In Italian art, contrapposto is a term to describe a human figure that is typically standing on one leg with their upper body twisting off axis in another direction. The pose can give the figure a dynamic or a more relaxed appearance. Contrapposto can be used to illustrate tension between characters and it can be used to show an action or anticipated action. It is one of the first techniques in western art that uses the human body to display a psychological disposition. Perhaps the most famous demonstration of this type of art in sculpture is Michelangelo’s David.
Human beings are in constant phases of contrapposto. The amazing architecture of our bodies is beautifully asymmetrical and contributes to contrapposto. Yes, most of us have two arms, two legs, two eyes, two ears, etc. However, if you take limbs out of consideration, you are left with a very asymmetrical being. As briefly mentioned in my last blog we are made very differently on the inside. We have a heart in our upper left chest wall. There are three lobes of our lung on the right, two on the left. The right side of our respiratory diaphragm is much larger than the left and there is a liver sitting underneath our right hemi-diaphragm. Additionally, the left side of our brain (which is responsible for the right side of our body) is more dominate for motor control, hence why most of us are “right handed”.
These asymmetries lead humans to lead very different lives on the left and right side of their body. For instance, most people tend to stand more on their right leg because of the left brain motor dominance and to help offset the weight of their heart on the upper left chest wall. We tend to reach across our body with our right hand as our trunk rotates to the left more readily than reaching with our left arm with right trunk rotation. We all seem to be “stuck” like David with a pelvis oriented to the right as we rotate our trunk back to the left.
Due to these inherent asymmetries that everyone has, some very smart people at the Postural Restoration Institute (www.posturalrestoration.com) have researched and described certain patterns that all humans present with (regardless of “handedness”). When these patterns become too dominant, injuries, pain, and decrease in performance occurs. As clinicians, we see that the patient will move different left vs. right and often visual disparities are apparent in the form of different muscle size and definition. Athletes playing asymmetric sports are in constant, excessive contrapposto and need to balance out their asymmetries. Many sports we play require us to orient our pelvis to the right and rotate left such as any throwing sports, volleyball, hockey, soccer, and even swimming if you are breathing to one side. Even “symmetrical” sports such as running, jogging, cycling, and other gym exercises can require symmetrical demands from an asymmetrical, contrapposto body.
Patients with pain, injuries, and declining athletic performance need to appreciate the inherent asymmetry of our bodies as do successful injury prevention and treatment techniques. For instance, on my bicycle I know that my rear tire will ALWAYS wear faster than my front tire as it has approximately 70% of my weight through it and it is the drive wheel. To maximize the lifetime of my tires, I need to regularly rotate the back tire to the front. With humans, we know certain patterns will always be dominant and can lead to injury. Like rotating your bicycle tire to decrease excessive wear, humans need to address muscles that oppose our dominant patterns to stay healthy and not excessively-asymmetrical. The normal, asymmetrical patterns do not always correlate with the same injury. However, treatment of an overuse injury needs to take into account the asymmetries of the body. For instance, left “patella-femoral pain” or “runner’s knee” may have a different cause and treatment than if it were to occur on the right. Likewise, right shoulder tendinitis may have a different cause and treatment approach than on the left side due to our inherent asymmetrical build and tendencies.
So how can you know if your inherent asymmetries are driving your injury and pain? Chances are if it is a non-traumatic injury, it is playing a large role. Many runners will see different wear patterns on their shoes. Cyclists may only feel one sit bone on their saddle and wear out their cycling shorts differently. Swimmers who have difficulty breathing to both sides with their freestyle stroke likely have dominant asymmetrical patterns. Individuals who notice one shoulder sitting lower than the other or observe different muscle sizes left versus right likely have a pattern that needs to be balanced.
The human body is designed to be beautifully asymmetrical with constant predispositions to be oriented in contrapposto. Like David, we humans are constantly using our bodies to display psychological dispositions as well as anticipated and former actions and tendencies. The key to staying healthy is to keep our psychological and physical actions in balance with our daily lives, our sport, and as we face our individual Goliaths.