One of the major complaints we hear as PT’s is: “I don’t really have a lot of pain. I just feel constantly tight or restricted with my movements”.
This is typically from someone who is generally healthy and active and has tried doing a consistent stretching program without improvements.
Sometimes muscles can feel tight from simply being inactive and “out of shape”.
As Physical Therapists, our expertise is to figure out why muscles are tight and/or limited and the proper approach to returning the muscle to full normal flexibility.
Muscle tone is one of the most interesting components we treat at Robinet PT.
Our brain is constantly sending messages to our muscles to either turn on or shut off. Think of muscles just like light bulbs. When the light switch is off the light bulb doesn’t work.
Same thing for muscles... in that if the neurological system isn’t working properly, the muscle won’t work properly.
Normal resting muscle tone should be similar to a well tenderized steak. It should be easily moved into a stretch and have no tenderness to palpation or pressure.
For the sake of this discussion consider the term hypertonicity (or increased muscle tightness) to be abnormal muscle tightness or restriction.
So why does this happen? There are a few reasons, and they are the key component in the evaluation.
We want to know why the muscle is tighter than it should be at rest and why it is acting this way.
The muscle can be directly injured which causes the muscle to have increased tightness to protect itself. It can do that for years from a previous injury that was never fully healed correctly.
If you have a muscle strain or “pull,” the muscle has been damaged. It does its best to heal using scar tissue. But that can restrict normal muscle length and flexibility, creating long term restrictions.
This can be specifically palpated and treated to correct the problem.
If the muscle has been “pulled” why do we feel the need to stretch it? Is that what we should be doing?
Imagine that a joint for which a muscle controls movement has been sprained or damaged in any way to cause the joint to have excessive movement or “hypermobility.”
The muscle will be in a constant state of guarding to prevent the joint from being further damaged.
A good example of this is when the ankle is sprained. The joint and ligamentous tissue has been damaged causing the joint to be loose but the joint feels stiff and restricted due to muscles guarding the joint to protect it from further damage (along with joint swelling of the capsule which limits movement as well).
If you were to take away the guarding muscle tone, you are left with an unstable joint which triggers further spasm to protect it.
Should we stretch the muscles that are guarding a joint that has been damaged?
If the neurological system is being irritated or pressured, the muscle will have increased tone due to the nerve sending more messages to contract than normal due to the pressure on the nerve.
A “pinched nerve” is quite uncommon and the effects of that are loss of sensation and movement control. So a pinched nerve wouldn’t cause tightness but an irritated nerve would.
Swelling at the spine from joint irritation can cause pressure to the nerve as it exits the spine and can create tightness in muscles. If the nerve is telling the muscle to be tight, will stretching change that muscle tightness?
Muscle tightness can be caused as a result of muscles not working together correctly.
When one muscle has weakness or dysfunction, another muscle will “pick up the slack” to help out but in the process can become irritated.
This is the most common cause for tendonitis.
Think of a group of people working together in a job situation. The “slacker” worker doesn’t pull their weight so in order for the job to get done, the other team members have to work harder.
The slacker doesn’t complain because he/she is still getting paid but not working hard at all. It’s the other workers who are picking up the slack who get more tired and irritated.
In physical therapy, it's called neuromuscular balance and it is a specialty here at Robinet PT that is quite rare to find in our field.
From a PT perspective, its about finding the muscle that’s not working rather than working on the muscle that is irritated sometimes.
Stretching the tight overworked muscle would be like adding even more work to a worker who is already helping to pick up the slack.
Chronic bad posture or repetitive movements can create increased tone in muscles, from being in a position that creates muscle length changes or from the muscle simply being overused.
This becomes evident when someone starts a new exercise program or new activity that pushes the muscle over the top. We think that we need to become stronger so we lift weights or exercise the muscles that we use to perform an activity.
But if that muscle is already overworked, it reacts poorly and creates pain to let us know “it's had enough”.
Each of these reasons can be objectively tested and measured through physical therapy techniques and testing.
If we find tone that doesn’t fit one of these reasons, it can be from something more serious or outside the realm of PT, and we refer back to your physician for higher level testing.
A gall bladder or kidney stone can cause lower back tightness to respond to internal issues that are not something PT can help. So, during the evaluation process, we do specific testing to determine the “why” for the tightness.
If it cannot be specifically measured and reproduced, we know that further assessment for diagnostic testing or physician consultation is appropriate.
So, if you are experiencing tightness and restriction in your body, Robinet Physical Therapy is here to help find your specific answer to your body’s limitations.
Our therapists are highly trained in evaluation to measure and assess your specific limitation and create a plan to improve your life.
Please call our office to find out how we can help and to set up an appointment for an assessment.
Jason Robinet is a physical specialist focused on peak performance training for elite and emerging athletes. His and his wife, Barbara, are co–founders of Robinet Physical Therapy.