Overactive Synergists Cheat Sheet

Overactive Synergists Cheat Sheet

by Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, H/FS

Brookbush Institute's Human Movement Science Rule #5: -

• Every inhibited prime mover will result in synergistic dominance of the ancillary movers for that joint action.

What is an overactive synergist?

An overactive synergist is a muscle that has disrupted normal recruitment patterns by adopting a more active role during joint motion; generally as a compensation for an inhibited or weak prime mover. This phenomenon occurs at any joint where postural dysfunction or movement impairment has altered joint motion.

How does this occur?

Adaptive shortening of a muscle will generally result in hypertonicity (overactivity) of that muscle. Over-activity alters normal reciprocal inhibition. This alteration decreases neural drive (activity) of the functional antagonist (opposing muscle); most often the prime mover of the opposing action. This leads to a decrease in force output for the inhibited action. The loss is compensated for by increasing neural drive to synergistic muscles. If this faulty motor pattern is reinforced and a movement impairment (postural dysfunction) develops, these synergists will adopt a new, compensatory level of tonicity (over-activity).

Why does this occur?

Simply, it has to. Every time postural dysfunction leads to changes in length/tension relationships - muscles will shorten, antagonists will be inhibited, and synergists will have to step-up. Think of synergists like the 3 interns you had to hire when your company cut your top producer because her salary was too high. Now you have to work twice as hard to keep them on task, you're less efficient because of it, and the 3 interns are ready to burn out because they can't handle it. In the short term it's saving the company money, but in the long term it can only lead to disaster. Your body works in the same way. Your body has found a compensatory pattern that is allowing you to maintain normal daily function, but increases the wear on joints and connective tissue. Every muscle we commonly use activation technique for will have overactive synergists we must inhibit.

Below is a list of our commonly inhibited (underactive) muscles, their overactive synergists, cuing to reduce activity of those synergists, and links to videos of release and stretching techniques that may be used prior to activation exercises to further reduce hyperactivity. This information is also included in the activation articles for each individual muscle.

I know this sounds fairly complicated - Fortunately, the body most often adopts a predictable set of compensation patterns. There are only 10 muscles that are commonly addressed using activation techniques (3-4 muscles for each of our major compensations patterns - some muscles are under-active in more than one compensation).

Upper Body Dysfunction (Upper Cross Syndrome, Protracted Shoulder Girdle):

External Rotator Activation (Isolated , Reactive )

1. Supraspinatus (inhibit w/ adduction)
   1. Release
2. Posterior Deltoid (inhibit w/ adduction and flexion into the scapular plane)
   1. Release
   2. Stretch

Serratus Anterior Activation (Isolated , Reactive )

1. Pectoralis Minor - (inhibit w/ posterior tipping, thoracic extension, and retraction)
   1. Release
2. Subscapularis -(inhibit w/ external rotation)
   1. Release

• Child's Pose is an effective stretch for both muscles

Trapezius Activation (Isolated , Reactive ):

1. Levator Scapulae (inhibit w/ scapular depression)
   1. Release
2. Rhomboids (inhibit w/ scapular depression)
   1. Release

Deep Cervical Flexor Activation

1. Sternocleidomastoid (SCM) - requires manual release and stretching (inhibit with retraction)
2. Scalenes - requires manual release and stretching (inhibit with retraction)

• Note: Although it is most likely that the SCM and scalenes are the muscles that would become synergistically dominant in the presence of weak/inhibited deep cervical flexors, I find that activation of the deep cervical flexors (without manual SCM and Scalene release) is still an effective addition to a routine designed to correct Upper Body Dysfunction (UBD) . Improving cervical mechanics is imperative to optimal function of the scapular stabilizers, and the following mobility techniques may be beneficial to improving cervical dysfunction and can be self-administered:
• Release:
  • Upper trapezius
  • Levator scapulae
• Stretch:
  • Upper trapezius
  • Levator scapulae
• Mobilization
  • Thoracic Spine

Note: Deep cervical flexor activation (when necessary), followed by external rotator isolated activation should precede other isolated activation exercises for the upper body. The exercises used for deep cervical flexor activation and external rotator activation are more "isolated" than the exercises used for trapezius and serratus anterior activation - as both require a large contribution from the external rotators. For those individuals with upper-body dysfunction isolated activation is best performed in the following sequence:

1. Deep Cervical Flexor Activation
2. External Rotator Activation
3. Serratus Anterior Activation
4. Trapezius Activation

Lumbo Pelvic Hip Complex (LPHC) Dysfunction (Anterior Pelvic Tilt, Lower Cross Syndrome)

Transverse Abdominus (Intrinsic Stabilization Subsystem ) Activation (Isolated , Reactive ):

1. Lats (inhibit w/ shoulder flexion and abduction)
   1. Release
   2. Stretch
2. Thoracic Spine Dyskinesis
   1. Self Administered Mobilization
3. Psoas (inhibit w/ “drawing in maneuver” and hip extension/posterior pelvic tilt)
   1. Stretch

Gluteus Medius Activation (Isolated , Reactive ):

1. TFL (inhibit w/ hip extension and neutral or slight ER foot position)
   1. Release
   2. Stretch
2. Piriformis (inhibit by preventing horizontal abduction - limiting hip flexion to 60° or less during activation)
   1. Release
   2. Stretch
3. Quadratus Lumborum (inhibit w/ neutral spine - no lateral flexion or hip hike)
   1. Stretch  (The Child's Pose w/ Reach Right or Left

Gluteus Maximus Activation (Isolated , Reactive ):

1. Biceps Femoris (inhibit w/ knee extension)
   1. Release
   2. Active Stretch
2. Erector Spinae (inhibit w/ "drawing in maneuver")
   1. Release
   2. Static Stretch
3. Posterior Head of Adductor Magnus (inhibit w/ slight hip abduction)
   1. Release

Note: Activation exercise for LPHC dysfunction is optimized if the relative contribution of each under-active muscle is considered in relation to the others. TVA isolated activation should precede other isolated activation exercises to improve core function, followed by gluteus medius activation to improve hip arthrokinematics, and end with gluteus maximus activation. For those individuals with LPHC dysfunction, isolated activation is best performed in the following sequence:

1. TVA Activation
2. Gluteus Medius
3. Gluteus Maximus

Lower Leg Dysfunction (Pronation Distortion)

Gluteus Medius Activation (Isolated , Reactive ):

1. TFL (inhibit w/ hip extension and neutral or slight ER foot position)
   1. Release
   2. Stretch
2. Piriformis (inhibit by preventing horizontal abduction - limiting hip flexion to 60° or less during activation)
   1. Release
   2. Stretch
3. Quadratus Lumborum (inhibit w/ neutral spine - no lateral flexion or hip hike)
   1. Stretch  (The Child's Pose w/ Reach Right or Left

Vastus Medialis Obliquus (VMO) Activation (Isolated )

1. TFL/Vastus Lateralis (inhibit with glute contraction to stimulate femoral external rotation)
   1. Release
   2. Release
   3. Myofascial Shear
   4. Stretch
2. Biceps Femoris (inhibit with tibial internal rotation, 5th metatarsal pointing forward)
   1. Release
   2. Active Stretch

Tibial Internal Rotator Activation (Isolated )

1. TFL/Vastus Lateralis (inhibit with hip extension (heel pressed into table) and tibial internal rotation)
   1. Release
   2. Release
   3. Myofascial Shear
   4. Stretch
2. Adductors (inhibit with abduction)
   1. Release
   2. Stretch

Posterior Tibialis Activation (Isolated , Reactive ):

1. Flexor Hallicus Longus & Flexor Digitorum Longus (inhibit w/ toe extension)
   1. Release (included in lower leg release below - trigger points are deep to the gastroc/soleus complex)
2. Peroneals a.k.a. Fibularis Muscles (inhibit w/ inversion)
   1. Release
   2. Stretch

Tibialis Anterior Activation (Isolated , Reactive )

1. Extensor Hallicus Longus & Extensor Digitorum Longus (inhibit w/ toe flexion)
   1. Release (not easily released using self-administered techniques)
   2. Stretch (video coming soon)
2. Peroneals a.k.a. Fibularis (inhibit w/ inversion)
   1. Release
   2. Stretch

Note: Activation exercise for lower-leg dysfunction are optimized if the relative contribution of each under-active muscle is considered in relation to the others, and the contribution of each is considered relative to the exercises performed during activation. Although practice has shown that the order of activation exercises in lower leg dysfunction is less critical it the following sequence is likely optimal:

1. Gluteus Medius Activation
2. Tibialis Anterior Activation
3. Tibial Internal Rotator Activation
4. Tibialis Posterior Activation
5. VMO Activation when neccesary

© 2014 Brent Brookbush

Questions, comments, and criticisms are welcome and encouraged.