Hypertonic Pain: What It Is And How To Overcome It
August 17, 2010 by Dr. Mark Wiley
What do headaches, shoulder pain, hip pain, tight quadriceps, pulled muscles, cold limbs, knots on the back, restricted breathing, plantar fasciitis, fibromyalgia, knee pain and chronic fatigue all have in common? Hypertonic muscles.
Hypertonicity of muscles is a common problem in our modern American society. Hypertonicity implies an excessively constricted muscle or, in layman’s terms, tight muscles.
Muscles constrict, or become tight, for many reasons. Included among them are: a lack of exercise or too much exercise; sitting, lying or standing for prolonged periods of time; everyday walking; lack of stretching; abundance of toxins in the body; stress, worry and anxiety; blood stagnation; exposure to cold and various psychosomatic triggers.
In order to understand why stretching is so important and how not doing it causes pain and ill health, we must first understand the basic composition of related areas in the body.
Understanding The Body
In terms of stretching and pain related to not doing it, the body consists of bones, joints, ligaments, muscles and tendons.
Bones are the basic framework of the body and give it its form. Joints are joining points between bones that allow motion and give the body its motive function. Joints are stabilized by ligaments. These are elastic bands that connect bone to bone and prevent joints from moving incorrectly. Motion in the joints is made possible when muscles contract.
Connective tissue is the binding structure of the body and is what makes up fascia, tendons and ligaments. Connective tissue is constructed of collagen and elastin fibers. It is these fibers that hold the many structures of the body in place.
Collagen fibers (such as make up tendons) are rich in protein and are non-elastic—that is, they cannot be stretched. Elastin fibers (such as make up ligaments) consist of elastin protein and these both elongate and return to its normal resting length.
Muscles are the things that both voluntarily and involuntarily contract to move the body. Muscles have a tendon of origin and insertion that crosses a joint. It is when a muscle is contracted that the tendon pulls over the joint and causes movement.
Most important is the muscle resting length. This is the correct and natural length the muscle should assume when at rest. This is important because understanding it is the first sign of recognizing how and when problems occur.
How Problems Occur
While the body is generally able to adapt to its environment, chronic misuse can cause the tendons to tear, ligaments to overelongate and muscles to become cramped or to tear.
Tendons can tear when a load is placed on them that is too great, such as when jumping or running without first warming up and stretching. These tears cause acute pain and if left to chance will take a very long time to heal, if they heal at all. Many athletes and weekend warriors will experience a tear and think it is a muscle pull and aggravate the situation by not taking care to heal the injury. This is how chronic pain occurs.
Ligaments can become over-stretched through prolonged misuse and this prevents them from constricting back to their normal resting length. The causes of such over-lengthening of ligaments are common and include stretching too much or stretching incorrectly.
One of the major problem areas I see in my practice is with yoga. So many yoga studios are run by well-intentioned people who only spent a short amount of time understanding their practice and have little to no basic anatomy education. This leads to overstretching and a holding of the overstretch of certain postures that cause the ligaments to elongate and not return to their normal length. Thus, the joints that the ligaments held in place are now able to move in directions they are not meant to, causing friction, wear-and-tear, nerve irritation and chronic pain.
Chronic hip and low back pain are conditions I see regularly from my patients who practice yoga. (Just to be clear, I am a fan of yoga—just not incorrect yoga.)
Muscles become “pulled” when we engage in any activity (including walking) at a time when our muscles are not at their resting length. In most cases people are not aware that there is a “resting length” of muscles and assume that tightness is common to the human body. This is not so (though it may be a chronic experience of the human condition).
When the muscles are hypertonic (shortened and not at proper resting length) while the body is inactive and then we attempt to do something requiring motion, the muscles cannot sufficiently elongate and problems occur. Actually, muscles don’t “stretch.” What actually occurs is myosin and actin proteins of the muscle myofilaments cross one another and allow muscles to elongate.
When we begin an activity with the muscles already in a shortened state and expect the body to allow us to run, jump, climb, kick, stretch deeply and even walk, we are looking for trouble. How can the body effectively elongate the muscles to accommodate the activity while the body is cold, inelastic, existing in blood stasis and beginning at a muscle movement deficit? It cannot.
Yet we do it all the time. We sit in a chair at the office all day and then walk. Chronic sitting causes the piriformis muscle to shorten and this can cause the hips to rotate. And walking without ever stretching causes chronic tightening of the calf muscles which is a ready cause of both knee and low back pain.
I am regularly appalled when I hear seasoned athletes and therapists alike claiming that you don’t need to stretch before an activity. They say, “Just do some jumping jacks and then run or bike or play tennis. After you’re finished and the muscles are warmed up, then stretch.” How absurd.
Running “cold and tight” causes tight thigh muscles and biking “cold and tight” causes tight hip flexors.
Yes, you must stretch after an activity. But you must stretch before an activity so that the muscles begin from a proper resting length and the activity does not cause harm. So the proper order is for you to first warm up, then stretch and then engage in the activity. If you don’t, you will be the cause of your own injury.
And many people try to “just work through” the pain, by lifting more, running more, getting a massage, doing more yoga. But these things will never correct the problem, as the problem is caused by engaging in activities while the muscles are at improper resting lengths. That is, doing any activity while muscles are tight. And this includes walking.
Another problem is than many people don’t know how to stretch.
Basic Stretching Guidelines
Since the beginning of every American physical education class, every martial art class and every dance class, we’ve been taught the improper way to stretch. That is, we’ve been taught stretches that were put in place before the science of sports medicine showed us the flaws to such methods as well as the proper ways to stretch. Unfortunately, we are creatures of habit, and it is easier to continue to teach incorrect stretching than to do some continuing education to learn and disseminate the up-to-date information.
In short, proper stretching allows a fresh supply of blood, nutrients and heat to move into a muscle to allow it to become supple and able to move past its resting length and then to return to its resting length.
For information on safe stretching, please click here.
—Dr. Mark Wiley