Tight and stiff are often words that I use in as part of a physiotherapy assessment. But what exactly do I mean by tight? What do I mean by stiff? Well hopefully by the end of this blog you will know.
Tightness and stiffness often go hand in hand, they often give similar if not the same symptoms, so how do we really know what is causing what, and then what can we do about it?
Let’s start with an example. Your horse is stiff on the left rein (or is he?) when you ride you feel that he is not able to bend as well on the left rein as he does on the right rein. There are a huge range of things that could be causing this, but lets’ try to keep it simple. So he struggles to bend on the left rein, if this is due to a tightness in the muscles this is likely to be due to the muscles on the opposite side, in this case the right side of his neck. If the muscles on the right side of his neck are tight, they will not allow him the freedom to stretch out and bend freely on the left. Make sense?
However if he is stiff it is more than likely that it is the facets joints of his vertebrae are causing or at least contributing to the problem. If the facet joints (so the joints that attach one vertebrae to another) are stiff, or if they are mildly arthritic, when you ask your horse to bend to the left you are closing down the joints/ bringing the two joints closer together, and for some this just isn’t possible and so it is the joint that is restricting the movement, not the muscle and feels 'blocked'
How can you tell the difference I hear you cry?
Well it’s a combination of things, but a simple thing to look at yourself is the quality (not the quantity) of the movement. So in the stable use a treat to ask your hose to bring his head around to his shoulder, firstly is he able to do this without moving his feet, trying to grab you, tilting his head etc. If he can do it, is it as easy as the other side? Did it take him a few attempts? Maybe he just can’t get as far one side before he HAS to move his feet. And lastly what does the curve in his neck LOOK like? It should be a nice ‘banana’ shape, showing that each joint in the neck are moving equally to each other. If you see a curve, a straight bit then a crook, chance are he is stiff, if you see a curve but he just can’t seem to reach without moving his feet, it’s more likely to be tight.
Of course you can have it where both are the issue, particularly if there is acute joint pain, the underlying stiffness is causing pain, so the overlying muscle go into spasm in an attempt to protect the joint, of course this causes more problems than it solves and is a scenario where physiotherapy can be particularly beneficial.
SO what can physiotherapy do to help?
Well firstly you would need to address the muscle spasm, there is no point trying to mobilise a joint under muscle spasm, muscle are massive and also quite strong (even the weak one in horses, they still have to hold up their head!) So there’s no way my measly little hands are getting through a protective muscle, and actually if you try you just end up causing more pain. We have to warm it up slowly. Sometimes using electrotherapy such as biomag also known as PEME (pulsed electromagnetic energy) LASER or even just a hot water bottle can be a good starting place. Relax the muscle, take away the guarding and you may be able to get through to the joint. So I would start with electrotherapy, then move on to myofascial release, before applying soft tissue massage, then deep tissue massage, see how I go deeper each time?
Once I am able to apply deep tissue massage with minimal muscle spasm I can then try some mobilisations (sometimes the mobilisations have to come sooner, the rhythmical motion of them also have a relaxing effect)
So that brings me nicely to mobilisations. I love joint mobilisations, I have a blog post dedicated to them here; https://www.huntshillphysio.co.uk/single-post/2019/02/12/part-three-manual-therapy
But essentially I can use joint mobilisations in increase synovial fluid, so the body’s natural lubricant, to help to reduce the stiffness, this will also have an effect on the pain gate theory (a blog for another time, but google it, it’s fascinating) and a stretch relax on the muscle attachments. I can also combine this with MWM’s (mobilisations with movement) or SNAGS (sustained natural apophyseal glides) which further help to reduce pain, increase pain free range of motion and improve function.
So there it is, a whistle stop tour of tightness verses stiffness. If you have any questions or if you think I could help your horse or dog then please get in contact.
Thanks
Maxine