Patients often ask me – “should I stretch…”. My answer is often something along the line of: “If you feel better doing that, then certainly go ahead. However, if you want to loosen a tight muscle, you’re probably not going to get the results you are looking for if you don’t strengthen the “opposing” (or opposite acting) muscle.
Before I go further, there are basically only two types of “tight” muscles. One occurs when the connective tissue (or fascia) overlying the muscle becomes shortened. The second would be an actual over-contraction of the muscle due to the nervous system causing it to contract and remain in a “shortened”, hypertonic state.
Why do I tell patients to strengthen the muscle(s) that act in an opposite fashion to the tight muscle? Think about it, do muscles “decide” to get tight for no reason; and stay that way? 99/100 times there is an inhibition, or true weakness, in an antagonistic (opposing), or sometimes synergistic (similar acting) muscle.
For instance, if a patient was concerned with a tight hip flexor (the psoas for example), I would look to find an inhibition/weakness in the opposite psoas causing a reflexive tightness. In this case the opposite psoas would be both an antagonist and synergist depending on the movement of the skeletal system. Think about it as an antagonist though, and then compare it to a tug of war. If each muscle is opposing one another with say 50 lbs. of force, and then one becomes inhibited and only has the ability to pull 25 lbs. of force; the opposing muscle will most likely become shortened because of the diminished resistance against it. If two teams are pulling an equal weight of 50 lbs. on a rope in a tug of war; what would happen when one side loses 25 lbs. of force?
To use this same example, I would also check the hamstring and gluteus maximus (for inhibitions) on the same side of the psoas (hip flexor) tightness. That’s because the hamstring and gluteus maximus are hip extensors, thus opposing muscles to the hip flexor, the psoas in this case.
The above examples represent a muscle tightness based on the overlying fascia being too “short” or “wrinkled”. When a muscle is too tight because of an over-contraction due to the nervous system, I would check the synergistic muscle for an inhibition. In this case of the psoas, it would be the rectus femoris, the second of the two main hip flexors. Although the opposite psoas may also be considered in the case of an over-contraction type of tightness as well.
The complicating issue may be for the practitioner to discover the cause(s) of the muscle inhibition; which for the psoas can often be related to foot/ankle imbalances.
Clinical pearl: tight hamstrings often result from inhibited calf muscles (synergists) which can ultimately result from not using your toes during the toe-off phase of gait. As one of my mentors, David Leaf, DC, DIBAK might say: girls and boys, toes are for more than just painting. There is a quick 2-minute, in-office procedure that can be implemented, which simulates the use of the toes (and entire range of ankle joint motion) in walking to determine if tight hamstrings are due to faulty gait mechanics.
Keep in mind that if you are intensely athletic, you’ll be more likely to need stretching in addition to “strengthening” than a person who is less active. Very often stretching is not necessary to relieve muscle tightness in a fairly sedentary person.
Lastly, Dr. Janet Travell, “The President’s Physician” – as she is known, especially for treating JFK – noted that a vitamin B12 deficiency can cause tightness or shortening in the fascia that overlies muscles. By the way, this type of tightness (also mentioned above) often causes myofascial trigger points (or knots) in muscles. More often I’ll focus on giving nutrition related to keeping the inhibited muscle facilitated. This could include collagen-building nutrients, or a nutrient based on the muscle-organ correlation. And of course, for extra difficult cases, consider nutrients essential in maintaining the connective tissue known as elastin.
Don’t forget, anything can cause anything, and sometimes where it is (i.e.: the pain) it isn’t (i.e.: the cause).
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology