Muscle Tightness

Written by Stephanie Lievense Cohn PT, DPT, OCS

Why am I ALWAYS so tight? 

I’ve been stretching and it’s not working….what gives?

I keep trying to stretch, but my body just doesn’t move that way!

Welcome to a small portion of a day in the life of a physical therapist. The above quotes come from those who firmly believe that their muscles are forever inflexible, and they wonder why stretching is not helping. I have bad news: stretching is not always the answer, and can actually be counterproductive. 

Before I get into the weeds, let’s clarify the definition of “tight.” To my patients, it means that they feel restricted, stiff, or even achy in their muscles, especially after tough training days if we’re talking about athletes. As a physical therapist, tight means that the actual length of the muscle is restricted. Why does this distinction matter? Doesn’t stretching fix everything? 

When I assess a patient’s muscle length, I perform very specific tests and passive movements of the tested limb. Patients may tell me that they “feel” tight when I perform a certain test, however, their muscle length will be completely normal, according to the test. This is often very confusing for the patient, as you would imagine!

So what gives? Let’s run through the possible reasons, besides actual decrease in muscle length, that can cause you to feel muscle tightness but may not warrant stretching.

Overuse

For the athletes out there, you know that you use your muscles ALL THE TIME and at a level that is more intense than most regular exercise routines. When you constantly use a muscle, you can develop trigger points. Trigger points are “knots” that form as a result of overuse, and they certainly do have the potential to limit muscle length. However, this is not always the case. They can just make you feel tight, plain and simple, because they’re made of a bunch of muscle fibers that are unable to release and/or function efficiently. To clarify, every human being has trigger points somewhere because we all load our bodies differently depending on our movement patterns, jobs, exercise routines, etc., and trigger points can be completely harmless. Once they become painful and/or actually restrict range of motion, they become a problem. We want to keep them from becoming a problem, so what do we do about it? 

Prevention is key here. To reduce or avoid overuse in the first place, take a look at your training/workout schedule. Are you giving yourself adequate recovery time between hard workouts? Are you compensating for one weak muscle group by overloading another? Physical therapists can help with this! We are trained in exercise prescription, as well as correcting faulty motor patterns. This could be your first stop.

Once the above has been addressed, maintenance is our next stop. Obviously, higher level athletes and those with very manual jobs may not be able to change their ways 100%, and we do not expect that. This is where we meet our patients in the middle and develop a maintenance routine to make sure nothing becomes an issue. Maintenance routines can include exercises specific to your impairment if you are over -compensating with a certain muscle group, and/or regular foam rolling or massages to help relieve trigger points.

Hypermobility

Believe it or not, being too mobile can cause you to feel tight. I know this sounds contradictory, but read on. First of all, let’s define hypermobile. This means exactly what you think – your joints move too much! Being “double jointed” is a more common term for this. Think about it: whenever something moves too much, such as that noisy ceiling fan that rattles around, your first plan of action is to tighten up the screws or do something to stabilize it so that it doesn’t fall from the ceiling and land on you. Your body works in a similar fashion. If your joints move too much and you don’t have the strength or control to stabilize them, your body is going to hang on for dear life however it can. This can mean utilizing protective stiffness of muscles, or even nerves and fascia! If you try to stretch fascia or nerves, you won’t have much luck, unfortunately. 

The solution? Stabilize those joints! Strengthening and motor control are a little different, so this doesn’t necessarily mean that you need to hit the weight room. Look in the mirror – do your hips sit in front of your ankles and shoulders? This is an example of hanging out on those hip joints just because it’s way easier than activating the glutes and core in a standing position. Physical therapists can help with this – we are very good at identifying the areas of hypermobility, as well as the motor patterns that may be trying to protect these areas.

Weakness

Yes, you read that correctly. Weak muscles can indeed feel tight! How exactly does this work? Let’s use the above example of hanging on your hip joints. In this position, your hip flexors actually become stretched out since they are basically being used as hammocks for your hip joints. When muscles are too lengthened, they cannot activate effectively. I love to use the example of trying to make a fist with your wrist extended – you would definitely not feel confident in punching someone with this fist, right? Those wrist flexors are too stretched out to help stabilize that punching fist. Anyway, now you’re probably confused about how a muscle can feel tight when it’s actually stretched out. When a muscle is in this position, it develops a protective stiffness in its current length to keep you from yanking on it any more than you already are. This can feel like the constant need to stretch.

Joint restrictions

Steph, didn’t you just tell us that hypermobile joints cause feelings of muscle stiffness? Yes, I did. However, a true joint restriction is very different from actual muscle tightness and can be easily confused. A restriction in joint mobility is a result of underuse of the joint (think rusty hinge), a surgery or trauma, or sometimes that’s just the way you are built. Obviously when a joint won’t allow you to move in a certain range, you can feel tight. However, you can stretch all you want but if the joint is the issue, you won’t get anywhere unless you actually address the joint itself. 

Part of the skill set of a physical therapist is to perform joint mobilizations, and in most cases we can actually show you how to perform a variation of this at home. To be very clear, if you are naturally restricted in a certain area, the goal is not to turn you into Gumby. As discussed earlier, maintenance is key here – we want to keep this restriction from becoming a problem. If the joint restriction is indeed something we know we can improve because it has been acquired, we can address it manually and with home exercises as well as digging deeper to determine why this joint stiffened up on you in the first place. 

To summarize, there are a few reasons, besides true muscle length restriction, why you may feel so tight all of the time. Before you dedicate 20 minutes of your day to stretching all of the things, consider these alternative reasons:

• Overuse
• Hypermobility
• Weakness
• Joint restriction

As previously stated, physical therapists are great at distinguishing these factors. We can get you going on a proper home exercise program with the appropriate interventions to address the true cause of your muscle “tightness,” and help you to understand how to keep it from becoming an issue in the future.