Don’t Let Your Tissue Get Uptight: Tone Vs. Tightness
As a movement coach, the question of “what is the difference, between tone vs tightness” is a common occurrence and one that is of significant importance to those who suffer the burden of chronic pain and compensatory dysfunction. To better understand, not only the difference, understanding how to identify the different are key factors that can make or break your intervention strategy.
First order of business is looking at the tools for assessing and screening dysfunction and compensatory movement:
The FMS and SFMA:
The FMS and SFMA protocols are tools used to capture movement dysfunction at the level of the pattern and then address whether the limitations are mobility, stability or motor control based. On average many practitioners often attribute “tightness” as a lack of muscle length or “weakness” to muscle inhibition like having “a weak core” or “weak glutes.” Now, they would not be wrong in their conclusion, but this is not the be all and end all. It’s only one piece of the puzzle and the puzzle (your body) has many moving parts that work together to give you performance output and synergistic movement. Now, the SFMA is only used by clinicians, therefore, my form of screening, is more an overall postural screen, luckily working in an integrated model, allows me to refer to a physiotherapist or most often the initial functional assessment has already been performed… now, I just want to see the client move through my own lens.
Our first role is to demonstrate how your muscle acts in association with the connective tissue, the nervous system etc and then also address how perhaps glute weakness affects a movement pattern, increases tone, redistributes engagement to other muscles; which in turn causes compensatory movement and tone.
Through this protocol we can go through the body like a checklist of the many imperfections we all carry on a day to day basis, or we could try to discover each individual’s major dysfunctions so that we can remove these negatives to uncover our strengths. Corrective intervention and a well-designed strategy is crucial for improvement, doing more of any exercise; corrective or other, can result in more pain if we do not address the full scope of limitations. If they could do more, they would, but most often pain is a limiting factor… and they can’t.
Let’s take the ASLR drill as an example of addressing the vast difference between tone vs tightness. During the FMS Screen and Y balance tests I will be able to identify the largest area of need, and most often in new clients with or without pain, the shoulder mobility (SM) and active straight leg raise (ASLR) are the two most often needing corrective intervention. The ASLR is also most often the starting point for the discussion of tone vs tightness.
Depending on your scope of practice, if you work in a clinical setting like in rehabilitation, you can apply a manual intervention, by mobilizing or manipulating a joint or you could apply soft tissue work either with our hands or tools; like the foam roller or magic stick, or if you are an RMT, FST or KMI practitioner you could provide deep tissue work into the muscles or on the fascia. You might use needles to do a musculoskeletal technique called trigger point dry needling, like in IMS or Acupuncture. Or if you are a personal trainer or movement coach, hands on technique may not be in your skill sets; therefore, educating the client and using corrective intervention is where your path for this client starts.
Let’s break down the screen first. Let’s say I deduce that Mr. Smith has the following:
- D/S (deep squat) – 2
- H/S (hurdle step) – 2/2
- In/L (inline lunge) – 2/2
- ASLR (active straight leg raise) – 1/1
- S/M (shoulder mobility) – 2/3
- TSPU (trunk stability push up) – 2
- R/S (rotary stability) – 2/2
- Spinal ext. – clear
- Spinal flex – clear
- Impingement test – clear
- Total: 13 out of 21 (no pain, but a lot of discomfort)
To see the ASLR test, please watch this video:
From the basic screen we can see that Mr. Smith has alright movement, but is lacking in some areas and exhibits a low score of 1’s in his ASLR and an asymmetry in his S/M. I see a lot of athletes and clients that have discomfort and limitations, yet overall do not score too badly on the FMS. The question then becomes why? From here I would then want to clear the spine and take a deeper look at Mr. Smith’s lowest score and asymmetry. This will include what we call “clearing” the spine and active vs passive testing.
I first start with his ASLR. I know that he cannot reach optimal range on his own, which is a minimum of 70 degrees in the leg lift. Therefore, I test this passively by assisting him. If I can take that leg through a larger range of motion and reach a 2 or 3, most often this is a motor control issue, not lack of hamstring tissue length. If I cannot then it’s certainly mobility and leg length. Sometimes genetics and structural elements can play a role, but I work with a lot of clients who do not have a tightness issue – its tone and motor control. That is 1 part physical and 1 part neuroscience. Motor control is in the brain and we know that Mr. Smith has poor motor control’ therefore, what are our next steps?
We could have a certain degree of muscle atrophy. We could have uncoordinated muscle behavior. We could have increased tone. We could have residual trigger points. What we have to do is identify, What are those motor control and movement limitations? What are the problems with mobility and stability?
What is Tone?
Let’s focus in on the tone. In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles, or the muscle’s resistance to passive stretch during resting state with a reduced range of motion in active engagement. Tone isn’t bad, but in excess it can limit mobility, stability and power output. When stretch occurs, the body responds by automatically increasing the muscle’s tension, which is ultimately, a reflex which helps guard against danger as well as helping to maintain balance. It helps to maintain posture and declines during REM sleep when that “alarm” of protection is somewhat shut off.
Tissue that has an increase in tone, can be known as hypertonia; which can present clinically as either spasticity or rigidity.
Spasticity is velocity-dependent resistance to passive stretch (i.e. passively moving a leg quickly, like the kickoff in football will elicit increased muscle tone, but passively moving the leg, like in the ASLR slowly may not elicit increased muscle tone). Spasticity can be in the form of increased resistance only at the beginning or at the end range of the movement.
Rigidity is velocity-independent resistance to passive stretch (i.e. there is uniform increased tone whether the leg lift is passively moved quickly or slowly).That sucker ain’t going anywhere. Rigidity can be of the stiff board, or the resistance to passive movement is in a jerky manner.
We must also take into consideration tissue contractures, adhesions, scar tissue and past injuries or structural concerns.
Getting back to Mr. Smith, I now know that Mr. Smith has tone in the ASLR and as an intervention I ask him to foam roll his posterior line (back, lats, glutes and calves), maybe even use a little magic stick). This also will tell me where he has trigger points and an increase in “whoa nelly” that’s the spot, discomfort or pain.
We then re screen his ASLR… and there is an improvement, but we know that this won’t stick. This is a great way to educate the client on the connection between the brain –to-muscle connection, but also the relationship of the fascia and nervous system in connection with the muscle-motor control arena.
To gain a deeper perspective and larger picture, I would also screen Mr. Smith’s spine, clearing the cervical in flexion, extension, lateral flexion and then the whole spine in flexion, extension, lateral flexion and rotation, as well as thoracic mobility. The spine plays a significant role in ASLR patterns, as does the thoracic spine. Most often if the ASLR, the shoulder’s and spine will offer us more information on a client’s motor control and integration of their nervous system and fascia systems functionality, but for the sake of this article, we will just use the ASLR as an example of tone vs tightness.
By rolling and applying soft tissue release, allows us to free up space and by moving those segments completely changes the neuromuscular support around that joint and associated joints. It will most likely also free up some muscle tone and allow you to move through your spine and lower quadrants a little bit better. This is still without suggesting corrective exercise as of yet, now it’s time to focus on the active part of the intervention strategy. This is merely “protective” not yet “corrective. “Protective measures keep you from getting worse, but may not make you better. Corrective measures actually work toward helping you foster or start the reset process yourself.” – Gray Cook
From this point forward, I will assign a few key corrective exercises for the client to perform on their own 1-2x per day, and will also offer a sequenced set of mobility movements to either prepare the client for daily life and/or sport, as well as a decompression set of movements to be performed at the end of their day or sport. This program is under 20mins, so that it’s time efficient.
At the end of that, we should see an appreciable change in something we measured. Below is a short sequence I use for clients with increased tone and low ASLR score.
Video on the ASLR correction:
Start: Screen ASLR
Corrective #1: 5 mins of breathing: diaphragmatic strengthening to re-engage posterior diaphragm. Recruiting the diaphragm and mechanics of the breath lowers anxiety, and connects the nervous system to the tissue, as well as biochemically releases chemicals to release and relax tonic tissue.
Soft Tissue Release: 5 mins of soft tissue release; including, foam roller, magic stick and tennis ball
- Quadruped spinal rolling (cats flow, with emphasis on spinal waving)
- Side cats flow (variations on exploring range)
- Lumbo Pelvic facilitation: supine pelvic tuck and tilt with bridge pattern rolling
- Bilateral hip rotations with legs crossed (TFL, ITB, lateral line and ribcage)
Corrective #2: Upper and lower body rolling pattern (unassisted and assisted)
Corrective #3: Leg Lowering Pattern (PNF, leg lowering 1 and 2)
Corrective #4: Hip Flexor Stretch with core assist to free up anterior line
Corrective #5: ASLR with core assist to recruit trunk and connect shoulders to hips and trunk to pelvis.
Re Screen ASLR: improvement in screen
Repeat mobility sequence (keeps it easy for the first set of notes)
Add in Rib pulls or thoracic rotations for good measure – we could all use more of that.
This would then be the clients homework for the next 2 weeks, and each session we work together, I progress or regress as needed. It’s also important to move clients from primitive patterns to foundational patterns, especially if they train with a strength coach or an athlete. Grooving the hip hinge and addressing single leg stance is usually on my session roster with a client so that they can see the long term picture of where and when these corrective exercises can improve performance overall.
To learn more about the FMS and Corrective Intervention Tools feel free to visit our website at www.fittotrain.com or http://www.functionalmovement.com/