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)

ROM is the only objective fact about flexibility than can be had. 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. A better measurement might be how much you want or need a joint to move — for instance, gymnasts need ROM more than accountants do. However, I’m not sure that desire or perceived need is even a good measure. People chronically assume their range is worse than it is, and that more range is better than it is. (It’s not that great.)

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 man has hamstrings that just aren’t very stretchy. It doesn’t necessarily hold them back in any way — it may not be causing any problems — they just can’t touch their toes! And yet many men bemoan their lack of flexibility.

The martial arts mostly demand flexibility, but not necessarily. The most memorable martial artist I ever worked with — a formidable, grizzled old practitioner of Aikido — was also one of the least flexible. 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.

The sensation of muscular stiffness

Only you can say that you’re stiff. Stiffness and tightness are imprecise symptoms and sensations — they are completely subjective, and only loosely related to anything that can be objectively measured, like ROM. No instrument can confirm it.

Most people think of stiffness as a bad thing. It feels like something is wrong. No one I’ve ever met thinks they are comfortably stiff.

Actually having a short but perfectly healthy range of motion is probably not the explanation for 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.

So what’s the difference?

“I feel really stiff — it’s nice!”

no one ever

Stiffness is a symptom of what disease?

If feeling stiff is a symptom, what is it a symptom of? It’s usually unclear: 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.2 So trying to diagnose stiffness is like trying to diagnose a funny feeling.

However, for most people who feel stiff, there is one particularly likely suspect: the ubiquitous phenomenon of “muscle knots,” technically called trigger points. Patches of soft-tissue that are painful 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,3 and trigger points could be pure neurology and sensation.4 So trigger-pointy tissues may actually resist stretch, or their extensibility may be unaffected,5 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!”

Or maybe it hurts every day. Chronic tissue inflammation or irritation has many possible causes, and is probably more prevalent and persistent than most professionals realize6 — trigger points are probably only a common sub-type.

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.

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. 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
  3. 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
  4. 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
  5. 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
  6. 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. 5030 words. BACK TO TEXT