Dominic Stone
Muscle guarding is a natural bodily response to injury, where the muscles around the injured area tighten up to prevent further damage. While muscle guarding can be beneficial in the short term, prolonged guarding can lead to issues such as restricted mobility, muscle weakness, and atrophy. To break the pain cycle, it is important to focus on reducing the source of pain and interrupting the cycle through treatments such as chiropractic adjustments, active exercise therapies, and physical rehabilitation. This may involve rest, ice, compression, and elevation (RICE), as well as specific rehab exercises to improve range of motion and strength.
How to Treat Muscle Guarding
| Characteristics | Values |
|---|---|
| Understanding the Pain Cycle | Recognise that the pain is not from the initial injury but residual pain that fuels the cycle. |
| Focus of Treatment | Apply treatments that interrupt the continuation of the pain cycle. |
| Physical Therapies | Heat, ice, massage, electrical stimulation therapies, chiropractic adjustments, and specific active exercises. |
| Reducing Anxiety | Targeting anxiety through intervention can be more effective than focusing on pain alone. |
| Gradual Strengthening | Gradually work to strengthen and maintain flexibility to prevent tissue atrophy and deconditioning of muscles. |
| Range of Motion Exercises | Perform active and passive strategies to increase the range of motion and break the pain cycle. |
| Psychological Stress | Address various forms of psychological stress such as frustration, anger, and depression that can increase tension and decrease motivation. |
| Professional Guidance | Consult a healthcare professional for a tailored treatment program. |
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What You'll Learn
Chiropractic adjustments
The Gonstead Adjustment is another technique used to restore normal disc alignment and maximum mobility. It can be administered with the patient sitting up or lying on their side, manipulating the lower back or pelvis. A small handheld device called an 'Activator' is also commonly used by chiropractors to administer a gentle impulse to the extremities or the vertebral segments of the spine. The spring-loaded device is used to adjust the tone of the nervous system and can treat a variety of conditions, including headaches and lower back pain.
After a chiropractic adjustment, you may feel tired or sore, and some people may experience mild headaches. Your chiropractor might recommend "homework" to extend your therapy after an adjustment, including exercises, stretches, posture improvements, icing or heat therapy, and advice on nutrition, diet, and stress management. Chiropractic care can help improve circulation, restore flexibility and range of motion, improve mobility, and reduce joint pain.
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Massage and physical therapy
Massage therapy, such as deep tissue massage, can be used to treat muscle pain and improve stiffness associated with muscle guarding. Deep tissue massage uses deep kneading and stroking with varying amounts of intense pressure to target problem areas. This type of massage is best suited for individuals who engage in highly physical activities or those who have an injury or chronic pain. It is important to note that deep tissue massage may not be suitable for everyone, and individuals with certain medical conditions, such as a history of blood clots or osteoporosis, should consult with their doctor before receiving this type of massage.
Another type of massage therapy that can be used to treat muscle guarding is Swedish massage, which is the most common massage therapy in the United States. Swedish massage targets muscles to promote relaxation and provide short-term pain relief. This type of massage is gentler than deep tissue massage and may be more suitable for individuals with a low pain threshold.
In addition to massage therapy, physical therapy exercises can also be beneficial for treating muscle guarding. A professional physiotherapist can outline a specific treatment plan based on the individual's condition and needs. This may include gentle stretching exercises before engaging in physical activity to prevent muscle spasms and therapeutic massage to treat muscle knots or trigger points. Other physical therapy treatments for muscle guarding may include heat and cold therapy, ultrasound, electrical stimulation, and trigger point injections.
For individuals who have failed conservative physical therapy treatments, more specialized techniques such as the Strain-Counterstrain technique may be considered. This technique is a passive, pain-free approach that is effective in reducing chronic and acute muscle spasms. It involves the therapist putting the body back into its normal position, which may require multiple visits to unwind the spasms and identify the original cause of the dysfunction.
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Reducing anxiety
Muscle guarding is a protective mechanism that occurs when the brain senses instability or tissue damage. It is characterised by involuntary muscle contractions that restrict movement and protect the injured area from further strain. While muscle guarding can be beneficial in the short term, prolonged guarding can lead to issues such as reduced flexibility, muscle weakness, and atrophy.
- Psychological interventions: Cognitive-behavioural therapy (CBT) can help individuals understand and manage their anxiety. Techniques such as cognitive reframing, relaxation training, and exposure therapy can reduce anxiety and improve coping strategies.
- Mind-body practices: Techniques such as deep breathing, meditation, and visualisations can help calm the nervous system and reduce anxiety. Practices like yoga, tai chi, or qi gong combine movement with mindful awareness, promoting both physical and mental well-being.
- Social support: Social connections and support networks can help reduce anxiety and improve coping. Joining support groups, participating in community activities, or seeking support from friends and family can provide a sense of belonging and reduce feelings of isolation.
- Stress management: Identifying stress triggers and learning effective stress management techniques can help reduce anxiety. This may include time management strategies, setting realistic goals and priorities, and practising self-care.
- Gradual exposure and desensitisation: Working with a therapist, individuals can gradually expose themselves to situations that trigger muscle guarding in a safe and controlled manner. This can help them learn to manage their anxiety and improve their tolerance for movement.
- Physical therapy and exercise: While not solely an anxiety-reduction strategy, physical therapy plays a crucial role in breaking the pain cycle. Chiropractic adjustments, massage, and specific active exercises can help reduce anxiety associated with pain and improve overall well-being.
It is important to work with healthcare professionals, including physicians, psychologists, and physical therapists, to develop a comprehensive treatment plan that addresses both the physical and psychological aspects of muscle guarding.
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Rehab exercises
Muscle guarding is a protective mechanism of the body that occurs when the brain perceives new or worsening pain signals. The brain then sends signals to the muscles in the area to contract and limit movement, thereby protecting the area from further injury. While muscle guarding can be beneficial in the short term, if it persists, it can lead to muscle weakness, atrophy, and decreased function.
To break the cycle of muscle guarding and address the associated pain, various rehabilitation exercises can be incorporated into a treatment plan:
Chiropractic Adjustments
Chiropractic adjustments have been shown to significantly impact the nerves, both at the site of the previous injury and in the central nervous system. These adjustments can help interrupt the pain cycle and improve overall nervous system function.
Active Exercise Therapies
Specific active exercise therapies can help restore normal function to the injured area and prevent the pain cycle from continuing. It is important to gradually introduce different structures to new motions and stress patterns under professional supervision. This helps to strengthen, stabilize, and remobilize the affected muscle groups, improving their function and reducing the need for muscle guarding.
Physical Therapy
Physical therapy can help address muscle guarding by improving flexibility, range of motion, and muscle strength. Techniques such as ultrasound therapy can be used to provide deep heating to muscles and tissues, reducing pain and improving recovery. Electrical stimulation, such as TENS (Transcutaneous Electrical Nerve Stimulation), can also be applied to reduce pain and improve the brain's perception of sensory stimuli rather than pain signals.
Progressive Muscle Contraction and Relaxation Exercises
These exercises involve training the muscles to contract and relax at appropriate times during an exercise or activity. This helps reduce muscle guarding and associated pain. Biofeedback techniques, such as electrical feedback or pulse oximetry, can be used to help patients relax guarded muscles and manage anxiety associated with certain movements.
Mind-Body Practices
Mindfulness, meditation, and deep breathing exercises can help alleviate anxiety, which is often a contributing factor to chronic muscle guarding. By reducing anxiety, patients may be able to reduce the subconscious tension associated with muscle guarding and improve their overall pain levels.
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Osteopathic treatment
Osteopathic Manipulative Treatment (OMT) is a group of techniques used by Doctors of Osteopathic Medicine (DOs) to treat muscle guarding. DOs are trained in the musculoskeletal system, the body's interconnected system of nerves, muscles, and bones. They use OMT to diagnose and treat illness and injury, as well as to encourage the body's natural tendency towards self-healing.
OMT techniques involve the DO using their hands to apply gentle pressure and manipulate the patient's muscles, soft tissues, and joints to relieve pain, promote healing, and increase overall mobility. The patient may be asked to stand, sit, or lie down on an exam table and move their limbs into different positions. The DO may also ask the patient to hold and release their breath at specific times during the treatment.
One specific OMT technique is muscle energy and counterstrain, which is particularly useful for treating the piriformis muscle. This technique involves finding a comfortable position for the patient and then applying gentle traction to ensure that any rotation comes from the hip and not the knees. The DO will then internally rotate the ankles to compare both sides, as a potential indication of a spasm within the piriformis muscle.
Another OMT technique is cranial osteopathy, which involves applying gentle pressure to the head and spine to ease tension and treat head and neck pain, as well as issues like temporomandibular joint (TMJ) disorders. Diaphragm techniques, which involve applying soft pressure to the diaphragm to improve breathing and ease back pain, are also used. Lymphatic pump techniques, which involve performing pumping or pulse-like actions to the feet, chest, or abdomen to clear lymphatic system blockages and reduce swelling, are another tool in the osteopathic treatment arsenal.
In addition to these specific techniques, OMT can also be used to complement or replace drugs or surgery in some cases. By combining OMT with the latest medical technology, Doctors of Osteopathic Medicine can offer comprehensive care to their patients.
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