IS IT TIGHT?
Updated: Oct 21
It’s a question every manual therapist gets asked. It doesn’t matter if you’re a myotherapist, physiotherapist, or an osteopath.
Of course, the easy answer is, “yes!” providing assurance that you need to be there, having treatment. But let’s explore this a little further.
Any feeling that we experience is influenced by how we conceptualise what is happening. There are 500 different parts of our brain which influence this feeling (ps- to dive further into this rabbit hole check out THIS blog post).
When I hear someone say that a muscle feels tight, I think, "ok, so this person has a low grade level of soreness that they don't feel is severe enough to warrant a more aggressive term such as sharp, or tearing, they can still move their body without severe pain limiting them, and the best descriptive word that explains their pain experience is the word- tight."
There are many ways to describe our pain. And I actually think the word "tight" does help me to understand the person's pain experience, as well as which tissue's could be involved in their problem. The issue is the next natural course of this conversation... "how to we make it not tight?" And the natural step all manual therapists arrive on, is a technique that will loosen that muscle. So we press, or we stretch, or we crack, or we needle, and the person's pain calms down a little bit, they then express this to the therapist, which confirms our pre-existing belief that the muscle was tight.
Sure, the end goal has been achieved - the person feels better. But in the longer term it is unlikely that this person's pain will stay resolved, because post-hoc pain relief doesn't necessarily mean that the route cause for their pain has been removed.
A better way to approach any painful experience is to think of it in a series of steps.
Reduce pain with manual treatment. Explain the problem to the person and the actions points we need to make to create longer lasting change.
Provide home-based self-care options. I call these, "get out of jail free cards."
Address underlying factors for the person's pain. The person needs to be integral to this, it can't be purely reliant on us, as the therapist.
Make their management sustainable for the longer term.
Now, lets dive further into this concept of a muscle being "tight." Are there examples of where a muscle may have the mechanical load changes that makes it tight? Absolutely, and we can really group this into three categories.
1. The muscle is contracted
2. The muscle is lengthened
3. The muscle is shortened
The muscle is contracted
Technically our muscles are always contracting, even at rest. Every muscle has an antagonist which is the muscle responsible for creating movement in the opposite direction. The biceps antagonist is the triceps. At rest they both contract an equal and very gentle amount, so your arm doesn't move. What we're talking about here is a muscle increasing the force of its contraction, increasing its tone. Activation of a muscle will elicit reciprocal inhibition of its antagonist. When your biceps contracts, your triceps relaxes. Hypertonic hip flexors will be accompanied by a decrease in tone of the gluteus maximus. This is referred to as the lower cross syndrome.
A muscle might increase its tone because it is working to protect an inflamed area. If you strain your lower back in some way, your neural system will promote muscular contraction in an attempt to limit further pressure on the strained area. This is influenced by many factors including how much danger you believe you are in but is usually a bit excessive, with the muscular protective response often a source of pain itself. This is one reason your back pain worsens hours after the time of injury. I think understanding this can help give you confidence in those horrible early days of acute low back pain that the original injury itself may not be responsible for all of your disability, and things will improve.
Another time a muscle might increase its tone is when it is required to work harder to maintain posture. Imagine you’re standing with a sore right foot, perhaps you have plantar fasciitis. It hurts so your centre of gravity shifts to the left. Your left gluteal muscles have to contract to hold you upright. Your left hip muscles "feel tight”.
The muscle is lengthened
You have “tight upper traps.” You have history of a shoulder injury which is often accompanied by poor shoulder blade control. Your shoulder carriage has dropped, so the distance from your head to your shoulder blade is further. Your upper traps are stretched and pulled taught. “It feels tight” insinuates that it needs to be released with massage, when what it really needs is to be strengthened along with the other muscles of your shoulder blade. We also need to have a look at your trunk/spinal posture to correct the shoulder blade position and take the strain off the upper traps.
You had a hectic week at work and you fell asleep Friday night on the couch with your head tilted to the left. You wake up to notice your neck is really sore, even just to straighten it to neutral. The muscles on the right feel really tight, like guitar strings, but they are on the convex side of your tilt, they are lengthened. The muscles on the left are the muscles which are short and probably need more treatment.
The muscle is shortened
Anyone who sits all day will notice how “tight” their hip flexors feel when they finally stand. Certainly, the hip flexors are shortened. This in one circumstance when some good old fashioned manual treatment can really help. Stretching, muscle energy technique and active release technique all help to release the shortened hip flexors. Given your major hip flexor, the psoas muscle, originates from the front of your spine, this can take a lot of strain off your lower back as well.
Lastly, let’s look at those poor old “tight hammies.” You’re told there is no need to strengthen your hamstrings because they are tight enough as they are. Instead you should stretch them. Stretching your hammies for 20 seconds, twice a day, is not an effective way to improve your hammy length.
A muscle that cannot support you at the end of its range will stiffen up to prevent you from going there.
Truly, you need to train the muscle in its lengthened form, improving its capacity to operate at length, and then you will feel less “tight.” Eccentrics can be great for this. Single leg dead lifts, or an arabesque, with a slow downward phase are also great ways to help.
For those tradies out there with low back pain, improve your hamstrings capacity to operate at length and your pelvis will be able to tilt further on your thigh bones, requiring less bending at your lower back.
For the runners with achilles tendinosis, a calf muscle that can better control its lengthening cycle will be more equipped to absorb load, taking the pressure off the tendon.
So there you go. Three different causes for a muscle feeling tight, all with very different causes.
If you have a muscle that feels tight, visit YouMove Osteopathy for a treatment plan that addresses the cause for your problem.