Monthly Archives: October 2026

In my experience as a Clinical Myotherapist at Melbourne Massage and Treatment Myotherapy and Lymphoedema Clinic in Coburg, I often look beyond the area where a person feels pain. Sometimes, the problem is not simply a tight muscle or a local injury. The way a muscle contracts, controls movement or produces force can also tell us something about how the nervous system is working. To better understand this, let’s use an example: unilateral hamstring weakness, where one hamstring appears weaker than the other. This can become particularly important when someone continues training, lifting weights or performing exercises that require both sides of the body to work together, like a squat. There are several possible explanations for this presentation. One of them involves the lumbar spine, including irritation of the facet joints and, in some cases, changes that affect the nearby nerve roots. The important point is that you do not always need to experience numbness, tingling or the typical symptoms of neuropathy to have a problem with muscular control that deserves further assessment. What are the facet joint? The facet joints, also known as zygapophyseal joints, are small synovial joints located in the posterior portion of the spine on each side of the vertebrae, and they help guide and control spinal movement. Facet joints’ role is to contribute to each spinal segment’s stability, together with the intervertebral disc. Therefore, they help manage loads during movements such as bending backwards, rotating the trunk and returning to an upright position. As with any joints, even facet joints can become irritated if placed under excessive loading, repetitive movements, trauma or degenerative changes that develop over time. Indeed, anyone, in their lifetime, would experience some form of facet joint degeneration. When a facet joint becomes painful, symptoms may include localised lower back pain, stiffness and pain that refers into the buttock or thigh (Meralgia parestetica). That said, not everyone with facet joint irritation experiences the same symptoms, and degenerative changes on an X-ray or MRI do not automatically mean those changes cause the person’s pain. Indeed, as we already discussed in other blogs, pain is brain interpratiation of a stressor fact, not only a and not always a response to a “damaged” body tissue. That’s where, looking at research on facet joint disorders, we can see the importance of combining the clinical presentation with an appropriate physical examination rather than relying on imaging findings alone. Can facet joint irritation affect a nerve? The quick answer to the above question is: Yes, it can. But there is a catch too. Indeed, a facet joint irritation can manifest itself and refer pain to areas of the body that are far from the facet joint itself, but still not irritating a nerve or a nerve’s root. So in the first instance, the irritated facet joint produces pain. Therefore, surrounding muscles may become more sensitive, guarded or less effective at producing movement because of pain. On the other hand, structural changes around the facet joint may reduce the space available for a nearby spinal nerve root, leading to still pain, but also to a lack of motor control and ability to use a muscle. And again, to identify what is what, we need to go through a tailored assessment, and only via this approach can we get a better clinical understanding of what the root cause of your pain is. And what is most important to keep in mind is that not everyone experiences all these symptoms together. Can nerve involvement occur without numbness or tingling? As briefly explained before, when someone experiences facet joint irritation, as part of their symptoms, they may experience loss of control of a specific muscle or group of muscles. That said, the loss of motor control is not always related to numbness, tingling or burning pain. So a spinal nerve root contains fibres involved in both sensory and motor functions, and based on the location and severity of the problem, these functions may not be affected equally. Together with active, passive and resisted range of motion, we can then start narrowing down the clinical presentation and any potential facet joint irritation and/or involvement of a nerve compression. Why unilateral muscle weakness matters? If someone presents with unilateral muscle weakness, which can happen when there is inflammation at the facet joint along the spine, you may end up compensating during everyday movement or at the gym with the functional side to deliver an action. Let’s make an example by looking at a hamstring that is not firing, due to nerve impingement via an irritated facet joint. Let’s take the case of a client who presents at the clinic with a right hamstring group, the muscle in the back of the thigh, which is not firing. While this person does walk, squat, or does a double-leg hamstring curl, they may notice the impairment. And this is a common presentation when the weakness, given by a non-firing muscle, is not correlated to any form of pain, at least in the targeted muscle. What happens if you continue training with one weak hamstring? Now the concern is not that every strength difference will inevitably cause an injury. We know that one side is more efficient at delivering power than the other side; that’s because we are either right- or left-dominant. The concern arises when a meaningful weakness changes the way someone performs an exercise. Depending on the movement, this could involve shifting more weight onto the stronger leg, rotating the pelvis or trunk, changing the depth of the movement or modifying how the hips and knees contribute to the lift. The other side may consequently perform more work than intended. The weaker side may also be exposed to loads it cannot currently manage well. This is to say that having one side not firing or working as well as it should can lead to injury, but it also can lead to waste of training, as a muscle that can’t perform at its full potential, due to […]