PainScience.com Sensible advice for aches, pains & injuries
 
 

Stiff, Tight Muscles and Limited Range of Motion

Is your range actually limited, or do you just feel that way?

updated (first published 2007)
by Paul Ingraham, Vancouver, Canadabio
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about memore about PainScience.com

Feel stiff? Tight? Think your range of motion isn’t what it should be? These things often go together, but they don’t always, and they definitely aren’t the same things. Wrapping your head around the difference is good human body owner’s manual stuff. Feelings of stiffness and tightness are usually a symptom of something at least a little bit wrong — a kind of mild pain.

Body is not stiff, mind is stiff.

K. Pattabhi Jois

Range of motion (ROM)

How far can you go? ROM is the only obviously objective fact about flexibility we have to work with. You can measure it with a protractor.1 A limited ROM can be confirmed in joint that actually cannot move as far as it “should” be able to move.

Which is how far, exactly? Human averages are almost meaningless, because the range of natural variation is generally large.2 A better measurement might be how much you want or need a joint to move — for instance, gymnasts obviously need ROM more than accountants do. However, a desired or perceived need for ROM is a good standard either, because so many people assume that their range is worse or more “abnormal” than it actually is, and because they assume that more range is better than it is. It’s not that great. Doing the splits is not especially useful.

Many people have trivially and naturally limited range of motion, especially men in their hamstrings. He seemed flexible, but it was all in how he used what little range of motion he had. Just as cats naturally have extremely extensible muscle tissue — about 100% stretchier than human muscle tissue! — the average human male has relatively rigid hamstrings. They just aren’t very stretchy. They doesn’t necessarily hold him back in any way — it may not be causing any problems — he just can’t touch his toes! And yet many men bemoan their lack of flexibility.

The martial arts seem to demand flexibility, and of course it can be powerful asset, but even there it’s not necessarily so. The most memorable martial artist I ever worked with — a formidable, grizzled old practitioner of Aikido — was also one of the least flexible.3

The sensation of stiffness

Only you can say that you’re stiff. “Stiff” and “tight” are imprecise symptoms and sensations, completely subjective, and unrelated anything that can be objectively measured, like range of motion. No instrument can measure stiffness.

Stiffness is an unpleasant sensation. It feels like something is wrong. No ever feels comfortably stiff.

A short but healthy range of motion is probably not the cause of any wrong-feeling stiffness. If your ROM is limited by natural biological variation, pushing at the end of the range is a neutral sensation — it doesn’t feel like there’s a problem, and therefore it is not “stiff.” It’s more just a sensation of being stopped, or of pulling too hard. If there’s nothing actually wrong, they probably won’t really feel “tight” or “stiff” unless you are trying too hard to stretch them.

The feeling of wrongness leads to an understandable assumption that to feel stiff is to be stiff — that is, feeling “stiff” and/or tight is the same thing as having a limited ROM. But it’s not necessarily so. People with normal range, or even good range, can feel stiff and tight! And people with lousy range can actually feel perfectly fine.

Most importantly, stiffness mostly occurs without even coming close to testing the limits of your range of motion. You can easily feel stiff when you stand up from a chair: an easy action that isn’t even remotely limited by poor ROM. What’s uncomfortable is movement, contraction, and tension on anatomical structures well within the normal ROM.

“I feel really stiff — it’s nice!”

no one ever

If stiffness is a symptom, what’s the disease?

There are so many possibilities, ranging from undiagnosed pathology to the purely psychological. If you feel limited emotionally, you may feel that way in the flesh too.4 Trying to diagnose stiffness is only a hair less baffling than trying to diagnose the cause of a “funny feeling.”

There are a couple some familiar circumstances where we obviously get stiff temporarily: the early stages of cold or flu, and the soreness that follow relatively big bout of exercise (delayed onset muscle soreness (DOMS)). Both of these involve some form of widespread inflammation, and often also actually feel painful. From these obvious experiences of acute stifness, we can infer that stiffness must have something to do with relatively widespread mild tissue irritation (although you can certainly also just be stiff in a specific area, like the back).

Why would we have tissue irritation without an obvious source like DOMS or infection? Chronic mild to moderate tissue inflammation has many possible causes, and is probably more prevalent and persistent than most professionals realize.5 But by far the most familiar source of inflammation — and stiffness — is aging. Everyone gets more inflamed as they age — known as “inflammaging” — and it happens to some people sooner and worse than others,6 like arthritis (which may itself just be one of the effects of the inflammation).

Muscle knots (myofascial trigger points)

Some tissues, when irritated, probably create stronger sensations of stiffness, and a prime candidate here is muscle. But why would muscle get irritated, other than a big workout? For younger people who feel stiff, and can’t just blame “inflammaging,” there is one major suspect: the ubiquitous phenomenon of “muscle knots,” technically called trigger points. These patches of soft-tissue that are sensitive to touch for no apparent reason are extremely common, and the pain is the tip of a bio-berg: for every spot that actually hurts (and “active” trigger point), there’s usually more that are just mildly uncomfortable (“latent”). There’s a sort of diffuse halo of stiffness and tightness around trigger points.

It’s unknown whether trigger points are a phenomenon of literal muscular tightness — actual contraction, or resisting elongation. They may be, and the dominant theory says so. On the other hand, the dominant theory is old and controversial,7 and trigger points could be pure neurology and sensation.8 So trigger-pointy tissues may actually resist stretch, or their extensibility may be unaffected,9 but they will feel stiff either way.

Another clue that the feeling of stiffness isn’t really about ROM is that it can so easily occur even when muscle isn’t even being stretched. For people who feel very stiff, this is unpleasantly obvious: it is apparent with even the slightest movement, or even just pressure. No stretch required! When you feel stiff and uncomfortable from sitting down for too long, you are feeling your trigger points. When you shift, or stand up, and feel extremely stiff and tight, obviously it’s not because you are challenging the limits of your joints’ ranges of motion! Rather, you are stimulating soft tissues that contain trigger points that are mildly irritated even by normal movement.

This is even more obvious when you have major post-exercise muscle soreness. There is clearly nothing wrong with your flexibility. In that state, you can stretch just as far as normal — it will just hurt more. Everything hurts more! All stimulation of your muscles is uncomfortable (stretch, pressure, vibration, anything). And yet people say, “I’m so stiff today!” Translation: “Moving hurts today!”

Think twice the next time you think that you need to “work on your range of motion” because your feel stiff and tight. In many cases, what you may need is some relief from trigger points instead — your ROM is beside the point!


About Paul Ingraham

Headshot of Paul Ingraham, short hair, neat beard, suit jacket.

I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.

Related Reading

For more information about trigger points, see my ebook Trigger Points & Myofascial Pain Syndrome or free articles like my popular Perfect Spots series. For more about why stretching is over-rated, and why most people stretch for the wrong reasons, see Quite a Stretch — which is always good for starting an argument. And the two topics merge in Stretching for Trigger Points, which is an excerpt from an even more ridiculously detailed section of my book.

What’s new in this article?

Several miscellaneous improvements, especially new information about the role of inflammation and “inflammaging.”

Minor update. Added a neat footnote and citation about the trouble with “average” ranges of motion. Plus miscellaneous editing.

Notes

  1. Actually, a “goniometer” — a more advanced sort of protractor used for measuring limb angles in kinesiology (and much else). BACK TO TEXT
  2. Ironically, almost no one is average, if you take more than a couple measurements of them. For instance, the American Air Force had a crisis of excessive crashing in the 1950s because they’d built their cockpits for “average” pilots, but most pilots didn’t fit in one or two crucial ways, and couldn’t control their planes because of it: “When he looked at just three [measurements], less than five percent [of the pilots] were average. Daniels realized that by designing something for an average pilot, it was literally designed to fit nobody.” That’s from a fascinating article/podcast episode on this topic: see On Average (Episode 266 of 99% Invisible). BACK TO TEXT
  3. He seemed flexible, but it was all in how he used what little range of motion he had. He worked within his limitations like an artist, and you probably would never even guess that he had quite limited ROM unless you spent time with him in training, and watched him failing to touch his toes. BACK TO TEXT
  4. This is somatization, and it’s not that far out. We already know that mood, posture and even pain sensitivity can modify each other (see Bohns, Carney). It’s really not much of a leap that believing you are stiff could result in feeling that way. Consider how a stressful situation can actually feel “suffocating.” BACK TO TEXT
  5. PS Ingraham. Why Does Pain Hurt? How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain. PainScience.com. 5139 words. Research has shown that immune cells (neutrophils) unnecessarily “swarm” sterile injury sites, causing damage and pain with no known or likely benefit as a tradeoff. It’s just a clear error: they appear to have mistaken mitochondria for a foreign organism, a legacy of ancient evolutionary history, and a biological glitch with profound implications about why some painful problems are so severe and stubborn. BACK TO TEXT
  6. PS Ingraham. Chronic, Subtle, Systemic Inflammation: A possible insidious cause of mysterious chronic pain. PainScience.com. 3404 words. Chronic, subtle, systemic inflammation is a possible factor in stubborn musculoskeletal pain. It can have many underlying causes, from bad genes to mild autoimmune disease (including allergies), smoking or other severe biological stresses, chronic infections, and even just getting old (known as “inflammaging”). The greatest culprit is metabolic syndrome: a set of biological dysfunctions strongly linked to poor fitness, obesity, aging, and likely emotional stress and sleep disturbance as well. BACK TO TEXT
  7. FMperplex.com [Internet]. Wolfe F. Travell, Simons and Cargo Cult Science; 2013 Feb 19 [cited 15 Mar 5].

    An informal survey of the poor state of trigger point science from an articulate expert, Fred Wolfe, a rheumatologist. Dr. Wolfe gives his first-hand account of the first trigger point diagnosis reliability study in 1992 (see Wolfe), and he tells the story of meeting Dr. Janet Travell and observing her unscientific conduct with a patient.

    BACK TO TEXT
  8. Quintner JL, Cohen ML. Referred pain of peripheral nerve origin: an alternative to the "myofascial pain" construct. Clin J Pain. 1994 Sep;10(3):243–51. PubMed #7833584. PainSci #54775.

    Quintner and Cohen’s 1994 paper is a historically significant critique of the “traditional” (Travell & Simons) explanation for the phenomenon of trigger points, known today as the “integrated hypothesis.” They propose that peripheral nerve pain is a better explanation. More specifically, they proposed that irritated or injured peripheral nerve trunks may be the cause of pain, rather than lesions in muscle tissue. This hypothesis has advantages and problems, just like the idea it is intended to replace. Its main problem is that there’s no obvious plausible mechanism for ubiquitous nerve irritation. I review the hypothesis more thoroughly in my book, Trigger Points & Myofascial Pain Syndrome.

    An updated version of this paper was published in 2015 in Rheumatology (Oxford).

    BACK TO TEXT
  9. It depends on several variables, like the muscle mass and length and the number and severity of the trigger points. Also, the mechanism of stretch-resistance is unknown: it could be physical tissue stiffness (the nervous system is willing, but simply cannot overcome physical resistance in the tissue), or inhibition and resistance (the brain refuses to allow the stretch, because it’s too threatening). That’s a sloppy thumbnail sketch, just for glimpse at how complicated it all is. BACK TO TEXT