Stiffness & Pain - Are They Related?

Feeling stiff or tight is a common feeling. It could be a stiff back or a tight hamstring. In my experience it is usually after some sort of overload, which could be

a planned exercise session (eg a gym workout, and probably a good thing!),
a training error (unplanned loading such as doing too much of an activity you are already regularly doing i.e. “load spike”, which could be in combination with introducing a new activity), or
from doing very little, like sitting for too long. Sitting, although a static activity, is actually relatively high load on the soft tissues of the spine, shoulders and hips (something is holding you up against gravity right??)
This last point (number 4) is common enough but less understood. The tightness may not necessarily be a physical or mechanical overload or cause, but a “non mechanical” one. This is more along the lines of tightness arising from stress, negative emotions, and even previous unresolved trauma. I think this is worth mentioning because of its relevance in my clinical practice, but it is outside the scope of this post.

Tightness is an extremely common symptom that people are forever trying to “fix”. And because there are a very wide range of causes for stiffness and tightness, until we can narrow down the cause of stiffness or tightness, all attempts to improve the stiffness will be short lived. Stretching is not always the answer.

If we think about some common causes of stiffness and tightness such as inflammation, muscle injury, ligament sprains, tendinopathy, active trigger points / “muscle knots”, and even stress, stretches may help alleviate the symptom/effect temporarily, but not address the cause of the problem.

A good way to think about stiffness and tightness is as a mild pain. Placing it on a pain scale after “0” and before “1” would make a lot of sense because it would then serve as a potential “warning sign” before a true problem actually develops. So a stiff neck would be interpreted as a sign you are overloading your neck, and a change may need to be made.

Long term stiffness or tightness is slightly different, in that it is not a recent overload, but more a combination of chronic (long term) overload and soft tissue adaptation. It develops when acute stiffness and tightness is ignored, or poorly managed.

Some common examples I often see are sitting with poor posture, increasing running mileage too quick and/or not scheduling in recovery, and lifting incorrectly. If a body part feels stiff or tight, and it is ignored or poorly managed (continue sitting poorly, keep running through pain etc), chronic long-term stiffness, tightness, and/or pain can develop. This requires a more in-depth analysis of the actual pain, problem and realistic management options.

When a body part feels stiff or tight and you view it as a “low grade pain” that is warning you of potential upcoming injury, you may be better placed to take early steps and prevent pain or injury.

From my perspective:

Start thinking about stiffness and tightness as a part of the pain scale. It should sit between 0 and 1, and use it as a warning sign. You have overloaded something.

Then ask yourself “why”. By doing a bit of detective work you may discover the cause, (eg bad posture), and then be in a good position to take steps to correct it before it becomes a problem.

And if you get stuck, make an appointment to see us at 20/20 Sports Physiotherapy in Engadine.