But for maybe some of the other issues or injuries from the sport, the symmetries may be more important. But I think at the end of the day, what do we know is helpful for hamstring injuries? What do we know is helpful for elbow injuries? Let’s modify those variables that we know are important. And when it comes to asymmetry, maybe it’s important, maybe not. It doesn’t seem like it’s as important. I think it’s probably lower hanging fruit than the more obvious things.
Yeah, that’s a good point too. We tend to blame things on symmetry sometimes because we can see it. But going back to Lenny’s point here too, I remember when we first started learning about these things in baseball players. We’d find all these asymmetries on injured players and be like, “Oh, well that must be why they’re injured.” And then I started working in pro baseball with healthy guys and I’m like, “Oh, they all look like that.” All the healthy guys look like that. I’m like, so the healthy guys and the injured guys look the same. So yeah, let’s not… Correlation versus causation. But Jonah, from your perspective, from the performance side, and I think not so much injury prevention, but performance side, if I’m a right-hand hitter, golfer, whatever it is, we’re working on med ball rotation, right? How do you program that? Do you make me do both sides? Are you trying to increase one side more than the other? How do you program that for performance?
Yeah, I think that actually ties in pretty well with what Mike was saying, or it depends a lot on the time of the year. So, if we look at, say the professional pitchers we’ve had in this year, early off-season, all our med ball drills we were doing on both sides for all those reasons that Mike was talking about. But as we get closer to the year, as the intensity of the drills ramp up and as we’re trying to get more specific to their pitching mechanics on the mound, we start to just mainly focus on their throwing side. So, if they’re doing a run and gun med ball throw, they’re not going to coordinate that well on their off side. So, it’s just not worth the time and effort. I think that’s a big piece of it, is just asking whether it’s trying to fix an asymmetry for performance health, whatever it is, how much time and effort is it going to take to really try to equal out these sides? And is doing so going to take away from the other stuff that we want to focus on?
A good point. I think inherently we have a dominant side. We have a dominant right hand, we have a dominant probably leg, right-legged or left-legged kickers and our neural wiring, our neural drive is completely different. Stuff that we can’t even conceptualize without higher level testing. So, to consider somebody truly symmetrical, it’s nearly impossible. Because if I tried to throw something lefty or kick lefty or lunge to once or whatever, it’s just not going to feel probably as stable for me just because of a dominant side and a dominant neuromuscular control. The wiring in my brain is completely different for the dominant side for me.
Yeah, that makes sense.
I was going to say, I feel like that’s where it comes down to, at least on the performance side. Yeah, maybe we want to keep these things in check, but you’re probably wasting a lot of time if you’re really pushing after just total symmetry with everything. But at the end of the day, you are who you are. If you’re not hurt, just keep improving performance.
Well, yeah, I was going to say, and what you are saying here is you do need to work on enhancing asymmetrical performance. That’s the whole point. To hit the ball further, you have to have more asymmetrical strength and power in one direction. That makes sense. So Rachel, I hope that helps. I think we answered your question. I think we agree with you, but hopefully we added a little bit more color to that… How we approach that. Because I think we agree with you. I think we see the dilemma, but I do think that there’s a way that we can do it periodized that might be a little bit more effective. So great question. If you have a question like that, head to mikereinold.com. Click on that podcast link and we will keep answering. Please rate, review, subscribe on Apple, Spotify, wherever you listen to your podcast, and we’ll see you on the next episode. Thank you.