Tightness in the muscle is a common complaint. Often part of a profile of symptoms following an injury and frequently a stand alone sense that persists, tightness and stiffness need addressing to normalise movement and control of movement. Normalising movement is a key part of desensitisation in that it is one less reason for the body to protect itself.
Tightness can be an expression of protection – what is being protected and why?
To address persisting tightness we must determine why and what is being protected. There could healing tissue, a pocket of inflammation or sensitivity to movement within the nervous system (mechanosensitivity). A detailed assessment of the problem, the preceding history and prior events reveal the nature and underpinning source(s), i.e. biological mechanisms. These mechanisms are then targeted with appropriate treatment and strategies.
A common treatment method that we use is called neurodynamics. This is a range of hands-on techniques and movement-based exercises that nourish and mobilise the nervous system. Bearing in mind that our tissues will only be as healthy as the nerves that supply them (a general rule of thumb, but other factors are important including the immune system and endocrine system), it is very important that the nervous system be moving and its blood supply patent.
Tightness can be a sign of guarding. Guarding is protection orchestrated by the brain and can occur at a motor planning level. This means that before moving, the brain increases the activity of certain muscles as a way of protecting a body region for when movement actually occurs. A common example of guarding is in the case of back pain when the muscles remain ‘on’ as the spine is flexed forwards. These muscles should switch off and relax, however the fact that they remain active means that the movement is not normal. Addressing this is important for re-establishing motor control.
Local treatments are often used and can help in the short-term. However, these should be used as part of a rounded programme addressing the pain, symptoms, impact, limitations and other dimensions of the problem. Delving into the details and observing the sometimes subtle changes in movement and control of movement allows us to elucidate the reason(s) for protection and deal with persisting tightness.