The 5 Areas of Muscle Health

By Dr. Jason Slagel | April 25th, 2022

Today we are talking about the Five Areas of Muscle Health. Most people don’t have these categorized in this way, so hopefully you learn something new. The five categories of muscle health are: strength, flexibility, endurance, pliability, and tone. Now, some people are familiar with some of these. For example, strength is an easy one, how much can a person’s muscles lift. Flexibility is how far muscles can stretch. With flexibility, we are talking about end range of motion and increasing that. Some people have a large range of motion, and some people don’t. Endurance is how long can your muscles last before they get fatigued. Marathon runners have more endurance than the average, for example. Pliability is the fourth area. Can a person’s muscles be hit, can a person bump into things, can a person work their muscles without them tearing, how bendable, how durable are they. If a person gets a lot of sprains and strains, they have bad pliability. The last category of muscle health is tone. Tone is the neurological control over the muscles. If there is problem with how the nerve is functioning, there is going to be a problem with how the muscle is functioning. These are the five areas of muscle health: strength, flexibility, endurance, pliability, and tone.

So, this matters for several different reasons. I am going to walk you through one example of why this will really matter, especially in healthcare. Most people think that the intervention must match the condition, and this is not true. Rather, the intervention must match the CAUSE of the condition. For our example, let’s look at the condition of low back-pain. If we say the intervention must match the condition then that means that everyone with low back pain needs to do the same thing, and that just simply is not true. The intervention must match the cause of the condition.

Now with low back pain we say “OK, they have low back pain…why do they have it? What area of muscle health is the cause of the low back pain?” In some people, low back pain can be caused from a lack of strength. To do an intervention with low back pain in somebody with a lack of core strength, we do sit ups, crunches, planks, that type of thing, and then the low back pain will go away. If a person has low back pain because of lack of flexibility and their end range of motion of their abs is beyond neutral, they won’t be able to move appropriately when they are walking. Twisting won’t happen correctly in this case. With this person, the intervention would be to stretch those muscles, and then the low back pain will go away. Let’s look at endurance causing low back pain. With a lack of endurance, throughout the day the person’s body will get fatigued and start to slump or slouch. To intervene here we will need to practice mindfully and purposefully sitting in a good posture, or jogging and running with good posture, or sitting on an exercise ball with good posture. This is how a person can build up endurance so that they don’t slump or slouch, leading to low back pain throughout the day. Low back pain caused by a lack of pliability means that a person can’t do much without pulling, straining, or spraining muscles. With pliability, the intervention would be using a foam roller or get a deep tissue massage on a regular basis. Some people even just put a tennis ball on their back, put their back against the wall and then rub the tennis ball up and down and all around their back. All these things can help to increase pliability. Now the last thing is tone. If the low back pain is caused by a tone problem this means that the nerves controlling the muscles are not working properly. In this case, a person must find the area where the nerves are being impacted and correct that so the nerves can work properly. At this point, the muscles can balance out and be functional again.

So, as we can see, we don’t match the intervention to the condition, we match the intervention to the cause of the condition. Now, to know the cause of the condition we must be able to parse out the five areas of muscle health. This is going to inform our intervention. Let’s go over some examples of poor intervention based on the 5 areas of muscle health. If a person has low back pain and let’s say it’s from a weak core, so lack of strength, but they try stretching instead of strengthening their abs, it is just not going to work well.

Now, there is a lot of interplay between the five areas of muscle health. For example, if a person has a tone issue, where the nerve that controls the muscles is not working properly, then that person is probably going to have other problems as well. They may not have balance strength in each muscle the way that they are supposed to have. Flexibility is probably going to suffer because of bio-mechanical imbalances and structural imbalances.

This is why the five areas of muscle health are very important to understand. The one that I fix, here at Structural Spinal Care, is tone. Since tone is the one that I fix, if a patient in my office needs help in one of the other areas I will send them to somebody that is good at that. If a person has a pliability issue, then I will send them to a massage therapist, or if they have a strength or flexibility issue, I will send them to a physical therapist. There are different professionals that I can send people to that are better at handling the other areas of muscle health, but my area is tone. After we fix the tone if there are other issues as well, I can send the person to a professional who specializes in fixing that. So again, the 5 areas of muscle health are strength, flexibility, endurance, pliability, and tone.

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