“Tight Muscles” Excessive Tone or Shortened?

I had a conversation recently with a injured friend about his “muscle tightness.”   Personally, this statement is very vague to me.  When I hear tight, I hear shortened muscles, but many times, it’s just an issue with increased muscle tone.  While this isn’t the same increase in muscle tone that occurs in an upper motor neuron injury, it’s is the sensation that the muscle feels tight.  The easiest way to distinguish the difference between a muscle that has excessive tone or a muscle that is shortened is to palpate and do a muscle length test.  If the muscle feels tight in a resting position (eg laying down) when it should not be active, there is a good chance there is excessive tone.  If the muscle has full range of motion, it most definitely has increased muscle tone.   Unfortunately, some muscles have both issues.

The next obvious question is how to treat these issues.  When a muscle is shortened, dynamic stretching and PNF stretching works as a warm up before exercise to temporarily improve ROM (probably not to full motion though).  I believe the best way to achieve long term muscle length change is static stretching.

Increased muscle tone is a more difficult problem.  There are several ways to work on improving the tone: self myofascial release (foam roller, lax ball, massage stick, etc.), heat, dynamic warm ups can help here, dry needling (although I have no experience here), and joint manipulation.  The long term problem here is to identify the weak or underused agonist muscle and make sure it starts to do its job.  For example, get your glutes active to help your hamstrings or low back.  The increase in tone will never improve if you don’t have your stability system working well.

Feel free to ask me any questions.


Great Podcast Resources

I’ve been listening to a few podcasts lately and I find them very interesting in how they allow me to learn during more hours of the day (like walking Rosie, driving, or waiting for Jack to fall asleep).  Here are some good ones that I like a lot:

Physical Therapy:
http://physioedge.com.au/ – great discussions with in depth ideas on how to assess and treat a variety of diagnoses from specialists in each area.

Strength and Conditioning:
http://www.bretcontreras.com – look for the B and B connection and some of the old strength of evidence podcasts.  I also love his interview with Stu McGill.
The Strength Coach Podcast with Mike Boyle is good too, but so far not quite as informative as the others.  Boyle is always good to listen to – he has such great experience and knowledge regarding Safe, but serious strength and conditioning.

For Patients:
http://www.patientpower.info/audio/modern-approaches-to-hip-replacement/player/0/player/0  – A good family friend is getting a hip replacement and he referred me to this website from Northwestern Memorial Hospital.  Really great patient education.  It sounds like everything I would tell someone about what to expect with a hip replacement surgery.