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Are You Tight Or Just Neurologically Out Of Control?

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Are You Tight Or Just Neurologically Out Of Control?

Many of us feel the need to stretch muscles that we perceive as being tight. Muscles can be “short” tight or “locked long”, giving the illusion of being tight.

A muscle that is “locked long” is often compensating for instability. It is neurologically tight.

Stretching a short muscle is often appropriate in the context of a prescriptive exercise program based on one’s specific needs.

Stretching a muscle that is “locked long” could result in destabilizing a joint and/or your core and lead to pain and injury.

Structure vs. Function

In musculoskeletal medicine, there are two main approaches:

  1. Structural
  2. Functional

The structural approach is the typical orthopedic approach that focuses on the pathology of specific static structures. The diagnosis is based on a localized evaluation and special tests, such as X-Ray, MRI, CT Scan, etc.

The functional approach focuses on evaluating the function and synergy of all processes and systems within the body, such as how the muscles, joints and the nervous system work together to produce, reduce and stabilize movement.

The structural approach is necessary and valuable for an acute injury, whereas the functional approach is more ideal when addressing chronic musculoskeletal pain.

Page, P., Frank, C., & Lardner, R. (2010)

 

Stability and Mobility- A functional perspective

Gray Cook, a physical therapist and movement specialist, teaches that the joints in your body alternate between primarily needing mobility or stability.

 

Joint                           Primary Need

Big Toe                        Mobility

Foot                             Stability

Ankle                          Mobility (sagittal)

Knee                           Stability

Hip                              Mobility (multi-planar)

Lumbar Spine             Stability

Thoracic Spine            Mobility

Scapula                       Stability

Gleno-humeral            Mobility

Lower cervical spine    Stability

Upper cervical spine     Mobility

In addition, given that the joints above and below are regionally interdependent, i.e. influence each other, it is imperative that a functional examination evaluates the entire kinetic chain in order to determine where the dysfunctional link or links are.

Cook, G. (2010)

 

Muscle Function

Janda, a Czeck neurologist identified two groups of muscles. He classified the groups functionally as “tonic” or “phasic”.

The tonic system consists of the “flexors”. These muscles are involved in repetitive activity and are prone to tightness or shortness.

The phasic system consists of the “extensors”. These muscles work eccentrically against the force of gravity and are prone to weakness or inhibition.

Patterns of muscle imbalance may be due to the influence of the central nervous system, rather than structural changes within the muscle itself.

Page, P., Frank, C., & Lardner, R. (2010)

 

Stability, Mobility and Pain

Functional low back pain is a good example illustrating the joint and muscle concepts outlined above.

It is common for the hips to lack mobility in people with chronic low back pain. Consequently, the lumbar spine becomes unstable.

In an effort to provide stability, the nervous system steps in and creates a dysfunctional muscle imbalance, i.e. the hamstrings and superficial back muscles neurologically tighten (“lock long”).

In low back pain, the core stabilization muscles are often delayed or “weak” (e.g. transverse abdominus, internal oblique, gluteus maximus and gluteus medius).

 

Should you stretch your hamstrings and low back muscles?

That depends. Are you tight, or just neurologically out of control- Unstable?

Instability signals the brain and nervous system to put the brakes on because it feels threatened. It does this by borrowing stability from somewhere else in order to provide a sense of security. This is called compensation.

The tendency is to want to stretch a muscle that “feels” tight, in order to provide relief.

If you stretch a muscle that has become neurologically tightened in order to provide stability, this will destabilize the area.

Myers, T. W. (2009)

 

What should you do?

A movement screen such as as the overhead squat is a good starting place, as this can quickly demonstrate potential areas of poor mobility and/or instability. These areas of dysfunction can then be further evaluated using range of motion and muscles testing.

Once the dysfunction is identified, then the appropriate stretching and strengthening can be prescribed.

In the case of  low back instability  and neurologically tight hamstrings, activating the core muscles with specific exercises can often lead to a normalization of tone in the hamstrings and superficial back muscles, followed by a reduction of pain.

Three ways of creating distal and proximal stability to release your hamstrings, without touching your hamstrings

First (The Toe Touch Test: Bend forward and touch your toes, If your hamstrings feel tight, note where your fingertips are when you start to feel tight.

  1. Foot stabilization
  • While standing,  roll a ball along the plantar surface of your foot
  • Find a tender area and apply pressure for 30-60 seconds
  • Do this to 3 areas

 

Re-check your toe-touch test

 

http://www.bodyworkmovementtherapies.com/article/S1360-8592(14)00209-5/abstract

 

  1. Neck Stabilization
  • Place two tennis balls under your suboccipital muscles and hold for 60 seconds.  Take away balls and then;
  • Hold a tennis ball or racket ball under your chin for 20 seconds
  • Side bend right and left four times keeping control of the ball
  • Rotate right and left four times maintaining control of the ball
  • Do not hold your breath
  • Do not clench your jaw

 

Re-check your toe-touch test

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4305561/

 

 

  1. Lumbo-Pelvis-Hip Stabilization

Bird-Dog (see below): 2×10 slow and controlled

Image result for bird dog exercise

Dead Bug (see below): 2x 15-30 seconds (Keep your spine neutral)

 

Re-check your toe-touch test

 

Summary

  • Joints require mobility and stability
  • Dysfunction and pain can result from both immobility and instability
  • Optimum function depends upon how the muscles, joints and the nervous system work together to produce, reduce and stabilize movement
  • Specific stretching and/or strengthening exercises should be based on a functional assessment that identifies compensation patterns

 

Got pain? If so, are you neurologically out of control?

 

References

Cook, G. (2010). Movement: Functional movement systems: Screening, assessment, corrective strategies. On Target Publications.

 

Myers, T. W. (2009). Anatomy trains: myofascial meridians for manual and movement therapists. Elsevier Health Sciences.

 

Page, P., Frank, C., & Lardner, R. (2010). Assessment and treatment of muscle imbalance: the Janda approach. Human Kinetics.

 

 

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin

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