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Dealing with Tight Muscles and Return to Play Following Injury

Have you ever worked out, been injured, and then had to deal with tight muscles and how can you get past that so that you can get back to playing? Dr. Jared Anderson discusses tight muscles, why they happen, how to treat them and more in his podcast. Read the transcript below or tune in to the Be Well Podcast channel. 

Maggie McKay (Host): This podcast is for informational purposes only and is not intended to be used as personalized medical advice.

Have you ever worked out, been injured and then had to deal with tight muscles? How do you get past that so you can return to play? Dr. Jared Anderson, a Sports Medicine Physician with Skagit Regional Health is here to tell us what we need to know about tight muscles.

Welcome to Be Well with Skagit Regional Health. I'm your host, Maggie McKay. So nice to have you here today, Dr. Anderson.

Jared Anderson, MD, CAQ: Thank you, Maggie. It's good to be here.

Maggie McKay (Host): First of all, can you tell us why tight muscles even happen?

Jared Anderson, MD, CAQ: Yeah, there's a lot going on with the tight muscle. A muscle that's tight is usually a muscle that's trying to overwork or is covering for some other muscle that isn't quite working as efficiently as it should. Tight muscles happen as we work out, as we move, when our system, our muscle system isn't quite in balance. Often what happens is when there's a muscle imbalance, our muscles try to compensate or our body recompensates by recruiting other muscles to cover for that imbalance. The muscles that come into cover for that compensation, typically aren't as efficient and often tighten up in order to perform the task that they're trying to do. Many times we've heard somebody say, boy, I have to stretch my hamstring out over and over every day. I have to stretch out my hamstring and it never seems to get any better. I have to do it over and over. Why would this be? If the tight muscles would improve by stretching it, in a few days of stretching it should get better. But, the problem is usually the muscle that's tight is actually just a muscle that's overworking.

At any time that we have a tight muscle without a specific injury, we should change our thinking from, you know, what's the best stretch for this tight muscle to where is that muscle imbalance that's making this muscle tighten, or what muscle group is that set of muscles covering for?

Maggie McKay (Host): Can tight muscles lead to injury? Can they cause injury?

Jared Anderson, MD, CAQ: Oh, definitely. A tight muscle is often a precursor saying, Hey, I'm not working as efficiently as I should be, and so I'm trying to use a muscle to help stabilize or balance that position. It'd be like, if the power goes out at your house, and you have a generator. That tight muscle's like the generator trying to fill in the gap for when the power is out, but eventually that generator can run out of gas and then we're left with nothing to cover for it and that would lead to a joint or a muscle to strain or tear or the muscle to twist and we lose stability, and then you get a sprain of the joint or a fracture or something like that.

So, we want to make sure that those tight muscles, they're kind of like the warning shots to tell us something isn't quite right in the system and we need to try and address it as best we can.

Maggie McKay (Host): And how do you treat tight muscles?

Jared Anderson, MD, CAQ: This is kind of maybe a part where I want to change how we think about tight muscles. Often we think of massaging it out or stretching it, and those can be good temporarily, to relieve some of the stress on the muscle. But if I have a muscle that's tight, I want us to think, where is the muscle imbalance that's making that muscle tight? Or what muscle is that tight muscle covering for? You treat tight muscles, by realigning the system so that each muscle only has to do what it's supposed to do. There's myofascial work or massage that can free up restrictions within the muscle. There's stretching that temporarily relieves that tight muscle. But usually that tight muscle is doing the extra work covering for a muscle that's not showing up. So, the way to find or treat a tight muscle is to find out where the system is imbalanced and try to correct that imbalance.

Maggie McKay (Host): And so do you have to go to the doctor for that? Because how would we know?

Jared Anderson, MD, CAQ: So let me use the hamstrings as an example. If the hamstrings are tight, they're covering for a muscle that's not working. So typically, if we're looking at that or trying to figure out for ourselves what it is; often it'll be the muscle up front, which is the opposite. So the hamstrings are in the back, then the quads might be up front and the quads might be extra tight or not working as well. If the hamstring is tight, we also need to look diagonally across the body, up into our core for that imbalance or compensation to happen. It is really hard to tell on yourself because your body is really good at finding somebody to cover the gap for you. So often we don't even notice that we're moving improperly without somebody watching us how we move. What I do as a sports medicine physician, is I look for those muscle imbalances. I look for the compensations in what we call a functional movement assessment, to be able to look from the neck down to the big toe and see which joint, which muscle group and which system isn't working how it's supposed to.

If you're treating it for yourself, I guess there's a couple, there are a couple of simple things or at least common things that happen because of the way our world is built. We spend a lot of time sitting in chairs, driving, typing at a computer, things like that. And so often the most common imbalances that I see, are that the lumbar extensors or the muscles of the lower back are really tight because we're not able to access our hips as much because they're spending so much time in chairs. So the lumbar extensors and the hamstrings try to make up for the hips that aren't able to be as active as we need them to be.

So if I were to have somebody just set up a program or say, boy, I have tight muscles, where can I find that imbalance? One of the most common places to look is the lumbar extensors are very overactive, or those low back muscles, that low back tightness, and also the core muscles up front aren't able to engage in a way that, that gives me access to the muscles of the back.

So being able to activate the core without the lower back muscles extending or turning on too tight as well, is one of the best places to start for any type of pain, whether it's a knee problem, knee tendinitis, shoulder tendinitis or impingement or anything like that.

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