Last week we talked about how bracing for lifting can help get rid of back pain when we do lifts. This week we are going to talk about another common reason for back pain in the gym, muscle tightness.
When we talk about pain, there are usually different types. We can have constant (chronic), sharp (acute), bone, breakthrough, soft tissue, nerve, referred, phantom, and total pain.
(Brief descriptions of each type of pain can be found here: Macmillan.org)
The most common pain that athletes in our gym come across with joint/back pain is a chronic dull pain that exists at the joint. The most common of which for most is lower back and knee pain. Why is this happening? A more relevant question to go along with this is; why is this happening during the COVID-19 pandemic?
The short answer we are all sitting way more than we used to.
To explain in long hand it may help to do some history.
Understanding Dynamic Anatomy (How we move):
In the 16th Century (circa 1543) a man by the name of Adreas Versalius released a book called De Humani Corporis Fabrica (On the Fabric of the Human Body).
This text was meant for the education of medicine practitioners who had previously prescribed to the Gelenic view of anatomy.
We could go on and on with how this changed the view of human anatomy but I think you rather go HERE to learn about that. (This is a great short read on how his findings shaped the way anatomy was viewed during his time).
We are going to talk about the why.
Versalius is most famous for using metaphors to describe the inner workings on the human body. The most important of these metaphors, to us, is the idea that the body is made of pulleys. We have gone over this in previous posts, but it’s incredibly important for understanding how muscle tightness can lead to pain.
The metaphor of pulleys moving our bones rings true through the fact that our muscles can only pull or relax. They cannot forcibly extend. When this comes into practice with a joint, we can start to see where pain can come from.
Take a look at the knee: Brittanica Anatomy of Leg
Most people end up feeling pain at the patellar tendon or the pes anserinus (center of the knee below the knee cap or a little to the inside of that). This can happen due to a tight muscle (#fullcircle). When a large muscle is tight, it is due to trigger points known as knots and ropes (large knot). Comprised of tense muscle fibers, these knots tighten up the muscle. Muscles have attachment points known as tendons, which connect muscle to bone. When a muscle is knotted up it begins to pull on its attachments which can lead to pain in the joint.
Knowing this we can look at the anatomy of the leg and begin to figure out where we need to stretch or roll out to get rid of the pain.
For instance with the pain just below the knee cap, we can see that it is the patellar tendon and the pas anserinus group that attach to that area. Now we go and look at the attached muscles and realize that we are looking at the tibialis anterior, vastus medialis, and the sartorious muscles (also known as the area to the outside of the shin or the inside of the thigh). Now we can go ahead and roll out or stretch these areas and see if we can’t relieve the pain!
One that is a little harder to pin point with this idea is the lower back. Here is what helps to think about in this instance. What are the biggest muscles that could pull on the back? You answer would be the traps, hamstrings, and hips.
How perform self care when muscle tightness is the case:
When we deal with muscle tightness, we have to take care of the knots.
A very popular term thrown around the fitness industry is myofascial release; meaning the release of muscles (yup, we can be pedantic). The popularity of this term is what led to foam rollers being in every gym. This tool is great for rolling out broad areas, such as the hamstring or top of the quad. Where it is limited is when we go back to talking about knots.
For knots we need something a little more accurate such as a golf, lacrosse, or baseball. The reason being that you can’t kill a cockroach in a room by using a car, ya gotta be a little more precise. These small and hard ball shaped objects allow for pin point pressure to applied to the desired area. This leads to us being able to roll out the knots that we find rather than going over them.
If you want to practice finding a knot you can lightly press on the side of your neck. Notice how you can feel the striations of the muscles. Now for most people if you feel around for a bit you can feel a little protrusion that feels like a bead. This bead is a knot. Now that you know what it feels like you can begin to find these in your leg, shoulder, and chest. Once you find these you can roll them out by putting that ball right on top and smoothly rolling back and forth on it. (Press until there is pressure and a small amount of dull pain. Do not put yourself in any situation that will cause sharp pain or damage).
Speaking of being careful, what do we do about areas that cannot be rolled out or rolled out well such as the neck, lower back, and hips? We can stretch the largest muscles that pull on these areas or the areas themselves.
In the case of the neck we would end up rolling our the traps and gently stretching out neck in all directions. We shouldn’t force stretches, only pull until you feel a stretch and do not push into pain.
For instances of stretching else where such as the lower back, we can stretch our hips and hamstrings. Yoga poses such as pigeon, forward fold, frog and lizard can do wonders for releasing tightness in these areas.
There are studies about the efficacy of stretching and timing involved with that, which we will go over another time. What you should know now is that we should never stretch to the point of pain and the best practice is to stretch and then test your mobility with a couple reps of squatting or any movement that uses the joint in question to teach the body the mental connections we need to make to release tension for certain movements. After all, our brain is what sends the signals for our muscles to act. We have to train it on why we are stretching the muscle in the first place.
I hope this helps demystify some of the issues around how muscle tightness can cause pain. This subject can go much deeper, but I feel that knowing why we are in pain can help us relax and better understand the situation. Some people can go through life thinking that will never be able to squat again and all that really is going on is a very tight hip (a situation that I have worked with on more than one occasion). The look of relief that someone like that has on their face when they finally can sit down without pain is a big reason why I do the job. If we can spread that relief, the world will be a better place.
If you are ever unsure of where to stretch, ask a coach that you trust with mobility. If you are in a gym with a responsibly trained coach, they should understand anatomy and be able to help you with your muscle tightness.
If you are unsure of the type of pain you are experiencing, remember that a doctor is the tried and true place to go for medical advice. We as coaches are trained to deal with muscle tightness. If you are experiencing severe pain such as bone or nerve pain, a trained medical professional is the place to go.