I appreciate how you brought in the psychosocial component to the subjective feeling of "pain". Well done. Pain is very complex and the latest research is looking more closely at the influence of emotion, trauma, and daily stress and lifestyle on patients reports of pain. Thanks Kai :)
I’ve recently come to understand my muscles are very weak. I have stretched and massaged for many months with out any effect. I’m shocked at how many physiotherapists completely ignore resistance training. Yes it does exacerbate symptoms initially but that slowly goes away. Really good video 👌🏻
Go see an actual professional! The op is (to my understanding) not in the medical field, neither am I. And even if he was, you shouldn’t trust someone diagnosing people without an in person or at least live examination.
As an Athletic training student, I thank you for providing these as a way for me to study and review. Keep up the good work and keep bringing these videos!!
Wow, almost 2 years of my physio telling me that stretching and tissue massaging was the right thing to do. Never got better and started to resistance train and within the first week my muscles felt better.... Thank you
Interesting video. I think you should consider one extra cause of muscle tightness: proprioceptive feedback from adjacent joints. You covered it partially in Changing Posture but only really scratched the surface. Joint movement stimulates a reflex relaxation of muscles through proprioceptors. (Basically, joints can't move unless the muscles relax enough to allow the joint to move) That's why everything feels stiff in the morning but when you get up and moving: blood flow and proprioceptor stimulation. As a chiropractor, the feedback I receive after mobilising spinal joints is that he patient feels a reduction of muscle tightness. Movement relaxes muscles and mobilising restricted joints reduces muscle 'tightness'.
As long as there is good enough research behind it, they'll share it. These therapists don't present info off of what patients feel or what chiro's think. That's not credible info
Tightness is subjective in that it is based on individual expectations and goals. In your anecdotal hamstring example - if your expectation was to be able to touch your toes and you can’t, then due to the objective fact you can’t, the subjective belief is you’re tight. Muscle fibre length is fundamentally related to activation. Acute overload = acute shortening imposed by inflammatory processes to promote healing. Progressive overload = progressive lengthening to promote joint MOBILITY as strength capacity improves. Progressive under load = progressive shortening to reinforce joint STABILITY as strength capacity reduces. Both Adaptations increase chances of survival of the organism based on its environment and function. Easy to see this when we look at stroke victims - spasticity and shortening/contracture through inability to sufficiently activate a muscle. The shortening response to inactivity eventually provides joint reinforcement, allowing weight bearing and gait to return after spasticity has stabilised flaccid joints. Therefore Improving their chances of survival. What we subjectively call tightness, i interpret as relative weakness based on previous experience and objective capacity.
@@mk11fan87 my recommendations based on years of struggle with tightness /spine issues: Lower carbs/sugar(not necessarily full keto) Intermittent fasting If youve been weight training for long time. Take 6 months break and allow your spine to readjust (if your posture is suboptimal) Improve Ergonomics (chair/firm mattress/low thickness pillow) Find out what triggers your mind to stress and try to avoid it, it might be certain people around you weighin you down Stop all medications and supplements, they put stress on your body and organs and they make you tighten Above to name a few When you do exercise avoid exercises that put compressive load on your(ex squats) and exercises that stretch your back in uncomfortable position (ex:seat quad curls/..)
I have all those problems and I know it’s because I have been sitting too long with bad posture. I definitely have inflammation with bursitis in the right shoulder, hip and knee. Walking was horrible because I was so stiff in the thighs and glutes. I had severe sciatica a few years ago and some nerve endings are still affected. My doctor said my problem is positional and I told the physiotherapists that stretching makes it worse to the point where I feel sick and light headed. Because I have good range of movement it has to be muscular but it’s been so hard to work out what to do for over a year. I’ve decided that the pain has travelled to many different areas, I get anxious and tense up. Meditation, some gentle yoga with breathing techniques and swimming has improved the problem. I think my brain has been overreacting to pain.
I am a massage therapist and I see so many patients will the pain thighs and glutes with siatica problems and nerve problems that run down the legs. You need to find a really good massage therapist that will break down all the built up tissue in the glute area. I mean they really have to break it down. All the tight tissue around the bones and deep into the whole glute. It's a lot of work. It usually takes me an hour to do it and usually requires 2 visits. The first time to break down the top layer and the second time to break down the deep layer. I can not tell you how many people I have see who have told me they have tried everything, stretching, different doctors, etc. have been dealing with this kind of pain for years and then after the session they either have no pain, or the pain is greatly reduced after one session. And gone after the second. I don't know any other massage therapists that focus that much on the glute area like I do, but if you come to Las Vegas, I can totally fix that problem for you. I have people tell me how much their quality of life has improved after. I usually only have to see them 1 to 2 times and then their good for months. I can almost guarentee I can help you with your problem... Stretching is not going to help the tissue that is compacted by the base of your spine where all the nerves of the lower back and down the legs are. Someone has got to break down all that compacted muscle tissue back there so that its not constricting the nerves and so that blood can run through that area. If you are in the Las Vegas Area, I know I can for sure help you with your problem.
@@UTubeSporaticUser thanks for the information but I'm not in the USA, lol I have improved a lot since then after seeing one physio who gave me some very practical advice for releasing pressure on my lower spine. Due to covid lockdowns I couldn't get out or feel safe going to any massage or physiotherapy since then. You're right about massages. The best I felt was after having one was when she massaged the sciatic nerves in my legs and everywhere else.
Hello , I hope you're doing okay. I am facing a similar problem since 6 months, I am a student and I used to travel 2 hours 4 says a week to college which created pain in my right lower back , well the pain now is worse and it is in me right shoulder blade, right arm, right side of the neck. I have got so many different opinions, last thing my doctor said is that I don't have anything dangerous and it's only muscle stiffness due to travelling and bad posture, I sit a lot for studying. The stretching and physio therapy only took the pain from me arm and shoulder for few weeks , it never faded away. I am tired and in pain, I think part of it is psychological . The doctor asked me to do resistance exercises in swimming pool. I really don't have the luxury
Did you have any luck? My legs are so damn tight and painful. I’ve been getting back in shape since July, and had to stop riding my hike and leg workouts because of the pain.
Thank you for answering this question! Brilliantly presented. Such an important point to understand for those with EDS. The conundrum of being super stretchy yet also having muscles that are constantly rocks full of knots that won’t let go even after repeated deep massage is perplexing. It does seem to be counterintuitive to resistance train when you are already so contracted, but it is the only option. I am curious as to why massage was not included as one of the remedies listed. Curious to hear the explanation for its usefulness alone and joined with resistance training.
thank you for the video! I do enjoy your channel a lot. I do appreciate your hard work. Can i ask you a question? Do you mind if you letting me know or recommend any thesis that explains about tightness, shortness or stiffness well?
Aaah now I know why my friends who work out regularly, especially the guys who go to the gym often and lift weights never complain about tight muscles. My friends and I who are not that fit are all the time complaining about burning shoulders 😪
As the guy says, stretching and foam rolling are good in the short term for pain relief but you have to care about the posture and strengthen the muscles in a smart way for the long term avoidance of recurring muscle pain. Crossing the first 2 out can be misleading who just skims the video.
Thank you for this thought-provoking video! I agree that muscle tightness is related to perception and psychosocial factors (e.g., stress, anxiety, pain, etc.). However, I don't feel that the explanation of tightness in this video accounts for physical changes in muscle length that occur with prolonged postures, such as shortened hip flexors with prolonged sitting or immobilization following fracture or surgery. There are definite changes in tissue tension that occur in these situations, which can manifest in ROM limitations or contracture over time if not addressed with mobility exercises (e.g., AROM, AAROM, contract/relax stretching, joint mobilization). I agree that changing postures frequently and resistance exercises can help combat muscle tightness, whether it is perceived or related to physical muscle shortening of the sarcomeres. I just have a hard time believing that muscle tightness is ONLY perceived. I am interested in reading the studies that were referenced in this video to get a better idea of how they were conducted and how "tightness" was defined. I love your videos, thanks Physiotutors!
Hey Caitlyn, we tried to differentiate "tightness" from "decrease in length" because patients use them interchangeably, but they are two different things. When patients say "tightness" they are often referring to a feeling of discomfort, rather than an actual decrease in length. There are definitely situations in which the actual muscle length is changed like you mentioned above. We will publish a video soon in which we will discuss if stretching is the best treatment option to counteract these changes. so stay tuned!;) Please read the articles and get back to us if you wanna discuss about them! Glad you like our videos and thanks a lot for following!
@@bmb8025 In the case of a tight muscle with foam rolling and massage, I believe it would indeed help. Applying pressure to a trigger point or a taut band in a muscle helps to relieve the tension in the muscle. When choosing a self care tool (ie foam roller, lacrosse ball, 3in ball, etc) you want to take into consideration the size of the muscle or the taut band/trigger point in specific and choose appropriately. Then think of the direction the muscle fibers run like a chain link fence, if you want to lengthen the muscle you go with the muscle fibers and in case of a lengthened or weak muscle you want to go across the muscle fibers. Hope this is helpful.
Thanks for the video. Your response to some comments suggests that your view of massages is that they just feel good, but there’s not much more to it. But if tightness is, as you postulate, just an unpleasant feeling, why should a massage that makes you feel pleasant not be considered a treatment to the problem?
Hi doc, I hope you'll notice may I ask I had a history of injury on my hand and I'm experiencing pain on palm and stiffness on hand And experiencing hardness on base of the thumb Can I do hand gripper exercise everyday? And how many sets should I do Thank you doc
I am 60 years old and I am not and I do not have a big stomach. And I find it very hard to even put my socks on and my shoes. I used to be very flexible nothing impressive, but I can't bend over backwards anymore. Thank you so much for your video. I tried to eat very healthy, but I still have this problem
This is very helpful. I do aqua aerobics in the deep end with weights. I am experiencing some difficulties with being in the same position and increased work load. Trying to make it back to the pool. 🤞I am noticing heaviness and tightening in my left leg, making it very hard to walk. It literally tightens as I do. How to get it to loosen enough to get there initially would be helpful. Thanks so much for your expertise.
Regarding muscular tightness: If tightness is not a shortening of the muscles, why is the sensation of tightness sometimes accompanied by joint noise/popping, which is clearly something mechanical? (and if foam-rolled or stretched, it goes away temporarily)
Does “bad” posture shorten the muscle when slouched too often? I see some PTs and chiros saying we cant help our posture and exercises like chest stretches and back exercises dont help. What are your thoughts?
I am 55 , and have always been a strong walker. In the last 4 months my thighs,buttock and calf muscles start giving me a burning sensation very easily. Now I have to stop every 200m and wait for 1 minute for the pain to stop before I can continue. Does this sound familiar?
when an athlete sense tightness in just a relatively small group of muscle fibers, not all the muscle, and you can palpate a tight band (going transverly through the muscle belly), what can it be? I ipotisized the presence of a tender point, as my local induced ischemia produced pain only in that area and not referred anywhere else. Tried to threat it with overpressure to create ischemia and then quickly release to create a vasodilatation, stretching the muscle but it seems not to work. The athlete is a futsal player, she trains 4 times a week. her quads are very strong at muscle testing, the pain is not provoked by either contraction nor stretching. Thanks for the answer, a freshly graduated physio
Hi Luca, hard to say to be honest! To my knowledge tender points are not necessarily taut bands in the muscle. Do you think that that tightness is related to that spot? Could also be a lipoma...
+Physiotutors well only an ecography or a mri could really define the problem. For the lipoma I can't see any bump on the skin, but upon palpation it slips away from my finger. The pain is referred more proximally but exacerbated when palpating this "tight band". The athlete refers to feel some apprehension when kicking the ball. Do you have some more info to rule out or rule in lipomas ? thanks again
Unfortunately not Luca. It's hard from afar to guess, but in general when we are in doubt, we would refer to the GP to get it clarified. Especially when it falls out of our expertise as physios.
What is the tightness you're referring to in this video? Just the sensation of "tightness" we have after prolonged bad posture? For instance, what I'm currently experiencing is the inability to fully extend my leg at the knee joint in a seated position, due to "hamstring tightness" or lack of muscle length at the hamstring. So in my case, I should be performing stretching for my hamstring instead of resistance training, correct? Thanks in advance!
The tightness I a referring to is the unpleasant feeling you get from ischemia in your muscles, or in a chonic case more likely sensitization of the nervous system. You are talking about a decreased muscle length. Stretching could be an option, but also in this case (not only to build up resistance against ischemia or sensitivity for example) you could train your hamstrings eccentrically. The question with a short muscle is always why it is short and why you want to lengthen it. Short hamstrings aren´t necessarily a bad thing. In my case as a soccer player, the short hamstrings help to prevent overextension (and potential damage to my ligaments) of my knee when I am shooting a ball.
The Humming Boy Short hamstrings have a protective function viz to prevent excess tension on tight neural structures. The SLR &/ slump will have a taut endfeel. In order to lengthen short hamstrings you need to treat the reason why they are short in the first place. In the case of the sciatic nerve, stretching of the piriformis muscle is often very effective. If the slump is restricted , mobilising of the thoracic spine, particularly the costovertebral joints in long sitting works extremely well. It also helps to perform 3-5 gliding manoeuvres (SLRV&Sslump) once you have treated the appropriate joints/"muscles. When you have dealt with WHY the hamstrings are short, THEN hamstring stretches will much more effective and the stretching effect will be longer lasting.
I don’t understand how this can be true. I have unbelievably tight traps. I’ve been overloading my back and traps for a few months and not seen a decrease in tightness. But also I disagree that the tightness is a sensation only i feel, any physio therapist i go to will immediately say wow your back and neck/shoulder muscles are incredibly tight within the first 2 minutes. How does this make sense?
You´re welcome Rob! Winning patients over for active treatment, when they think they should be "released", massaged or cracked etc. is the hardest part of this!
Hello! I'm suffering from this issue and I can't describe how terrible it is. Things you described sounds very similar and helped me to understand many things. However, I'm having tightness in my arm in overall and sometimes reaching behind my shoulder so, what kind of resistance training would you suggest? And would you suggest taking magnesium pills, they say lack of magnesium cause such problems. Hope you reply this because I really need it. Thank you.
Hard to give you individualized advice. Sounds like you have actual limited range of motion in the shoulder, for which you could seek counseling of a local physio. Don't think that magnesium pills are the answer, but there can be so many underlying reasons for your personal situation that it's hard to give any advice at all.
@@Physiotutors first really appreciate your reply and I understand. Btw, I went to physiotherapist, orthopedics, checked nerves and anything but results coming out "normal" yet, especially when I use mouse, my arm ache very badly. Is there any way to get treatment in your hospital or clinic? Because honestly speaking, this is really really tiring and just trying to find a solution for this problem. I checked your other videos and especially resistance training made me feel like a bit relieved but it's just one day and I'm not so sure if it's going to be permanent or temporary solution.
Bhai mujhe bhi morning may uthta hun toh collar bone se lekar face or garden may jakdan tightness feel hota hai apke kya symptoms hote hain mujhe 8 month se hain
Sir , can u tell if i got sprain in upper traps, what should I do next , rest ? or should I apply any pain relief gel , or should I straightway start doing some exercise, ,, My question is when muscles gets tight how does it heal ,,1) time 2) nutrition or medication 3) rest ? ?
"A study in patients with chronic tension-type headache found a significant correlation between muscle hardness and local tenderness(3). In the present study in healthy subjects, 2 of the most sensitive sites (upper boarder of trapezius) were the softest parts compared with all other sites. This reflects that the site is in an area of thicker muscle tissue. Previously, increased hardness has been seen after exercise in healthy subjects(20) and after 15 minuets of sustained computer work(10). This was not seen in this study, probably because the duration of exercise was too short to cause metabolic changes. This suggests that increased muscle hardness is mainly found in chronic pathologic muscle condition. Based on the previous findings,(3) it might be expected that the subjects with a higher number of latent trigger points would show increased hardness due to the taut bands. The limited number of latent trigger points in the current study does not allow a detailed analysis of this relation, but future studies should assess a potential difference in hardness between tender points and latent trigger points." This is exactly what Andersen et al. wrote in their article (Page 498- Andersen H, Ge HY, Arendt-Nielsen L, Danneskiold-Samsøe B, Graven-Nielsen T. Increased trapezius pain sensitivity is not associated with increased tissue hardness. J Pain. 2010 May;11(5):491-9.). I don't agree with your conclusions reading that. Why you don't cite these papers (they are references in Andersen's paper)? 3. Ashina M, Bendtsen L, Jensen R, Sakai F, Olesen J: Muscle hardness in patients with chronic tension-type headache: Relation to actual headache state. Pain 79:201-205, 1999. 10. Horikawa M: Effect of visual display terminal height on the trapezius muscle hardness: Quantitative evaluation by a newly developed muscle hardness meter. Appl Ergon 32: 473-478, 2001. 20. Murayama M, Nosaka K, Yoneda T, Minamitani K: Changes in hardness of the human elbow flexor muscles af- ter eccentric exercise. Eur J Appl Physiol 82:361-367, 2000. I like your videos but it is not fair that your conclusions are so biased in this video. Best regards, Claudio
Hi Claudio, thanks for your critical input! Always good to discuss - and of course we are biased because we always combine evidence (consciously or unconsciously) with our clinical expertise and opinion. it will take a bit of time to give you a detailed answer coz we gotta read your references. With which of our conclusions do you disagree exactly?
when I workout my entire body will stiffen up for hours to the point where I'm almost disabled. I can barely walk or turn my head to check my blind spots on the way home from the gym, simple things like opening a bottle of water and putting the cap back on become difficult cause my hands and fingers will stiffen up so bad, all I do is walk on the tread mill and do a stair stepper and by the end of my workout my shoulders, stomach, calves, thighs, and neck are so stiff I feel like I've got no control of my muscles any more. I also find that if I sit in the sauna for 20 minutes after a workout to attempt and relax the muscles or improve circulation it actually makes my symptoms much worse and I feel like I'm becoming trapped inside my own body because of how stiff and unmovable my muscles become. I also wanna say there is no pain when this happens, just the inability or struggle to move my body. 90% of my symptoms seem to go away within a few hours after I've finished my workout but certain areas like my neck and hands will stay tight for days sometimes. Is this just muscle tightness or something bigger I should worry about?
I have since years pain in my neck shoulder muscles. I have lost all hope tried every type of stretching, cupping therapy, acupuncture, pain killer. It has made my life very hard. Please need help
I am a person without professional or specialized knowledge in a particular subject. Please help me understand what you said and didn't say with your solution. Thank you kindly Mary Kate
''You're best posture is always your next posture.'' As a student in physical therapy, I love this. Thanks ! I've also favored active therapy i.e. exercices, strenghtening, etc. Do you think the type of muscle fiber may play a role in the sensation of tightness ?
Yes, and an easy one for the patients to remember! Here is an excerpt from Falla (2007) about motor impairment in neck pain: "Biochemical alterations in the upper trapezius muscle have been observed in people with neck pain, including increased interstitial levels of glutamate and serotonin in women with trapezius myalgia-which are positively correlated to pain intensity [47]-and higher interstitial interleukin and serotonin in people with chronic whiplashassociated disorders [48••]. Furthermore, muscle biopsies have shown evidence of disturbed oxidative metabolism of trapezius muscle fibers in people with myalgia [49,50], impaired trapezius intramuscular microcirculation in women with neck and arm pain [50,51], and a significant increase in the proportion of type-IIC fibers in the cervical flexor and extensor muscles in patients with chronic neck disorders, possibly indicating preferential atrophy of slow-twitch muscle fibers [52]. Researchers have also observed atrophy and connective- tissue infiltration of the extensor muscles-notably for the deeper muscles, the rectus capitis minor/major, and multifidi-in people with chronic neck pain"
That's the point of the video. People are often confusing "tightness" which is a feeling with shortening=contracture. Tonicity and spasticity are 2 other terms.
I have neck muscles tightness for years. I feel sore neck muscles after some physical work like after playing badminton or carrying small bag on my shoulder, even after wearing high neck jacket. And not get relief massage or so many physiotherapy.pls suggest causes and treatment.
Great content! I just graduated from university, and muscle tightness was regularly related to trigger points. This video claims that muscle tightness can't be related to tissue hardness, what are trigger points then? I regularly perform trigger point therapy, with a good outcome and i 'feel' the triggerpoint/ taut bands. What are these 'knots' then? :) And what about dry needling? Thanks in advance!
Thanks Elien, appreciate it! The answer based on evidence is "we don't know what trigger points are". They are certainly there and sore spots of unknown origin: www.ncbi.nlm.nih.gov/pubmed/25950032 We are planning on doing a video about the topic as well. Taut bands cannot be reliably palpated: www.ncbi.nlm.nih.gov/pubmed/28098584 Dry needling is not more effective than placebo: www.ncbi.nlm.nih.gov/pubmed/27831670 With all that being said, we do press on tender spots here and there and some patients seem to benefit from that. The working mechanism is probably neurophysiological.
Thank you for the concise explanation. What if you don't recover normally after exercise because of health conditions like chronic fatigue syndrome /fibromyalgia/adrenal fatigue? And the pain relief you experience is temporary i.e. while exercising but from just an hour after you finish your pain is more intense and this pain lasts for several days?
This is a different kind of muscle tightness that we are not covering here. Those conditions you describe are driven by the central nervous system and need a different approach in collaboration with a health care provider. Exercise will form part of their treatment, but most probably more in a manner of graded exposure/graded activity.
I feel stiff most of the time. When I get up after sitting down or lying down, I'm so stiff I can hardly walk. Is this from inflamation? My muscles burn when I exercise. Thank you.
Me too. I think I have very poor circulation. I get cardio almost every day, hiking, biking, lifting weights. Every day I feel like shit. I don't understand.
@@mycatisromeo Diet matters a lot. Sugar raises insulin in the blood. Being under constant stress can keep us in the fight or flight mode all the time.
if my mri showed short intact hip abductors then does that mean its not tight? basically did lots of squats in abducted position loading those abductors heavy. Do you think its mechanically shortened and probably not from injury?
Not sure what anxiety issue is linked to muscle tighness in your case, so can't say. Maybe something for a psychiatrist either. In movement-related fear a graded exposure program is often helpful.
Spasticity is caused by lesions in the pyramidal tract like in a stroke or spinal cord lesion. It's velocity-dependent, there is more resistance in one direction and there is more initial muscle tone when moved (clasp-knive phenomenon). Rigidity is seen in extrapyramidal lesions (e.g. Parkinson) such as the rubrospinal or vestibulospinal tracts. There is rather intermittent increase in tone (cog wheel phenomenon) or uniform increase in tone (lead pipe phenomenon) and same resistance in all directions, which is velocity-independent. Tightness is just an unpleasant feeling in a muscle.
Does muscle tightening cause my upper and mid back to get tired fast? I get fatigued fast from my back once I cook or stand for a while. Since quarantine I started feeling this.
Hence why I tell my patients that the soft tissue work I perform will provide temporary benefits to reduce pain and stiffness, but that the exercise is the treatment for long term benefit!
There's no evidence that stretching actually change muscle length. Changing posture is very difficult and probably requires a constant conscious effort to change habits.
your video is very useful explaining your opinion & expertise about the benefit of exercise & muscle adaptation but subject is more about the vocabulary thank you people for building our knowledge and god bless you
Hi I m having neuromuscular strain due to side effect of homeopathy medicine now I have tension type head ache for simple emotions how to resolve suggest kindly pls
understanding this Physiology can be very confusing, as people who do such exercises as Yoga, Ti Chi, have experienced positive results as well. Their bodies certainly benefit & become more flexible as well. Also, even athletes (Football, basketball, soccer player, etc.) benefit from lots of stretching & massage before workouts as opposed to resistance exercises right before the game. All these exercises have their right place & time.
Would we "palpate" the tightness objectively as manual therapists and thus then this would make the findings objective and not "subjective patient experience"? trying to understand...I am a massage therapy student . Thanks
this is so helpful. thanks so much. I really resonate with this as my tight shoulder muscles hurt more I stretch. This is more related to posture and keeping my arms a little too way from body when I work and lift. So what Kind of training to do suggest please? I do pilates once a week though! ANY OTHER WHICH CAN ME MORE HELPFUL..THANKS AGAIN
Thanks for the video!! It was really interesting, and I wanted to ask you a few questions... 1. In the video you seemed to brush off the notion that, when dealing with tightness, muscles tend to be short, and you cited some anecdotal evidence based on patients you’ve seen at your clinic. Are there any studies you could link me to that could back that up? (I.e. muscle weakness, not shortness, is the primary cause of tightness). How can you tell when a muscle is short vs when a muscle is just stiff? Could it be both? Do you modify the treatment plan to include stretching if the muscle is short? 2. One of the things you noted as the cause for tightness is overload of the muscle. How can you tell when the muscle is overloaded because it’s compensating for other weak muscles versus if it’s overloaded because it’s simply a weak muscle? Should you strengthen a compensating muscle, or should you stretch it and strengthen the weak muscles? Or should you do both? 3. The standard treatment plan for APT (Anterior Pelvic Tilt) is to stretch lower back/hip flexors and strengthen glutes/hamstrings/core, with the idea being that the lower back and hip flexors are “tight and shortened” and the glutes/hamstrings/core are “weak and elongated”. What do you think about this and its traditional stretching/strengthening protocol? Do you agree with it?
Hi Michael, you're welcome! 1) Don't think that there are any studies proving the theory scientifically, but the examples with the hamstrings (short, but not tight) and the trapezius (tight, but not short) are pretty clear examples that show that there is hardly if a relationship at all between shortness and tightness 2) We base this mostly on patient history: increasing pain during the course of the day, description of pain as tightness, job, daily activities, posture etc. In case of the trapezius, most exercises strengthen the upper trapezius and the rotator cuff, so you don't have to be very specific. Stretching is just a short-term pain relief and is a good option for self-management by the patient. 3) What you're referring to is Lower Crossed Syndrome. There is no scientific data to back the idea that this exists or ever has been. How do you assess "Anterior Pelvic Tilt" and is it a problem? There is so much variation in posture. If we encounter patients who sensitize their backs in the extension position, we are working on exercises for them to move out of this position - that's all. On top of that we know that stretching does not elongate muscles unless done with extremely high volume and frequency. At the same time, strengthening probably doesn't change posture either.
@@Physiotutors what to do then if some person have scalenius muscle tight and that is causing radicular pain-stretch or strengthen? According to you we should strengthen .
@@Physiotutors So if I understand correctly, someone experiencing the same amount of stiffness regardless of time of day or daily activities may have short muscles and could benefit from stretching?
Thnks for this..... Suppose a person with hamstring tightness(always in a position with 45° of knee flexion).... So in this case.... What should i give??? Resistance against knee extension???? Or stretching???? Sorry for my english
what do you mean by resistance training? I have extreme tight muscles in the forearm. So how do I make resistance training for the forearm? Do you mean making slow negative movements at the exercices?
Resistance training = Moving heavy weight around 60-100% of your maximum 1 repetition maximum. Could be as easy as eccentric training with dumbbells and moving your wrist.
I have pain in my index finger and weekness in wrist and my physio told there is a contraction in my brachioradialis due to continuous work on system...could you please help me
Thank you, young version of Arnold
True
Get to the choppa
Hahahha
@@marlon1be yooo😂😂
I will be back
I appreciate how you brought in the psychosocial component to the subjective feeling of "pain". Well done. Pain is very complex and the latest research is looking more closely at the influence of emotion, trauma, and daily stress and lifestyle on patients reports of pain. Thanks Kai :)
I’ve recently come to understand my muscles are very weak. I have stretched and massaged for many months with out any effect. I’m shocked at how many physiotherapists completely ignore resistance training. Yes it does exacerbate symptoms initially but that slowly goes away. Really good video 👌🏻
Hi I am having a stiffness at my belly area causing me hard to breathe in can you tell me what is it about
Go see an actual professional! The op is (to my understanding) not in the medical field, neither am I. And even if he was, you shouldn’t trust someone diagnosing people without an in person or at least live examination.
@@ananhardeo904 may be you have anxiety & depression
@@imransyed5509 I know . Right now I am getting pain underneath my boddy area I had gastritis as told by my doctor. Pain in me is terrible
As an Athletic training student, I thank you for providing these as a way for me to study and review. Keep up the good work and keep bringing these videos!!
You're welcome Mathew! Always good to hear that people from other professions are watching our videos as well!
We'll definitely keep em coming!
I disagree only that no solution was absolute.
Thank you kindly
Mary Kate
I am a PT in China!Actually incredibly helpful to the patients even 5 years later. Thanks a lot!
Thanks
We are actually on billibilli too now
@@Physiotutors Great！really helpful！
plz send send me your whats app no
Wow, almost 2 years of my physio telling me that stretching and tissue massaging was the right thing to do. Never got better and started to resistance train and within the first week my muscles felt better....
Thank you
Stretching is just not for tightness
you should do all 3 of them actually, along with some life style changes probably
Interesting video. I think you should consider one extra cause of muscle tightness: proprioceptive feedback from adjacent joints. You covered it partially in Changing Posture but only really scratched the surface. Joint movement stimulates a reflex relaxation of muscles through proprioceptors. (Basically, joints can't move unless the muscles relax enough to allow the joint to move) That's why everything feels stiff in the morning but when you get up and moving: blood flow and proprioceptor stimulation. As a chiropractor, the feedback I receive after mobilising spinal joints is that he patient feels a reduction of muscle tightness. Movement relaxes muscles and mobilising restricted joints reduces muscle 'tightness'.
PO
As long as there is good enough research behind it, they'll share it. These therapists don't present info off of what patients feel or what chiro's think. That's not credible info
Tightness is subjective in that it is based on individual expectations and goals.
In your anecdotal hamstring example - if your expectation was to be able to touch your toes and you can’t, then due to the objective fact you can’t, the subjective belief is you’re tight.
Muscle fibre length is fundamentally related to activation.
Acute overload = acute shortening imposed by inflammatory processes to promote healing.
Progressive overload = progressive lengthening to promote joint MOBILITY as strength capacity improves.
Progressive under load = progressive shortening to reinforce joint STABILITY as strength capacity reduces.
Both Adaptations increase chances of survival of the organism based on its environment and function.
Easy to see this when we look at stroke victims - spasticity and shortening/contracture through inability to sufficiently activate a muscle. The shortening response to inactivity eventually provides joint reinforcement, allowing weight bearing and gait to return after spasticity has stabilised flaccid joints. Therefore Improving their chances of survival.
What we subjectively call tightness, i interpret as relative weakness based on previous experience and objective capacity.
Stress increases inflammation and tightness from my experience.
Also creatine increases tightness.
That explains my muscle tightness since lockdown I can’t even have a normal workout without getting a tight lower back shoulder or neck 😫
@@mk11fan87 my recommendations based on years of struggle with tightness /spine issues:
Lower carbs/sugar(not necessarily full keto)
Intermittent fasting
If youve been weight training for long time. Take 6 months break and allow your spine to readjust (if your posture is suboptimal)
Improve Ergonomics (chair/firm mattress/low thickness pillow)
Find out what triggers your mind to stress and try to avoid it, it might be certain people around you weighin you down
Stop all medications and supplements, they put stress on your body and organs and they make you tighten
Above to name a few
When you do exercise avoid exercises that put compressive load on your(ex squats) and exercises that stretch your back in uncomfortable position (ex:seat quad curls/..)
I've never gotten much relief from stretching, strengthening always helped me much more.
Strengthening is usually the best answer.
I have all those problems and I know it’s because I have been sitting too long with bad posture. I definitely have inflammation with bursitis in the right shoulder, hip and knee. Walking was horrible because I was so stiff in the thighs and glutes. I had severe sciatica a few years ago and some nerve endings are still affected.
My doctor said my problem is positional and I told the physiotherapists that stretching makes it worse to the point where I feel sick and light headed. Because I have good range of movement it has to be muscular but it’s been so hard to work out what to do for over a year.
I’ve decided that the pain has travelled to many different areas, I get anxious and tense up. Meditation, some gentle yoga with breathing techniques and swimming has improved the problem. I think my brain has been overreacting to pain.
You sound old like me 😲
I am a massage therapist and I see so many patients will the pain thighs and glutes with siatica problems and nerve problems that run down the legs. You need to find a really good massage therapist that will break down all the built up tissue in the glute area. I mean they really have to break it down. All the tight tissue around the bones and deep into the whole glute. It's a lot of work. It usually takes me an hour to do it and usually requires 2 visits. The first time to break down the top layer and the second time to break down the deep layer. I can not tell you how many people I have see who have told me they have tried everything, stretching, different doctors, etc. have been dealing with this kind of pain for years and then after the session they either have no pain, or the pain is greatly reduced after one session. And gone after the second. I don't know any other massage therapists that focus that much on the glute area like I do, but if you come to Las Vegas, I can totally fix that problem for you. I have people tell me how much their quality of life has improved after. I usually only have to see them 1 to 2 times and then their good for months. I can almost guarentee I can help you with your problem... Stretching is not going to help the tissue that is compacted by the base of your spine where all the nerves of the lower back and down the legs are. Someone has got to break down all that compacted muscle tissue back there so that its not constricting the nerves and so that blood can run through that area. If you are in the Las Vegas Area, I know I can for sure help you with your problem.
@@UTubeSporaticUser thanks for the information but I'm not in the USA, lol
I have improved a lot since then after seeing one physio who gave me some very practical advice for releasing pressure on my lower spine. Due to covid lockdowns I couldn't get out or feel safe going to any massage or physiotherapy since then.
You're right about massages. The best I felt was after having one was when she massaged the sciatic nerves in my legs and everywhere else.
Hello , I hope you're doing okay.
I am facing a similar problem since 6 months, I am a student and I used to travel 2 hours 4 says a week to college which created pain in my right lower back , well the pain now is worse and it is in me right shoulder blade, right arm, right side of the neck.
I have got so many different opinions, last thing my doctor said is that I don't have anything dangerous and it's only muscle stiffness due to travelling and bad posture, I sit a lot for studying.
The stretching and physio therapy only took the pain from me arm and shoulder for few weeks , it never faded away.
I am tired and in pain, I think part of it is psychological .
The doctor asked me to do resistance exercises in swimming pool. I really don't have the luxury
Stretching is absolutely essential. It has given me back my life!
Excellent and straight forward video! Thank you for the great explanation.
+Jennifer Thai thank you 😊
Hi,it is a good video. What kind of the resistance training can be given to reduce the muscle tightness?
All the other therapists/ masseuses who make money from telling people they are tight and need stretching and massage are screaming right now.
Stretching and massages are not bad, they can feel great. But there is not much more to it than that.
Aaaaaa!
Thank you for this informative vid, physiotutors!
More vids like this please! ❤️
I am 45 years old and have stiff muscles in my legs, feet and back. Hopefully this video will help me to know how to deal with this ailment. Thank you
Did you have any luck? My legs are so damn tight and painful. I’ve been getting back in shape since July, and had to stop riding my hike and leg workouts because of the pain.
It could be low potassium and magnesium.
@@BeeBopGaming did you found any solution?
Was it useful to you?
Actually incredibly helpful even 4 years later. Thanks a ton!
Great to hear!
Just by watching this video my muscles started relaxing 😎 Placebo at it’s finest.
Ty for sharing this video 🙏🤓
Chris its been 3 years how you feeling?
Stiffness starts when I'm sleeping and tinkling goes through my fingers and my toes and I want to know what's going on with my body
Thank you for answering this question! Brilliantly presented. Such an important point to understand for those with EDS. The conundrum of being super stretchy yet also having muscles that are constantly rocks full of knots that won’t let go even after repeated deep massage is perplexing. It does seem to be counterintuitive to resistance train when you are already so contracted, but it is the only option. I am curious as to why massage was not included as one of the remedies listed. Curious to hear the explanation for its usefulness alone and joined with resistance training.
excellent video, I have been stretching for months without result just further pain. I'll start with resistance training now - thank you
How is it now , please tell
thank you for the video! I do enjoy your channel a lot. I do appreciate your hard work. Can i ask you a question? Do you mind if you letting me know or recommend any thesis that explains about tightness, shortness or stiffness well?
Aaah now I know why my friends who work out regularly, especially the guys who go to the gym often and lift weights never complain about tight muscles. My friends and I who are not that fit are all the time complaining about burning shoulders 😪
This helps alot.. appreciate your help Chief
As the guy says, stretching and foam rolling are good in the short term for pain relief but you have to care about the posture and strengthen the muscles in a smart way for the long term avoidance of recurring muscle pain. Crossing the first 2 out can be misleading who just skims the video.
Thank you for this thought-provoking video! I agree that muscle tightness is related to perception and psychosocial factors (e.g., stress, anxiety, pain, etc.). However, I don't feel that the explanation of tightness in this video accounts for physical changes in muscle length that occur with prolonged postures, such as shortened hip flexors with prolonged sitting or immobilization following fracture or surgery. There are definite changes in tissue tension that occur in these situations, which can manifest in ROM limitations or contracture over time if not addressed with mobility exercises (e.g., AROM, AAROM, contract/relax stretching, joint mobilization). I agree that changing postures frequently and resistance exercises can help combat muscle tightness, whether it is perceived or related to physical muscle shortening of the sarcomeres. I just have a hard time believing that muscle tightness is ONLY perceived. I am interested in reading the studies that were referenced in this video to get a better idea of how they were conducted and how "tightness" was defined. I love your videos, thanks Physiotutors!
Hey Caitlyn,
we tried to differentiate "tightness" from "decrease in length" because patients use them interchangeably, but they are two different things. When patients say "tightness" they are often referring to a feeling of discomfort, rather than an actual decrease in length. There are definitely situations in which the actual muscle length is changed like you mentioned above. We will publish a video soon in which we will discuss if stretching is the best treatment option to counteract these changes. so stay tuned!;)
Please read the articles and get back to us if you wanna discuss about them!
Glad you like our videos and thanks a lot for following!
@@Physiotutors Then, in the case of contracted or shortened muscles, would foam-rolling or massage be helpful?
@@bmb8025 In the case of a tight muscle with foam rolling and massage, I believe it would indeed help. Applying pressure to a trigger point or a taut band in a muscle helps to relieve the tension in the muscle.
When choosing a self care tool (ie foam roller, lacrosse ball, 3in ball, etc) you want to take into consideration the size of the muscle or the taut band/trigger point in specific and choose appropriately. Then think of the direction the muscle fibers run like a chain link fence, if you want to lengthen the muscle you go with the muscle fibers and in case of a lengthened or weak muscle you want to go across the muscle fibers.
Hope this is helpful.
Thanks for the video. Your response to some comments suggests that your view of massages is that they just feel good, but there’s not much more to it. But if tightness is, as you postulate, just an unpleasant feeling, why should a massage that makes you feel pleasant not be considered a treatment to the problem?
Good question!
Hi doc, I hope you'll notice may I ask I had a history of injury on my hand and I'm experiencing pain on palm and stiffness on hand
And experiencing hardness on base of the thumb
Can I do hand gripper exercise everyday? And how many sets should I do
Thank you doc
Hi, can medication also cause muscle stiffness in legs and if yes what are those groups of medicines.
TIA 🙏
Short and sweet and very relevant! Thank you!
Is there any medications you know of that will help in this case?
I am 60 years old and I am not and I do not have a big stomach. And I find it very hard to even put my socks on and my shoes. I used to be very flexible nothing impressive, but I can't bend over backwards anymore. Thank you so much for your video. I tried to eat very healthy, but I still have this problem
This is very helpful. I do aqua aerobics in the deep end with weights. I am experiencing some difficulties with being in the same position and increased work load. Trying to make it back to the pool. 🤞I am noticing heaviness and tightening in my left leg, making it very hard to walk. It literally tightens as I do. How to get it to loosen enough to get there initially would be helpful. Thanks so much for your expertise.
Regarding muscular tightness: If tightness is not a shortening of the muscles, why is the sensation of tightness sometimes accompanied by joint noise/popping, which is clearly something mechanical? (and if foam-rolled or stretched, it goes away temporarily)
I have this yes fascia tightness France prof shows this I'm camera
What about muscles that don't feel tight but are painful when applying pressure to them?
Does “bad” posture shorten the muscle when slouched too often? I see some PTs and chiros saying we cant help our posture and exercises like chest stretches and back exercises dont help. What are your thoughts?
This is incredibly helpful, thank you again, for stating the science behind it.
I am 55 , and have always been a strong walker. In the last 4 months my thighs,buttock and calf muscles start giving me a burning sensation very easily. Now I have to stop every 200m and wait for 1 minute for the pain to stop before I can continue. Does this sound familiar?
when an athlete sense tightness in just a relatively small group of muscle fibers, not all the muscle, and you can palpate a tight band (going transverly through the muscle belly), what can it be? I ipotisized the presence of a tender point, as my local induced ischemia produced pain only in that area and not referred anywhere else. Tried to threat it with overpressure to create ischemia and then quickly release to create a vasodilatation, stretching the muscle but it seems not to work. The athlete is a futsal player, she trains 4 times a week. her quads are very strong at muscle testing, the pain is not provoked by either contraction nor stretching. Thanks for the answer, a freshly graduated physio
Hi Luca, hard to say to be honest! To my knowledge tender points are not necessarily taut bands in the muscle.
Do you think that that tightness is related to that spot? Could also be a lipoma...
Thanks a lot for your translations! Awesome!
+Physiotutors well only an ecography or a mri could really define the problem. For the lipoma I can't see any bump on the skin, but upon palpation it slips away from my finger. The pain is referred more proximally but exacerbated when palpating this "tight band". The athlete refers to feel some apprehension when kicking the ball. Do you have some more info to rule out or rule in lipomas ? thanks again
Unfortunately not Luca. It's hard from afar to guess, but in general when we are in doubt, we would refer to the GP to get it clarified. Especially when it falls out of our expertise as physios.
What is the tightness you're referring to in this video? Just the sensation of "tightness" we have after prolonged bad posture?
For instance, what I'm currently experiencing is the inability to fully extend my leg at the knee joint in a seated position, due to "hamstring tightness" or lack of muscle length at the hamstring. So in my case, I should be performing stretching for my hamstring instead of resistance training, correct?
Thanks in advance!
The tightness I a referring to is the unpleasant feeling you get from
ischemia in your muscles, or in a chonic case more likely sensitization
of the nervous system.
You are talking about a decreased muscle length. Stretching could be an option, but also in this case (not only to build up resistance against ischemia or sensitivity for example) you could train your hamstrings eccentrically.
The question with a short muscle is always why it is short and why you want to lengthen it. Short hamstrings aren´t necessarily a bad thing. In my case as a soccer player, the short hamstrings help to prevent overextension (and potential damage to my ligaments) of my knee when I am shooting a ball.
+Physiotutors Thanks for your valuable insight!
The Humming Boy Short hamstrings have a protective function viz to prevent excess tension on tight neural structures. The SLR &/ slump will have a taut endfeel. In order to lengthen short hamstrings you need to treat the reason why they are short in the first place. In the case of the sciatic nerve, stretching of the piriformis muscle is often very effective. If the slump is restricted , mobilising of the thoracic spine, particularly the costovertebral joints in long sitting works extremely well. It also helps to perform 3-5 gliding manoeuvres (SLRV&Sslump) once you have treated the appropriate joints/"muscles. When you have dealt with WHY the hamstrings are short, THEN hamstring stretches will much more effective and the stretching effect will be longer lasting.
I don’t understand how this can be true. I have unbelievably tight traps. I’ve been overloading my back and traps for a few months and not seen a decrease in tightness. But also I disagree that the tightness is a sensation only i feel, any physio therapist i go to will immediately say wow your back and neck/shoulder muscles are incredibly tight within the first 2 minutes. How does this make sense?
Thanks for this. it will help explaining to my clients.
You´re welcome Rob! Winning patients over for active treatment, when they think they should be "released", massaged or cracked etc. is the hardest part of this!
exceptional breakdown. Very to the point. No long winded garbage.
Hello! I'm suffering from this issue and I can't describe how terrible it is. Things you described sounds very similar and helped me to understand many things. However, I'm having tightness in my arm in overall and sometimes reaching behind my shoulder so, what kind of resistance training would you suggest? And would you suggest taking magnesium pills, they say lack of magnesium cause such problems. Hope you reply this because I really need it. Thank you.
Hard to give you individualized advice. Sounds like you have actual limited range of motion in the shoulder, for which you could seek counseling of a local physio.
Don't think that magnesium pills are the answer, but there can be so many underlying reasons for your personal situation that it's hard to give any advice at all.
@@Physiotutors first really appreciate your reply and I understand. Btw, I went to physiotherapist, orthopedics, checked nerves and anything but results coming out "normal" yet, especially when I use mouse, my arm ache very badly. Is there any way to get treatment in your hospital or clinic? Because honestly speaking, this is really really tiring and just trying to find a solution for this problem. I checked your other videos and especially resistance training made me feel like a bit relieved but it's just one day and I'm not so sure if it's going to be permanent or temporary solution.
We are both working in a private practice in Amsterdam.
Furthermore, we can refer you to our partner www.yourphysio.online for help.
After morning wakeup I feel extremely pain in collar bone traps kindly suggested me what is the traetment to solve the problem
Please watch our Tight upper traps video
Bhai mujhe bhi morning may uthta hun toh collar bone se lekar face or garden may jakdan tightness feel hota hai apke kya symptoms hote hain mujhe 8 month se hain
Sir , can u tell if i got sprain in upper traps, what should I do next , rest ? or should I apply any pain relief gel , or should I straightway start doing some exercise, ,, My question is when muscles gets tight how does it heal ,,1) time 2) nutrition or medication 3) rest ? ?
Very uncommon to have a strain in the traps. Best is to load gradually as long as pain is tolerated
Thanks appreciate ur reply :)))))))
Great video, thanks for quality content.
Ur welcome!
Very nice video. I couldn't find any video on this topic in full detail. But now my problem is solved. Thank you very much bro
"A study in patients with chronic tension-type headache found a significant correlation between muscle hardness and local tenderness(3). In the present study in healthy subjects, 2 of the most sensitive sites (upper boarder of trapezius) were the softest parts compared with all other sites. This reflects that the site is in an area of thicker muscle tissue. Previously, increased hardness has been seen after exercise in healthy subjects(20) and after 15 minuets of sustained computer work(10). This was not seen in this study, probably because the duration of exercise was too short to cause metabolic changes. This suggests that increased muscle hardness is mainly found in chronic pathologic muscle condition. Based on the previous findings,(3) it might be expected that the subjects with a higher number of latent trigger points would show increased hardness due to the taut bands. The limited number of latent trigger points in the current study does not allow a detailed analysis of this relation, but future studies should assess a potential difference in hardness between tender points and latent trigger points."
This is exactly what Andersen et al. wrote in their article (Page 498- Andersen H, Ge HY, Arendt-Nielsen L, Danneskiold-Samsøe B, Graven-Nielsen T. Increased trapezius pain sensitivity is not associated with increased tissue hardness. J Pain. 2010 May;11(5):491-9.). I don't agree with your conclusions reading that.
Why you don't cite these papers (they are references in Andersen's paper)?
3. Ashina M, Bendtsen L, Jensen R, Sakai F, Olesen J: Muscle hardness in patients with chronic tension-type headache: Relation to actual headache state. Pain 79:201-205, 1999.
10. Horikawa M: Effect of visual display terminal height on the trapezius muscle hardness: Quantitative evaluation by a newly developed muscle hardness meter. Appl Ergon 32: 473-478, 2001.
20. Murayama M, Nosaka K, Yoneda T, Minamitani K: Changes in hardness of the human elbow flexor muscles af- ter eccentric exercise. Eur J Appl Physiol 82:361-367, 2000.
I like your videos but it is not fair that your conclusions are so biased in this video.
Best regards,
Claudio
Hi Claudio,
thanks for your critical input! Always good to discuss - and of course we are biased because we always combine evidence (consciously or unconsciously) with our clinical expertise and opinion.
it will take a bit of time to give you a detailed answer coz we gotta read your references.
With which of our conclusions do you disagree exactly?
Excellent explanations , thanks
Do you think a high dietary intake of sugar makes the muscles and connective tissues feel more sore or inflamed?
Would have to do research to give a qualified response
when I workout my entire body will stiffen up for hours to the point where I'm almost disabled. I can barely walk or turn my head to check my blind spots on the way home from the gym, simple things like opening a bottle of water and putting the cap back on become difficult cause my hands and fingers will stiffen up so bad, all I do is walk on the tread mill and do a stair stepper and by the end of my workout my shoulders, stomach, calves, thighs, and neck are so stiff I feel like I've got no control of my muscles any more. I also find that if I sit in the sauna for 20 minutes after a workout to attempt and relax the muscles or improve circulation it actually makes my symptoms much worse and I feel like I'm becoming trapped inside my own body because of how stiff and unmovable my muscles become. I also wanna say there is no pain when this happens, just the inability or struggle to move my body. 90% of my symptoms seem to go away within a few hours after I've finished my workout but certain areas like my neck and hands will stay tight for days sometimes. Is this just muscle tightness or something bigger I should worry about?
Following
I have since years pain in my neck shoulder muscles. I have lost all hope tried every type of stretching, cupping therapy, acupuncture, pain killer. It has made my life very hard. Please need help
I have Lyme infections which are symptoms of Lyme. My neck and entire left side are stiff constantly. It’s very uncomfortable.
Came here to find out how to relax my leg muscles after working out, and I get told I'm fat, and sit in one place to long xD
I am a person without professional or specialized knowledge in a particular subject.
Please help me understand what you said and didn't say with your solution.
Thank you kindly
Mary Kate
What if the muscle area starts to have numbness after the resistance training?
Hello. Can you add the references again? The spina one doesn't work. Thanks!!
WOW he's steam rolling all the goof balls
''You're best posture is always your next posture.'' As a student in physical therapy, I love this. Thanks ! I've also favored active therapy i.e. exercices, strenghtening, etc. Do you think the type of muscle fiber may play a role in the sensation of tightness ?
Yes, and an easy one for the patients to remember! Here is an excerpt from Falla (2007) about motor impairment in neck pain:
"Biochemical alterations in the upper trapezius muscle have been observed in people with neck pain, including increased interstitial levels of glutamate and serotonin in women with trapezius myalgia-which are positively correlated to pain intensity [47]-and higher interstitial interleukin and serotonin in people with chronic whiplashassociated disorders [48••]. Furthermore, muscle biopsies have shown evidence of disturbed oxidative metabolism of trapezius muscle fibers in people with myalgia [49,50], impaired trapezius intramuscular microcirculation in women with neck and arm pain [50,51], and a significant increase in the proportion of type-IIC fibers in the cervical flexor and extensor muscles in patients with chronic neck disorders, possibly indicating preferential atrophy of slow-twitch muscle fibers [52]. Researchers have also observed atrophy and connective- tissue infiltration of the extensor muscles-notably for the deeper muscles, the rectus capitis minor/major, and multifidi-in people with chronic neck pain"
Thanks !
what is the medical term for muscle tightness....is it hypertonicity, spasticity, or plain tightness?
That's the point of the video. People are often confusing "tightness" which is a feeling with shortening=contracture.
Tonicity and spasticity are 2 other terms.
@@Physiotutors got it. i actually just used tightness in writing my clinical summary (objective findings) for UR case.
I have neck muscles tightness for years. I feel sore neck muscles after some physical work like after playing badminton or carrying small bag on my shoulder, even after wearing high neck jacket. And not get relief massage or so many physiotherapy.pls suggest causes and treatment.
Wow, this was really helpful. Thanks a lot
Thank you very much for this info
Great content!
I just graduated from university, and muscle tightness was regularly related to trigger points. This video claims that muscle tightness can't be related to tissue hardness, what are trigger points then? I regularly perform trigger point therapy, with a good outcome and i 'feel' the triggerpoint/ taut bands. What are these 'knots' then? :)
And what about dry needling?
Thanks in advance!
Thanks Elien, appreciate it! The answer based on evidence is "we don't know what trigger points are". They are certainly there and sore spots of unknown origin: www.ncbi.nlm.nih.gov/pubmed/25950032
We are planning on doing a video about the topic as well.
Taut bands cannot be reliably palpated: www.ncbi.nlm.nih.gov/pubmed/28098584
Dry needling is not more effective than placebo: www.ncbi.nlm.nih.gov/pubmed/27831670
With all that being said, we do press on tender spots here and there and some patients seem to benefit from that. The working mechanism is probably neurophysiological.
Thank you for the concise explanation. What if you don't recover normally after exercise because of health conditions like chronic fatigue syndrome /fibromyalgia/adrenal fatigue? And the pain relief you experience is temporary i.e. while exercising but from just an hour after you finish your pain is more intense and this pain lasts for several days?
This is a different kind of muscle tightness that we are not covering here. Those conditions you describe are driven by the central nervous system and need a different approach in collaboration with a health care provider.
Exercise will form part of their treatment, but most probably more in a manner of graded exposure/graded activity.
Thank you.
Your Sympathetic Nervous System is agitated in chronic pain conditions. Have you tried passionflower for pain and relaxation?
Excellent video!
Thank you! Can you please explain how do you tell the difference between a mild strain and tightness?
I feel stiff most of the time. When I get up after sitting down or lying down, I'm so stiff I can hardly walk. Is this from inflamation? My muscles burn when I exercise. Thank you.
Me too. I think I have very poor circulation. I get cardio almost every day, hiking, biking, lifting weights. Every day I feel like shit. I don't understand.
@@mycatisromeo Diet matters a lot. Sugar raises insulin in the blood. Being under constant stress can keep us in the fight or flight mode all the time.
I have the same issue, did you ever find anything to help you?
if my mri showed short intact hip abductors then does that mean its not tight? basically did lots of squats in abducted position loading those abductors heavy. Do you think its mechanically shortened and probably not from injury?
My left arm stiffness up everytime I irrigate my nose. It only last for a couple of seconds. What is the cause?
I m suffering from ischial tuberosity can u help me
How to deal with anxiety muscle tightness im dealing with that right now
Not sure what anxiety issue is linked to muscle tighness in your case, so can't say. Maybe something for a psychiatrist either. In movement-related fear a graded exposure program is often helpful.
Excellent deduction.
Thank You.
Thanks but what is the resistance training please how can i find and know it ? ❤️
Resistance training is just exercise with weights.
what is the difference between spasticity , rigidity and tightness?
Spasticity is caused by lesions in the pyramidal tract like in a stroke or spinal cord lesion. It's velocity-dependent, there is more resistance in one direction and there is more initial muscle tone when moved (clasp-knive phenomenon).
Rigidity is seen in extrapyramidal lesions (e.g. Parkinson) such as the rubrospinal or vestibulospinal tracts. There is rather intermittent increase in tone (cog wheel phenomenon) or uniform increase in tone (lead pipe phenomenon) and same resistance in all directions, which is velocity-independent.
Tightness is just an unpleasant feeling in a muscle.
Physiotutors thanks
@@Physiotutors thank you so much✨
Does muscle tightening cause my upper and mid back to get tired fast? I get fatigued fast from my back once I cook or stand for a while. Since quarantine I started feeling this.
Hence why I tell my patients that the soft tissue work I perform will provide temporary benefits to reduce pain and stiffness, but that the exercise is the treatment for long term benefit!
But you need stretching to be able to change posture right?
There's no evidence that stretching actually change muscle length. Changing posture is very difficult and probably requires a constant conscious effort to change habits.
The muscles in my back are in a lot of pain, due to a heavy pregnancy. How do I do strength training there? Thanks.
your video is very useful explaining your opinion & expertise about the benefit of exercise & muscle adaptation but subject is more about the vocabulary thank you people for building our knowledge and god bless you
Excellent and very well explained sir
👌🏻
Sir what we do if an athlete has QL tightness pain ...which exercises is best for him ?
Try side bends with or without weight.
@@Pentagathusosaurus Thankyou 😊
Hi I m having neuromuscular strain due to side effect of homeopathy medicine now I have tension type head ache for simple emotions how to resolve suggest kindly pls
Bad posture has nothing to do with muscle tightness ? Can sitting for long time make our hip flexors tight.?
understanding this Physiology can be very confusing, as people who do such exercises as Yoga, Ti Chi, have experienced positive results as well. Their bodies certainly benefit & become more flexible as well. Also, even athletes (Football, basketball, soccer player, etc.) benefit from lots of stretching & massage before workouts as opposed to resistance exercises right before the game. All these exercises have their right place & time.
Thank you for this!
hii, can u post a video that is differentiating between spasm , stiffness, tightness, spasticity , contracture ??
The difference between stiffness/tightness and contracture/shortened muscle length should have become clear in this video.
Physiotutors tysm
You are the best.Thank you so much.
Would we "palpate" the tightness objectively as manual therapists and thus then this would make the findings objective and not "subjective patient experience"? trying to understand...I am a massage therapy student . Thanks
So what is flexibility, and why are buff people not flexible if resistance training reduces stiffness?
this is so helpful. thanks so much. I really resonate with this as my tight shoulder muscles hurt more I stretch. This is more related to posture and keeping my arms a little too way from body when I work and lift. So what Kind of training to do suggest please? I do pilates once a week though! ANY OTHER WHICH CAN ME MORE HELPFUL..THANKS AGAIN
Glad it was helpful!
Thanks for beautiful information.
I would suggest if you demonstrate everything on a person would be better to understand.
Rest was excellent
Thanks for the video!! It was really interesting, and I wanted to ask you a few questions...
1. In the video you seemed to brush off the notion that, when dealing with tightness, muscles tend to be short, and you cited some anecdotal evidence based on patients you’ve seen at your clinic. Are there any studies you could link me to that could back that up? (I.e. muscle weakness, not shortness, is the primary cause of tightness). How can you tell when a muscle is short vs when a muscle is just stiff? Could it be both? Do you modify the treatment plan to include stretching if the muscle is short?
2. One of the things you noted as the cause for tightness is overload of the muscle. How can you tell when the muscle is overloaded because it’s compensating for other weak muscles versus if it’s overloaded because it’s simply a weak muscle? Should you strengthen a compensating muscle, or should you stretch it and strengthen the weak muscles? Or should you do both?
3. The standard treatment plan for APT (Anterior Pelvic Tilt) is to stretch lower back/hip flexors and strengthen glutes/hamstrings/core, with the idea being that the lower back and hip flexors are “tight and shortened” and the glutes/hamstrings/core are “weak and elongated”. What do you think about this and its traditional stretching/strengthening protocol? Do you agree with it?
Hi Michael,
you're welcome!
1) Don't think that there are any studies proving the theory scientifically, but the examples with the hamstrings (short, but not tight) and the trapezius (tight, but not short) are pretty clear examples that show that there is hardly if a relationship at all between shortness and tightness
2) We base this mostly on patient history: increasing pain during the course of the day, description of pain as tightness, job, daily activities, posture etc. In case of the trapezius, most exercises strengthen the upper trapezius and the rotator cuff, so you don't have to be very specific. Stretching is just a short-term pain relief and is a good option for self-management by the patient.
3) What you're referring to is Lower Crossed Syndrome. There is no scientific data to back the idea that this exists or ever has been. How do you assess "Anterior Pelvic Tilt" and is it a problem? There is so much variation in posture.
If we encounter patients who sensitize their backs in the extension position, we are working on exercises for them to move out of this position - that's all.
On top of that we know that stretching does not elongate muscles unless done with extremely high volume and frequency.
At the same time, strengthening probably doesn't change posture either.
@@Physiotutors what to do then if some person have scalenius muscle tight and that is causing radicular pain-stretch or strengthen?
According to you we should strengthen .
@@Physiotutors So if I understand correctly, someone experiencing the same amount of stiffness regardless of time of day or daily activities may have short muscles and could benefit from stretching?
Is knee pain is related to thigh muscle tightness ?
Hey brother please let me know if yoga is beneficial. It would also make a great video topic i think! Thx
Great topic !! more videos like this please !
Thanks Pierre! We will go more into the Clinical Reasoning Direction in the future for sure!
Thnks for this..... Suppose a person with hamstring tightness(always in a position with 45° of knee flexion).... So in this case.... What should i give??? Resistance against knee extension???? Or stretching???? Sorry for my english
Try eccentric training with this person
what do you mean by resistance training? I have extreme tight muscles in the forearm. So how do I make resistance training for the forearm? Do you mean making slow negative movements at the exercices?
Resistance training = Moving heavy weight around 60-100% of your maximum 1 repetition maximum.
Could be as easy as eccentric training with dumbbells and moving your wrist.
gonna try, thank you ?
I have pain in my index finger and weekness in wrist and my physio told there is a contraction in my brachioradialis due to continuous work on system...could you please help me