“If you have ever held your hand to your neck or back in pain, you may have or have had a muscle contracture.”
A contracture is described as the elevated tone of a muscle as a whole. This increased tone is an involuntary and sustained contraction over time. If a muscle is subjected to sustained strain, incorrect posture, nervous tension, poor warm-up or lack of stretching after training, the muscle fibers shorten in length and have a reduced blood supply. This circulatory deficit, in turn, causes the fibers to be poorly nourished, thus creating a vicious circle that maintains the pathology. In the case of moderate contracture the pain is usually local, without radiating to any other body area, and on palpation there is a slight stiffening of the area due to partial shortening of the muscle fibers.
When patients tell us that they have contractures in a muscle they usually refer to nodules that are palpated superficially. These painful nodules found in tight bands within the muscle are known as muscle trigger points.
Are there groups more prone to muscle contractures?
A muscle contracture can occur at any age. The prevalence is higher in young adults over the age of 20, as they tend to be competitive, play more sports and/or carry a high stress load. There is a striking increase in cases of school-age children who end up in consultation for contractures in the cervical area. This is caused by spending too much time with technological devices, or a poor diet.
What types of muscle contractures are there?
Contractures can be classified into those originating during physical exertion or those that appear after physical exertion, and residual contractures, which accompany another injury.
Post-traumatic or defensive contractures occur after an impact. In response to the impact, the brain activates the adjacent musculature to protect the sensitive structures. They cause intense pain but resolve practically on their own after 48 to 72 hours. This group includes cervical contractures, for example.
The postural contractures are produced slowly and progressively by bad postures or bad gestures. They do not usually cause much pain, except when associated with other nearby muscles. Here would be the typical knots in the neck.
Muscle spasms or contractures due to hypotonia occur when the muscle is weak and we are asking for a stronger contraction. It is at that moment when a contracture occurs to avoid fiber rupture, something that usually happens with sports practice.
On the other hand, in addition to the typical contractures, neglecting oral health can cause muscle contractures in the neck and back. The occlusive postural syndrome is characterized by muscular contractures in the neck and back, as well as headaches during the day. These symptoms are closely related to alterations in the position of the teeth, the tone of the masticatory muscles and the change in position of the temporomandibular joint. It is estimated that approximately 30% of the population may suffer from these disorders. This syndrome is a postural dysfunction. Misaligned teeth cause an imbalance to be transmitted to the musculature surrounding the mouth and this, in turn, to the cervical vertebrae, spine, hips and sometimes even to the feet.
How to avoid and treat muscle contractures?
The best way to treat muscle contractures is to prevent them, knowing and practicing healthy habits. The first step in prevention is the adoption of good posture, since 90% of contractures are due to bad habits maintained over time. Many people are sitting or standing for a long time, among which is due to 8 hours or more for work. In these cases it will be recommended to do stretching every hour, to prevent contractures in the areas of the body that they use the most.
Another way to prevent contractures is to warm up properly before practicing sports and then warm down to return to the previous situation, stretching and resting the muscles used in the sport.
If pain has already been generated and a contracture occurs because the body’s prevention mechanisms have failed, there is no choice but to treat it. We recommend the application of moderate dry heat in short periods of time (about 15 minutes) throughout the day, accompanied by slow, gentle and controlled stretching. If the pain is more severe, chronic or accompanied by inflammation in the area, pharmacological measures can be used, but always under medical prescription. The drugs used are anti-inflammatory and muscle relaxants.
The objectives of the treatment will be:
- Muscle relaxation, reducing tension and pain, which is achieved through massotherapy (massage).
- Inhibition-ischemic compression. This improves local blood flow, helping the tissue to heal.
- Stretching of the affected musculature.
- Kinesiotaping. Stabilizes muscles and joints, improving mobility. Reduces inflammation and produces analgesic effect.
- Dry needling to unblock the trigger point.
Why is an assessment by the rehabilitation physician necessary in these patients?
The rehabilitation physician is the medical specialist who is responsible for the diagnosis, evaluation, prevention and treatment of disability, aimed at facilitating, maintaining or restoring the highest degree of functional capacity and independence possible. A global assessment of the patient is carried out and the most appropriate physiotherapy treatment is prescribed so that the patient can regain independence of movement.