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  • On Your Mark

The 14 Most Neglected Muscles in the Body

Updated: Feb 6

Mark Greenfield is a Licensed Massage Therapist, Certified Personal Trainer and Active Release Techniques provider in New York City. He has over 16 years of experience helping clients prevent and recover from many types of orthopedic and sports injuries. His practice is centrally located in the heart of Midtown Manhattan.


So many muscle pains and injuries could be prevented with the right attention to neglected muscles. Injuries like pulled hamstrings, lower back pain, knee pain, strains and muscles tears, and more, can all be prevented by using the right approach. But where do you start?


When it comes to fitness and exercise, there are so many options. Options for strength training programs, cardiovascular exercise, mobility and flexibility, functional training and on and on. Options for how many days per week and how intensely to exercise. Options based on your fitness goals, experience, injury history and time in your schedule.



The amount of variables and options to consider when choosing your fitness program and planning your workouts is staggering. And while this is in part what makes exercise so beneficial and accessible to so many people, it also creates challenges in what choices to make and when.

Are you making the best exercise selection choices for your body type? Do your workouts achieve what you want them to? Are you risking injury based on these choices? Is there enough balance, diversity and recovery time in your program?



Are you neglecting certain muscles that are vital to your fitness goals and to staying injury-free? This is a question that receives less attention than many of the other questions listed above? But it shouldn’t be overlooked because doing so is one of the biggest reasons people fall short of their goals, reach frustrating plateaus, underperform and get injured.


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There are well over 600 muscles in the human body. And while many of these are small ones that don’t significantly affect sports performance and orthopedic health, most of them do. And of theses muscles, there are many that are neglected when exercising and training for a sport.

Let’s take a look at these muscles in detail to better understand their anatomy, function, reasons for being neglected and benefits of including them in a training program.


Glute Muscles


Perhaps the most neglected muscle group in the body, the Glutes are also one of the most important muscle groups for proper biomechanics and optimal sports performance. They’re also connected to your spine, so weak Glutes muscles can lead to back pain and injury. The Glutes are comprised of 3 muscles; the Gluteus Maximus, Gluteus Medius and Gluteus Minimus.



Gluteus Maximus


The Gluteus Maximus is one of the largest and strongest muscles in the entire body. It is considered an anti-gravity muscle because it helps us get up and down from sitting and propels us when we jump, lift heavy objects and climb stairs. When the Gluteus Maximus is neglected and under-active, other muscles have to work harder and joints absorb extra wear and tear.


Low Back Pain? Check out our many articles on this topic.


Specifically, the low back musculature including the QL, Iliopsoas and Lumbar Erectors get overworked which can contribute to low back muscle pain and spasm. In addition, the low back / lumbar vertebrae and facet joints may experience extra wear and tear due to overactivity of the low back muscles and heightened external torque and shearing on the intervertebral discs. This is one reason why you often hear some variation of the the expression, “lift with your legs, bend your knees”. Doing so makes it easier to more complete engage the Gluteus Maximus.



Neglecting the Gluteus Maximus can also predispose an athlete to chronic hamstring strains and knee pain. The reason for this is similar to the description for the low back. Specifically, the Gluteus Maximus and Hamstrings both extend the hip. Hip extension is fundamental to any sport but especially ones that are running intensive, so soccer, football, tennis, running and baseball, to name a few. So when the Gluteus Maximus is weak, the hamstrings are forced to work harder and withstand additional stress which predisposes them to strains and tears.



Similarly, the Quad muscles and the Gluteus Maximus are synergists for many movements including jumping, planting, running and climbing. If the Gluteus Maximus isn’t doing its job, the quads must work harder and this can predispose them to strains as well as lead to extra stress on the knee joint.


Gluteus Medius


The Gluteus Medius is one of the most important muscles for hip, pelvis and knee stability. It is smaller than the Maximus but its location more to the side of the pelvis makes it important for lateral stability, coordination and power. Anyone whose knees collapse inward when lunging, squatting, running, walking and even just standing can lead to knee pain and injuries. A strong Gluteus Medius can help counter this tendency. It won’t always completely resolve it because for some people the reason why their knees collapse inwards is due to structural alignment such as Q angle and foot pronation.



The Gluteus Medius is one of the most important muscles for controlling and producing lateral (side to side) movements, so especially tennis, soccer, baseball, hiking, running and volleyball. A weak gluteus medius on one side can completely change the way the pelvis tilts and what the muscles and joints in the hip, pelvis and low back have to do in order to compensate.



Rotator Cuff


The rotator cuff is composed of four muscles that collectively function to stabilize the shoulder (glenohumeral) joint. The shoulder joint is a ball and socket joint but a very shallow one compared to the hip joint. While this allows for extra mobility, it also creates less stability. Whereas the hip joint is protected by many strong ligaments, muscles and a deep socket, the shoulder has comparatively much less of these.



Weightlifters and many athletes neglect the rotator cuff in place of working the bigger and more visible muscles in the upper body such as the Pecs, Lats, Delts, Triceps and Biceps. But in order for those muscles to do effectively do their jobs without comprising the shoulder joint, the rotator cuff muscles must do their part.


Learn 11 great exercises for shoulder injury prevention and recovery!


Infraspinatus and Teres Minor


These are two small muscles that form the posterior / back side of the rotator cuff. These two muscles work together to keep the humerus from tilting forward excessively. When they are weak and under-active, it can lead to rubbing and pinching of the biceps tendon long head and labrum, leading to tears and impingement. In addition, the weaker these muscles are, the more prone they can be to strains, trigger points and tears.



The infraspinatus and teres minor help decelerate the shoulder and arm during throwing movements such as pitching, a tennis serve and throwing a football. Weakness in these muscles can mean big trouble for serious athletes in these and other sports. In addition, these muscles often get torn when lifting heavy objects overhead.


Supraspinatus


The Supraspinatus is on top of the shoulder underneath the Upper Traps. It is primarily responsible for lifting the arm through the first 70 degrees of range of motion. It helps keep the head / ball of the humerus tracking properly when lifting the arm overhead. Shoulder Impingement is usually when this tendon gets pinched. It can be a very painful and chronic injury. It is one of the most common injuries in the entire body.



To strengthen this muscle requires very precise exercises to get the muscle to help keep the head of the humerus (ball) from jamming into the underside of the acromion when the arm is lifted upwards and overhead. Proper rehab from injuries affecting or affected by this muscle often also require integrated shoulder and scapular exercises. If you have a sharp, painful shoulder issue or have been diagnosis with shoulder impingement, it is recommended that you work with a highly-skilled physical therapist.


Have shoulder pain? Call our NEW YORK CITY office to speak with one of our therapists or to book an appointment.


Subscapularis


The Subscap is somewhat of a complicated muscle because it must be strong but in many people it is actually overactive. Its overactivity can contribute to poor posture, inhibition of the Infraspinatus and Teres Minor and poor shoulder mechanics in general. With that said, the Supraspinatus also ensures shoulder stability so for anyone with a shoulder joint laxity or a history of dislocations, the Supraspinatus is a vital muscle to keep strong.



So when it comes to the rotator cuff, not all muscles are equal in their function and the extent to which they need to be strengthened. So while it may help to focus on all four of these muscles, doing so equally can actually work against you. So be sure to approach the rotator cuff with some complexity and creativity because a one size fits all approach may not be appropriate.


Scapular Muscles


The Scapula or shoulder blade serves as a central attachment structure for many important but often neglected upper body muscles. When some of these muscles are neglected and become weak, it can lead to poor posture and many injuries of the upper body. We will discuss four of these muscles.


Lower Trapezius


The lower Trap is a relatively large and flat muscle that runs from the thoracic spine to the scapula in a diagonal orientation. When healthy and strong this muscle promotes shoulder stability through proper sequencing and movement of the scapula when the arms are lifted overhead. When this muscle is neglected and becomes weak, the Upper Traps will take over which can lead to shoulder soreness, neck injuries and poor posture. It can be a tricky muscle to strengthen precisely because of its hidden role and specific function.



Rhomboids and Middle Trapezius


These two muscles work together to keep the scapula retracted, meaning positioned posteriorly / backwards. When healthy and strong these muscles resist the tendency of the scapula to rest and move in an excessively forward / protracted position. Protraction is often a component that contributes to poor posture and all of the potential issues that come with it. Corrective exercises often include a central focus on these muscles.


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When the scapula is protracted, the chest muscles are often further shortened making it harder to sit up straight and for a person to move optimally during exercise and activities of daily living. These two muscles are small but very important so they should not be overlooked when designing a comprehensive strength training program.


Serratus Anterior


The Serratus Anterior is a strong muscle that attaches to the side of the ribs and to the front, inner border of the scapular. This muscle is perhaps the most important muscle in preventing the shoulder blade from tilting or tipping forward. When the scapular does tilt forward excessively, often because the Pec Minor and a few other muscles are so overactive, it becomes very difficult for the thoracic and shoulder muscles and joints to function optimally.



Strengthening the Serratus Anterior muscle requires doing somewhat subtle, specific and unknown exercises which is one reason why it is often neglected during exercise. The Serratus Anterior is hard to feel working. The nerve connections to the Serratus just aren’t as strong as they are for other muscles in the region and this is one reason it becomes underactive and neglected.


In addition, the SA does not attach the humerus and so cannot be enhahed just by moving the arms by themselves, as with push-ups and bicep curls. For these reasons, engaging the SA requires some intention and patience. But doing so can aid in shoulder injuries, posture and upper body strength.


Spine Stabilizers / Core Muscles


We’ve all heard that it is important to “strengthen your core” for many reasons. A strong core helps increase low back stability, improve balance, increase power and avoid injuries. A strong, stable and active core is essential for long-term lumbar spine health and injury recovery.



But what is “the core”? The word tends to get used synonymously with the term ‘abdominals’ which is a misnomer for a few reasons. First, there are other muscles that make up the core that are not considered abdominal muscles. And second, not all abdominal muscles are the same and in fact, they sometimes get in each other’s way.


There are four primary “abdominal muscles” that make up the primary muscles connecting the pelvis, ribcage, spine and sternum. These muscles include: Rectus Abdominus, External Oblique, Internal Oblique and Transversus Abdominus (TVA). The Rectus Abdominus and External Oblique do not contribute in any way to lumbar spine stability and instead can serve to undermine it. Meanwhile, the Internal Oblique and especially the Transversus Abdominus, are very important core muscles that help stabilize the spine.



To some degree it is semantics. But the main point is that overactivity of the Rectus and External Obliques often occurs instead of or because the TVA and Internal Obliques are neglected and thus underactive and weak. In addition, the Pelvic Floor and Lumbar Multifiti muscle groups are prime lumbar spine and pelvis stabilizers that, like the TVA, often get neglected.


4 great advanced core/ab exercises - video guide!


Transversus Abdominis (TVA)


The TVA is one of the most important muscles in the body due to its central role in lumbar spine stability. The TVA is the deepest of the four main abdominal muscles listed above and it forms a cumberbun around the abdominal cavity. Its muscle fiber direction is transverse (hence the name) which positions the muscle perfectly to draw the abdominal contents close together, meaning front to back, back to front. Its attachments into the side of the lumbar vertebrae enable it to have a direct role in creating intervertebral stability and intra-abdominal strength.



Engaging the TVA can be very difficult for several reasons. First, it is a thin, deep muscle which makes it hard to feel when it contracts. It is not a muscle that stretches or can be felt easily. It is not a muscle that creates large movements like the rectus abdominis does or many other muscles. It is also deactivated when the other abdominal and low back muscles become overactive, causing a continuous cycle of disengagement, unawareness and neglect.



Exercises to engage the TVA are very common in Pilates. But just going to a Pilates class without having some individual instruction might not cut it. Contracting the TVA can be difficult, subtle and even frustrating. But the rewards for learning how to do so can be extremely valuable in how one can perform, feel and look, especially is there is a history of low back injury.


The Pelvic Floor


The Pelvic Floor are a group of muscles that, like their name indicates, literally form a floor-like structure at the base of the pelvis. These muscles work collaboratively with the TVA and multifiti to produce spinal stability. Learning how to activate them can take time, repetition and patience. They are very small muscles that produce very small movements that cannot be seen visibly. But they can be felt with proper instruction and training. Doing so is very important for serious athletes and anyone with a history of low back pain.


The Lumbar Multifiti


These are small but strong muscles that attach adjacent vertebrae to one another in a diagonal orientation. They produce and control rotation of the lumbar spine along with other muscles. Their unique fiber direction, strength and attachment sites position them optimally for creating spine stability. As with the TVA and Pelvic Floor these muscles can be very difficult to feel and engage. This is especially the case when considering just how many other strong and often overactive muscles in the low back region there are.



Many of the same exercises that can engage the TVA and Pelvic Floor will also target the Multifiti when done correctly. There are also some very precise exercises that can target them individually. If you’ve suffered with low back then finding a qualified injury rehab specialist or advanced personal trainer to teach you how to engage these muscles might go a long way in helping you rid yourself of pain once and for all.


Back Pain? Learn more about how we can help.


Tibialis Muscles


The Tibialis Anterior and Posterior are very important muscles in the lower leg but they are very often neglected and weak. This is in part due to the fact that the calves and other muscles in the lower leg are often overactive and tight. Many people also have limited mobility in the ankle which prevents dorsiflexion and thus further impedes the Tibialis Anterior from contracting forcefully and regularly. Neglecting these muscles can lead to shin splints, calf strains, foot issues and more.



Tibialis Anterior is actually a large and strong muscle in the front of the lower leg. It is one of just a few muscles that dorsiflexes the ankle compared to many muscles in the back of the lower leg that produce plantar flexion. This muscle also inverts the ankle which is key for proper ankle and foot mechanics. Underactivity of this muscle can contribute to excess foot pronation and the many issues that pronation can cause.



Tibialis Posterior also inverts the ankle and thus is a key muscle to strengthen if you are a runner and/or have pronation tendencies. It is often the primary muscle that gets inflamed in what is known as Medial Tibial Stress Syndrome (Shin Splints) and thus strengthening it can be key to recovering and preventing this injury. Strengthening this muscle is a little more tricky and subtle than the Tibialis Anterior.


Running Injuries?? Read our articles specifically for runners.




Bringing It All Together


It is vital not to neglect certain muscles when creating and executing an exercise or sports-specific training program. Doing so can predispose an exercise enthusiast or serious athlete to many small and serious injuries. Doing so can also get in the way of optimal performance due to poor mechanics and injuries.


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The body regions, muscle groups and specific muscles discussed above are the most commonly overlooked or neglected in the body. With that said, each person usually has his or her own unique compensatory patterns that should be assessed and addressed with a customized strategy. It’s not enough and can be counterproductive to just target these muscles with a one-size fits all approach.



Taking a one-size fits all approach to activating and strengthening these muscles can actually reinforce the patterns and issues that one seeks to rectify by doing them in the first place. The most common mistake people make is to do approach each side of the body exactly the same. And while this is well-intentioned and in many cases is exactly what should be done, in others it can work against you.


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For example, if a person has an asymmetry between his or her left and right hip, then each side has to be dealt with separately. It is not uncommon for there to be weakness, for example, in one Gluteus Medius or Maximus. When this happens, the same muscles on the other leg might be overworking. This can then adversely affect one side of the low back or one knee. In this instance you may only want to put more emphasis or focus entirely on the weak side while doing stretching and release techniques to help create asymmetry and balance.



To get a customised approach to help you meet your individual needs and goals, consider finding a highly-skilled personal trainer, physical therapist or medical massage therapist. A tailored program that includes a movement and postural assessment, corrective exercises, medical massage to unwind overactive muscles such as Active Release Techniques and a range of other modalities can get you moving in the right direction.


In short, it is important to be aware of what muscles you may be neglecting as you train for an event and exercise regularly. Most people have some compensations and biomechanics issues that need to be addressed. Doing so will help you stay injury-free, reduce pain and maintain flexibility while enhancing sports performance.