Tag Archive for: muscles

Hip Flexors Always Tight? Maybe stop stretching.

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When it comes to chronically stiff muscles – tight hip flexors are the second most common complaint I hear after tight hamstrings. Tight hip flexors are annoying, achy, and they often contribute to lower back pain. When your hips are always tight, it can interfere with your ability to enjoy walking, running, golfing, and just exercise in general.

Typically – the recommended treatment for tight hip flexors is to stretch – right along with advice to foam roll and massage. But what do you do when none of that works? What if no matter how often you stretch, the tightness just keeps coming back?

First, you need to make sure that the tightness you feel in your hips is actually due to tight hip flexors. Just because your muscles feel tight – doesn’t mean they are tight. 

Let me explain.

Your hip flexors (or any muscle for that matter) can feel tight for different reasons. They can literally be shortened and constricted – in which case – they need stretching – and lots of it. But they can also feel tight due to weakness or being overworked. If your hip flexors are weak, they are going to feel strained when you use them, which can create a sensation of tightness. If your hip flexors are compensating for another underperforming muscle group – say your deep core – then a sensation of tightness may occur because they are simply tired and overworked.

So the first and most important thing you need to figure out is what is causing the sensation of tightness in your hips. Are they actually short and tight? Are they weak? Or do they simply need a break?

Let’s do a quick anatomy review of your hip flexors to help you figure this out…

Your hip flexors consist of the muscle group located in the front of your hip and groin. They are responsible for bending (flexing) your thigh up and toward your chest. But they also play a role in stabilizing your pelvis and lower back – and this is where I see a lot of problems and confusion. The rectus femoris, part of your quadriceps muscle group, and your psoas, part of your deep abdominal muscle group, are the two major hip flexors. Your rectus muscle is the one primarily responsible for lifting (flexing) your thigh. When you are walking or running, and repetitively flexing your leg, this is the muscle primarily at play. Your psoas, on the other hand, is much shorter and has a connection to your lower back. Because of this, it has more of a stability role. When functioning properly, it will assist in exercises like the crunch or sit up, and also work alongside your deep abdominals and glute muscles to help you have good upright posture when you’re sitting or standing.

Let’s talk about the psoas for a moment, because this is where many folks I speak with are misinformed. The psoas gets blamed for a lot of things – most notably – tilting your pelvis forward and being the cause of low back pain. The theory is that if you stretch, massage, and “release” your psoas muscle, then you will balance out your pelvis and your back pain will disappear. Sadly, this is rarely the case. Most of the time, your psoas feels tight because it’s either too weak and not able to keep up with what it’s being tasked to do, or it’s overworking to compensate for your deep abdominals not working properly. Either way, the result will be an angry psoas that retaliates against you by feeling tight and achy. And stretching it over and over again will simply not work.

Now sometimes your hip flexors – particularly your rectus femoris – can get deconditioned from not being used enough – and this can result in actual constriction of your muscle tissue. This typically happens slowly over time, and is more likely to occur if you sit too much and aren’t very active. In this case, you actually do need stretching to fix the problem – but one of the reasons it doesn’t work – is because you aren’t doing it properly. When your muscle tissue is actually constricted – it requires a very specific stretching protocol to work. The days of holding a stretch for 30 sec and repeating it 3x are long over. If your muscle fibers have actually become constricted – the only way for them to improve their length is to remodel. They need a lot of stress to remodel (aka get longer) and the only way to accomplish this is to stretch repeatedly and often.

At the end of the day, if you’ve got chronically tight hip flexors and you’re stretching all the time, you’re either doing it wrong or shouldn’t be doing it at all. Perhaps you need to strengthen your hip flexors so they don’t feel so tense all the time? Or maybe your core isn’t kicking in and you need to strengthen that instead? Don’t stress yourself trying to figure it out on your own.

Talk to an expert who gets this.

Stretching a muscle that feels tight isn’t always your answer, and you’ll know this because stretching over and over just isn’t fixing the problem. 

Request to speak to one of my specialists to see if we are the right fit to help get to the root cause of your tight hip flexors. CLICK HERE to request a Free Discovery.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

back pain

Tight knots in your muscles? Do’s and Don’ts

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At one point or another, or perhaps even this very second, you’ve experienced tight knots in your muscles.

They are annoying, nagging, uncomfortable, and quite often painful.

The most common area to feel these knots is in your upper traps (the triangle shaped area between your shoulder blades and base of your neck). But other areas of your body that love to get knotted up include your mid and lower back, your hips and butt, the front and sides of your thighs, and the back of your lower legs.

The first thing people think to do when experiencing these tight knots or muscle spasms is to get a massage or try rolling them out with a foam roller. Lately, theraguns seem to be the craze. These devices look like power drills and use percussive therapy to reduce pain and relieve tightness in the affected area. In our office, for really stubborn and painful knots, we use something called dry needling, which is where you take a tiny acupuncture needle and insert it into the tight knot to bring blood flow to the area and release tension.

These are all great options, and for the most part, I put them in the category of “Do’s” when it comes to getting rid of tight knots in your muscles.

Sounds pretty simple, right? Well, not so fast. Not all muscle knots are meant to be released.

“Don’t” aggressively release a tight knot in your muscle until you know why it’s there. 

Sometimes, muscle knots form as a critical compensatory strategy. If released too quickly, they can set off an array of problems. I was just talking to my massage therapist about this, because she’s seen it happen to her own clients. Occasionally, she’ll work her magic to get rid of tight muscle knots only to find the client feels worse after the session. This can happen when the tight knot was there to compensate for a weak muscle elsewhere. 

Let me explain. 

Muscles are connected via highly innervated tissue called fascia. It looks like a spider web and one of its main functions is to connect organs and muscles together. Fascia is still being studied, but one of the theories is that if one muscle group in that fascial line is not doing its job, a different muscle will work extra hard in its place to take up the slack. Eventually, that muscle will get exhausted and tighten up into a knot, because it’s doing more work than it was designed to.

If you release a knot that is “holding the line” together, you’re asking for trouble.

In this example, what I’ve found is that the passive methods of releasing muscles (those I mentioned earlier) aren’t very effective at helping you get rid of the problem. You might actually end up feeling worse or having pain elsewhere. If your tight muscle knot is there to act as a survival mechanism, it’s going to take a more comprehensive and total body approach to resolve it. You’ll need to figure out which muscle or muscles the tight knot is compensating for and address them at the same time you work to release the tight knot. You can keep getting your weekly massage, but you’ve got to pair it up with correctly prescribed exercises.

To summarize, DO figure out WHY you have a tight knot in your muscle first.

Is it there because you overworked it in the gym? Maybe you’ve taken on a new project at home that is repetitive in nature?

If these are the reasons you’ve got tight knots in your muscles, then DO release them. You’ll likely feel better. And then correct the movement patterns, so the knot doesn’t come back.

If you feel worse after releasing the tight knots in your muscles, or the knot keeps coming back, then the problem likely involves more than just that muscle and you need a more comprehensive approach to get rid of it.

DON’T continue to release it over and over.

If you’re suffering from stubborn knots that won’t go away, get assessed by movement experts like us who can diagnose your problem accurately and help you get rid of the tight knots in your muscles for good.

 

Dr. Carrie Jose – back pain specialist and Pilates expert – owns CJ Physical Therapy & Pilates in Portsmouth, NH

What is Dry Needling?

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At CJ Physical Therapy and Pilates, our goal is to help you live a pain-free life without pain pills or invasive procedures.

Trigger Point Dry Needling is one of several strategies we use to treat muscles that are extremely tense and in spasm. The spasm causes the muscle to be in constant tension which reduces blood flow, decreases oxygen, and can produce fibrotic unhealthy tissue over time (scarring). When a physical therapist inserts the very thin acupuncture needle (dry needle) into a knotted up muscle, it creates a local twitch reflex. Research shows that this not only relaxes the muscle, it breaks up the pain cycle by improving blood flow and oxygen to the muscle. This whole process helps to reduce and normalize inflammation in the area to promote healing. However, dry needling is not necessary for everyone, so it’s important that you know what it is and when it can be used to improve your health! Here’s our advice when it comes to pursuing dry needling treatment.

Work with a physical therapist to use dry needling in conjunction with movement based rehabilitation.

Dry needling can work wonders to relax your muscles. However, they’re just going to get tense and damaged again if you don’t learn how to use them properly and address any movement dysfunction that may be occurring. You don’t want to think of it as a quick fix! Dry needling is just the first step for some individuals who aren’t able to begin a physical therapy or movement regimen without first breaking up the pain cycles in the muscles that are prohibiting healthy movement. Dry needling serves as a “helper” to relax those muscles – and should be integrated with physical therapy treatment and strengthening activities such as Pilates.

Don’t be afraid of trying dry needling!

It can be uncomfortable for some people, but others say they feel no pain at all. It’s not dangerous and has lasting positive effects when used in conjunction with hands-on physical therapy under the direction of a specialist. Furthermore, our clients love it:

“After two back surgeries in my 20s and a new hip at 58, I figured I was lucky just to be walking. Dry needling has transformed the way I move. I’m more flexible. My walking stride has more length and I can stand longer.” – John

Do you have questions about dry needling? Want to see what a specialty physical therapy practice can do for you? We offer FREE Discovery Sessions right here in Portsmouth that give you the opportunity to ask any questions you may have! It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health. All you have to do is fill out this quick form, and we’ll be in touch!