Joint and/or muscle stiffness can be felt in any part of the body. While it may be accompanied by pain, this is not always the case and it can have many different causes. Feelings of stiffness can be easy to ignore, however, they can be a sign that you're at increased risk of injury or pain. Here are a few reasons why you might be feeling a little bit less flexible...
Muscle stiffness can be a sign that strength is lacking. Our body will prioritise stability over flexibility if our muscles don't have the ability to provide both. This means that your muscles will be a bit tighter and stiffer to compensate for any weakness. If you are feeling a tight and sore, your physiotherapist can help to identify any muscles that maybe need targeted strengthening to help.
Delayed Onset Muscle Soreness (DOMS)
Many of us are familiar with post-exercise pain and stiffness. This is a somewhat protective mechanism to help you recover from a bout of increased exercise. This kind of stiffness will be present in muscles that have been used recently and usually lasts for just a day or two. DOMS usually goes away on its own, although it can be quite uncomfortable, it is usually nothing to be too concerned with. Your physiotherapist can help you with tips to avoid DOMS in your regular workouts.
Lack of movement
Along with muscle weakness, inactivity can lead to joint stiffness. Joints need to move through their full range regularly to maintain their flexibility, as anyone who has kept a joint immobilised in a plaster cast will know! Lack of movement can lead to a reduction of blood flow and nutrients, also impacting joint health. Your physiotherapist can help you to identify any joints that are not moving well and advise you on how to restore joint flexibility. Activities such as Pilates aim to help you move all of your joints through their full range safely and maintain flexibility.
Stiffness is the hallmark of arthritis, often noticeable as increased stiffness on waking that progresses gradually over time. Pain and stiffness caused by arthritis can often be helped by a targeted muscle strengthening program to help support the joints.
Speak to your physio about any tightness or inflexibility and see how they can help you feel your best.
Can prolonged stress affect your pain and healing? There's a strong suggestion that it can, particularly with chronic pain. If you suffer from ongoing pain you may have noticed this relationship yourself. Many people know that their pain is worse when they are stressed but they don't know why.
Stress activates your sympathetic nervous system, this is the state where we move into 'fight, flight or freeze' mode. This part of our nervous system is responsible for keeping us safe when we are in danger, however it can be activated for prolonged periods due to life stressors and many of us lack skills to return control to our parasympathetic nervous system, which is responsible for helping us to rest and digest.
How would this affect pain?
During this state, muscles become tensed and ready for action, the nervous system is extra sensitive to stimulus, blood pressure is raised and we are more likely to notice and have negative thoughts. Tense muscles can become tired and painful or put extra stress on other structures, causing pain and irritation. Quite often when in a stressed state, our breathing becomes shallow and rapid, particularly when doing work of low exertion, such as while sitting in an office.
Use your breathing to recover.
An effective way to help your body return control to the parasympathetic nervous system is to consciously change your breathing. One method is to hold your breath for as long as you can, then let it all out slowly. Once you exhale, your body senses that a threat has passed and can return to a more relaxed state.
Another commonly used technique is box breathing. To do this, breathe in for four seconds, hold for four, breathe out for four, hold again for four and repeat. Do this for a few minutes until you start to feel more relaxed and calm.
Show your body that you are safe.
Other activities that can help your body to relax include yoga, going for a swim or having a shower, or doing some intense exercise where your heart rate is raised.
A common fear for people when discussing pain is the idea that their symptoms are 'all in their head' or that they won't be believed by friends, family, therapists or workmates. This fear can be worse when there appears to be no obvious or visible cause for their pain or if it has been present for a long time.
What is pain?
Many of the models used in the past to explain pain lead us to believe that the intensity of pain will always be proportional to the severity of an injury. The experience of pain is always real and usually distressing. However, pain is a warning system used by our nervous system to alert us to danger, not a direct indicator of damage done. This is an important distinction, meaning that the experience of pain can be influenced by many different factors and not exclusively tissue damage.
How can stress impact pain?
Part of the role of your nervous system is to sort through a huge amount of sensory input and interpret it in a meaningful way. When pain is considered to be a serious threat to the body, the intensity of the pain will be worse.
This can happen in many situations, such as...
-The source of the pain is not well understood, leading to fear that the pain might be something very serious;
-The nervous system is in a state of hyper-arousal, such as when you are stressed or tired;
-The pain or injury has a significant impact on your quality of life, work, relationships or hobbies; or
-The injury occurred through a traumatic event such as a car accident.
What does this mean for my treatment?
Along with more traditional treatments, we also know that stress reduction strategies, mindfulness and addressing any emotional trauma associated with pain can all help to aid recovery and improve quality of life. Your physiotherapist is a great person to speak to about pain management strategies so you can get the most out of your life while dealing with your pain and injury.
What is it?
Fibromyalgia is a chronic condition characterised by widespread pain throughout the body along with fatigue, memory problems, sleep and mood disorders. Sufferers of fibromyalgia often spend years trying to find a diagnosis that fits their symptoms and fluctuate between periods of having high energy and ‘crashes’ of fatigue and pain. In severe cases, fibromyalgia can cause significant lifestyle disruptions, including reduced activity, unemployment and depression.
The underlying mechanism that creates the symptoms of fibromyalgia has been shown to be increased pain amplification by the central nervous system and reduced activation of the sympathetic nervous system. Essentially this means that small pain signals in the body are processed as large pain signals by the central nervous system.
What causes it?
Fibromyalgia is a complicated condition that is poorly understood. This can be very frustrating for sufferers, who often find themselves being shuffled between health practitioners looking for answers and long term relief. While the pain generally feels muscular, usually little to no muscular damage or injury can be found on physical assessment or investigations. The symptoms can also mimic those of an infectious illness or other chronic diseases. Often a diagnosis of fibromyalgia is reached after other diseases and causes have been ruled out.
The cause of fibromyalgia is as yet unknown. It was initially thought that the depression and reduced activity that are often associated with fibromyalgia could be causative, however it has been shown that these are symptoms of fibromyalgia rather than causes. Other significant signs are a lack of REM (good quality) sleep in sufferers and a positive result of more than 11 out of 18 muscular trigger points.
What is the treatment?
Following a diagnosis of fibromyalgia, the primary strategy is to understand and manage your symptoms. This can involve pacing activities and exercise so as to reduce ‘crashes’ and pain cycles that lead to frustration. Identifying activity, employment and a routine that doesn’t exacerbate symptoms can have a significant impact on quality of life for someone with fibromyalgia. Having psychological support can also be very important to help deal with the emotional distress of a complex chronic condition that has no outward physical signs.
Treatments that have been shown to help reduce symptoms are TENS (electrical stimulation) which produces an endorphin response and can reduce pain; certain medications may be helpful when prescribed by a doctor; and education and understanding of this condition, helping to manage and maintain some control over your symptoms. Physiotherapists can have a large role in education and helping patients find a routine and activity level that helps them manage their condition as best as possible, as well as providing symptomatic relief during pain cycles with manual therapy, stretching and massage techniques.
It is always best to see a medical professional for advice on your individual injury or condition.