A common complaint physical therapists get is that the person they are seeing has ‘tightness’ in an area or areas. This term can be interchanged with ‘stiffness’ and will generally mean the person feels their movement is restricted or feels a constant level of tension even at rest.
However, tightness or stiffness is not always related to a restriction in muscle lengthening, or movement of a particular joint or series of joints, and can occur well within a persons normal range of motion. Aside from an underlying pathological cause (muscle spasticity or rigidity caused by Parkinson’s disease as an example) the exact cause of this feeling is not well understood and is certainly not uniform across all cases.
Despite a range of presentations and individual circumstances some common ‘reasons’ for muscle tightness still occur, these are described below:
Post Exercise Soreness – commonly referred to as delayed onset muscle soreness, or DOMS. This is believed to be as a result of micro damage to the muscle tissue following strenuous activity. This leads to an inflammatory response within the tissue and may account for the feeling of tightness/stiffness. If repeated consistently this micro damage triggers an adaption in the nervous system and in the tissue making your muscles stronger and more efficient in order to handle the increased demand. In the meantime the muscle feels stiff and sore and often unwilling to move or lengthen.
Myofascial Trigger Points – these are the tender points that exist inside taught bands of muscle tissue, often referred to as ‘knots’. While their existence and contribution to muscle tightness is widely debated, there is no doubt that these areas have a neurological effect, or are the result of a neurological issue within the central nervous system or local tissue. So like the chicken and the egg, opinions are divided about what comes first. Treatment of these ‘knots’ generally brings great relief and a perceived increase in movement freedom however, so regardless of their exact role treatment of trigger points is effective and widely used.
Myofascial restriction – another hotly debated topic in the physical therapy world is the role of the fascial network in musculoskeletal pain and dysfunction. Fascia being the non contractile tissue that separates muscle fibres and groups of fibres, and plays a major role in the structural integrity of the body. Fascia allows the muscle fibres to side past one another with minimal friction allowing them to contract and relax, thus allowing movement. Sometime these fascial layers lose their ability to slide and glide and thus restrict free movement of the muscle tissue and therefore make the individual feel tight. That feeling when you wake up in the morning and stretch is the feeling of fascia being released and re-hydrated via movement.
Other reasons include contracture (like frozen shoulder), anxiety related stiffness, age related changes in muscle tissue and fascia, as well as inflammation, and diseases such as the flu.
While having some idea as to why you feel stiff and tight is great, whats more important is to know how to get rid of this feeling! Across the board, movement and exercise are being heralded as the cure all for these issues. Add pain into this equation and suddenly reluctance and inhibition occur, leading to far lower rates of adherence to exercise and activity recommendations. This is where having a trained and reputable musculoskeletal care professional on your team is vital. Myotherapists are highly trained in muscle pain and advanced release techniques that can allow clients an opportunity to move with less pain and thus begin to take the necessary rehabilitative steps.
Written by Dan Hammond, Myotherapist (Bachelor Health Science – Myotherapy) and Master Functional Trainer (CertIV Fitness). 2018
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